Olesen, Stine Chabert; Hansen, Dorte Lindqvist; Almdal, Thomas;
The resolution of diabetes after gastric bypass is already observed during the first days after the operation, while the control of diabetes after gastric banding occurs after weight loss. Other mechanisms than weight loss must therefore explain the improved glucose tolerance. Focus has been on a...... with the aim of curing type 2-diabetes are warranted. Udgivelsesdato: 2009-Feb-16......The resolution of diabetes after gastric bypass is already observed during the first days after the operation, while the control of diabetes after gastric banding occurs after weight loss. Other mechanisms than weight loss must therefore explain the improved glucose tolerance. Focus has been on...
Drivsholm, Thomas Bo; Snorgaard, Ole
The organization of treatment and control of type 2 diabetic patients in Denmark has undergone a major development within the last decade. From being based on local hospital guidelines, treatment and control have moved towards a more organized collaboration between primary and secondary care based...... on common national guidelines. Quality indicators from primary and secondary care are collected routinely, and gradually an increasingly precise depiction is documented in the National Indicator Project....
A Cochrane analysis concluded that glucagon-like peptide-1 (GLP-1) analogues were effective for the improvement of glycaemic control in patients with type 2 diabetes. What is the significance for the treatment of Danish patients with type 2 diabetes? In Denmark, two drugs exist, exenatid and...
Larsen, Claus Morten; Faulenbach, Mirjam; Vaag, Allan; Vølund, Aage; Ehses, Jan; Seifert, Burkhardt; Mandrup-Poulsen, Thomas; Donath, Marc
Interleukin-1 receptor antagonist (IL-1Ra) expression is reduced in islets of patients with type 2 diabetes. 70 patients with type 2 diabetes were randomized to treatment with anakinra (IL-1Ra) or placebo for 13 weeks. Following treatment glycated hemoglobin was 0.46 percent lower, C......-peptide secretion was enhanced, and systemic IL-6 and C-reactive protein levels were reduced in the anakinra group compared to the placebo group. Insulin resistance remained unchanged. Blocking IL-1 activity improved glycemia and b-cell secretory function and reduced markers of systemic inflammation. Udgivelsesdato...
Parving, Hans-Henrik; Persson, Frederik; Lewis, Julia B;
We evaluated the renoprotective effects of adding aliskiren to treatment with losartan in hypertensive patients with type 2 diabetes and nephropathy. A total of 599 patients were randomized to six months of treatment with placebo or aliskiren in addition to losartan 100 mg and optimal antihyperte...
Borch-Johnsen, Knut; Beck-Nielsen, Henning; Christiansen, Jens Sandahl;
World wide the prevalence of type 2 diabetes is increasing and 30-50% of patients are undiagnosed. Early detection and intervention may decrease the risk of late diabetic complications, and thus clear guidelines for early detection and diagnosis of type 2 diabetes are needed. We recommend those...... individuals with either previous gestational diabetes; obesity (BMI > 30 kg/m2) and/or two or more relatives with diabetes should be considered eligible for testing for diabetes. In order to make the diagnosis two diabetic glucose values on separate days are required. The diagnosis may be made using plasma...... glucose or capillary whole blood, but quality control measures are essential for glucose measurements in general practice as well as in departments of clinical biochemistry....
Knop, Filip Krag; Vilsbøll, Tina
GLP-1 is secreted from the small intestine in response to ingestion of nutrients. It has a powerful insulinotropic effect and stimulates beta-cell growth and is therefore being developed for treatment of type 2 diabetes. The GLP-1 analogue, exenatide, is on the market in the USA as an add......-on therapy. Another strategy to increase circulating GLP-1 is to inhibit the enzyme DPP-IV which degrades endogenous GLP-1. GLP-1-based therapy results in HbA1c reductions of approximately 1 percent point, and the lack of serious side effects and the low risk of hypoglycaemic episodes are unique traits....
Gram, Dorte Xenia
This chapter deals with type 2 diabetes in vivo models and techniques suitable for testing new anti-diabetic compounds. In particular, the testing of TRP antagonist for beneficial effects against type 2 diabetes is considered. There are many choices of both in vitro techniques and in vivo models......, impaired glucose tolerance, impaired insulin secretion, and insulin resistance in vivo and should, thus, be sufficient to demonstrate preclinical proof of concept of a TRP antagonist in type 2 diabetes in rodents. The experiments are suggestions and could be replaced or supplemented by others....
DeFronzo, Ralph A; Ferrannini, Ele; Groop, Leif;
Type 2 diabetes mellitus (T2DM) is an expanding global health problem, closely linked to the epidemic of obesity. Individuals with T2DM are at high risk for both microvascular complications (including retinopathy, nephropathy and neuropathy) and macrovascular complications (such as cardiovascular...
... Care Diabetes Statistics Delaying or Preventing Type 2 Diabetes What is type 2 diabetes? Type 2 diabetes, formerly called adult-onset diabetes, ... for some, taking aspirin daily. Can type 2 diabetes be delayed or prevented? Yes. The results of ...
Banihani, Saleem; Swedan, Samer; Alguraan, Ziyad
Over the last decade, various studies have linked pomegranate (Punica granatum Linn), a fruit native to the Middle East, with type 2 diabetes prevention and treatment. This review focuses on current laboratory and clinical research related to the effects of pomegranate fractions (peels, flowers, and seeds) and some of their active components on biochemical and metabolic variables associated with the pathologic markers of type 2 diabetes. This review systematically presents findings from cell culture and animal studies as well as clinical human research. One key mechanism by which pomegranate fractions affect the type 2 diabetic condition is by reducing oxidative stress and lipid peroxidation. This reduction may occur by directly neutralizing the generated reactive oxygen species, increasing certain antioxidant enzyme activities, inducing metal chelation activity, reducing resistin formation, and inhibiting or activating certain transcriptional factors, such as nuclear factor κB and peroxisome proliferator-activated receptor γ. Fasting blood glucose levels were decreased significantly by punicic acid, methanolic seed extract, and pomegranate peel extract. Known compounds in pomegranate, such as punicalagin and ellagic, gallic, oleanolic, ursolic, and uallic acids, have been identified as having anti-diabetic actions. Furthermore, the juice sugar fraction was found to have unique antioxidant polyphenols (tannins and anthocyanins), which could be beneficial to control conditions in type 2 diabetes. These findings provide evidence for the anti-diabetic activity of pomegranate fruit; however, before pomegranate or any of its extracts can be medically recommended for the management of type 2 diabetes, controlled, clinical studies, are needed. PMID:23684435
Lund, Asger; Bagger, Jonatan I; Christensen, Mikkel;
In normal physiology, glucagon from pancreatic alpha cells plays an important role in maintaining glucose homeostasis via its regulatory effect on hepatic glucose production. Patients with type 2 diabetes suffer from fasting and postprandial hyperglucagonemia, which stimulate hepatic glucose...... production and, thus, contribute to the hyperglycemia characterizing these patients. Although this has been known for years, research focusing on alpha cell (patho)physiology has historically been dwarfed by research on beta cells and insulin. Today the mechanisms behind type 2 diabetic hyperglucagonemia...... or antagonization of the glucagon receptor constitutes potentially effective treatment strategies for patients with type 2 diabetes. In this review, we focus on the regulation of glucagon secretion by the incretin hormones glucagon-like peptide-1 (GLP-1) and GIP. Furthermore, potential advantages and limitations...
Mario; Barbagallo; Ligia; J; Dominguez
Type 2 diabetes is frequently associated with both extracellular and intracellular magnesium(Mg) deficits. A chronic latent Mg deficit or an overt clinical hypomagnesemia is common in patients with type 2 diabetes, especially in those with poorly controlled glycemic profiles. Insulinand glucose are important regulators of Mg metabolism. Intracellular Mg plays a key role in regulating insulin action, insulin-mediated-glucose-uptake and vascular tone. Reduced intracellular Mg concentrations result in a defective tyrosine-kinase activity, postreceptorial impairment in insulin action and worsening of insulin resistance in diabetic patients. A low Mg intake and an increased Mg urinary loss appear the most important mechanisms that may favor Mg depletion in patients with type 2 diabetes. Low dietary Mg intake has been related to the development of type 2 diabetes and metabolic syndrome. Benefits of Mg supplementation on metabolic profiles in diabetic patients have been found in most, but not all clinical studies and larger prospective studies are needed to support the potential role of dietary Mg supplementation as a possible public health strategy in diabetes risk. The aim of this review is to revise current evidence on the mechanisms of Mg deficiency in diabetes and on the possible role of Mg supplementation in the prevention and management of the disease.
Amiel, S A; Dixon, T.; Mann, R.; Jameson, K
The primary cause of hypoglycaemia in Type 2 diabetes is diabetes medication—in particular, those which raise insulin levels independently of blood glucose, such as sulphonylureas (SUs) and exogenous insulin. The risk of hypoglycaemia is increased in older patients, those with longer diabetes duration, lesser insulin reserve and perhaps in the drive for strict glycaemic control. Differing definitions, data collection methods, drug type/regimen and patient populations make comparing rates of h...
... Type 2 Diabetes? be treated promptly because elevated blood sugars can Also called adult onset or non-insulin dependent diabet , es damage the kidneys, heart, and eyes; and predispose type 2 diabetes is a chronic ...
... medlineplus.gov/ency/patientinstructions/000328.htm Type 2 diabetes - self-care To use the sharing features on ... seeing a diabetes educator. Symptoms of Type 2 Diabetes You may not have any symptoms. If you ...
Beck-Nielsen, Henning; Henriksen, Jan Erik
Our vision is that the opportunistic screening system will be improved in order to find patients with occult type 2 diabetes (T2D), since an early treatment based on a correct phenotyping is the goal. Individual goals for HbA1c, blood pressure and lipids must be set up, and the number of drugs us...... must fit with the patient's phenotype to avoid polypharmacy. A new flow chart for the organisation of T2D has been formulated giving the general practitioners the role as co-ordinators....
Type 2 diabetes is a common and chronic disease caused by interactions between genetic and environmental factors. The Goto-Kakizaki (GK) rat is a well-established genetic model of type 2 diabetes. Since several aspects of the pathophysiology of diabetes are shared between human and GK rats, we used this model to perform the first genome-wide scan for quantitative trait locus (QTL) of type 2 diabetes. A genetic linkage map with 530 microsatellite markers was constructed in ...
Gyawali, Bishal; Sharma, Rajan; Neupane, Dinesh;
BACKGROUND: Understanding the prevalence of type 2 diabetes in Nepal can help in planning for health services and recognising risk factors. This review aims to systematically identify and collate studies describing the prevalence of type 2 diabetes, to summarise the findings, and to explore...... populations was 8.1% (95% CI: 7.3-8.9%) and 1.0% (95% CI: 0.7-1.3%), respectively. CONCLUSIONS: This is, to our knowledge, the first study to systematically evaluate the literature of prevalence of type 2 diabetes in Nepal. Results showed that type 2 diabetes is currently a high-burden disease in Nepal...
... builds up in your blood. The rest of your body is starved of energy. What is type 2 diabetes? Type 2 diabetes is the most ... healthy recipes. Get active. Getting active can lower your risk of type ... See what counts as aerobic activity. Try this sample walking ...
... En español Take Steps to Prevent Type 2 Diabetes Browse Sections The Basics Overview Types of Diabetes ... 1 of 9 sections The Basics: Types of Diabetes What is diabetes? Diabetes is a disease. People ...
... Things to Know About Zika & Pregnancy Type 2 Diabetes: What Is It? KidsHealth > For Parents > Type 2 ... in learning to live with the disease. About Diabetes Diabetes is a disease that affects how the ...
Engelgau, M M; Narayan, K M; Herman, W H
Definitive studies of the effectiveness of screening for type 2 diabetes are currently not available. RCTs would be the best means to assess effectiveness, but several barriers prevent these studies from being conducted. Prospective observational studies may characterize some of the benefits of screening by creating screened and unscreened groups for comparison. The availability of better data systems and health services research techniques will facilitate such comparisons. Unfortunately, the interpretation of the results of such studies is extremely problematic. Several screening tests have been evaluated. Risk assessment questionnaires have generally performed poorly as stand-alone tests. Screening with biochemical tests performs better. Venous and capillary glucose measurements may perform more favorably than urinary glucose or HbA(1c) measurements, and measuring postprandial glucose levels may have advantages over measuring fasting levels. However, performance of all screening tests is dependent on the cutoff point selected. Unfortunately, there are no well-defined and validated cutoff points to define positive tests. A two-stage screening test strategy may assist with a more efficient use of resources, although such approaches have not been rigorously tested. The optimal interval for screening is unknown. Even though periodic, targeted, and opportunistic screening within the existing health care system seems to offer the greatest yield and likelihood of appropriate follow-up and treatment, much of the reported experience with screening appears to be episodic poorly targeted community screening outside of the existing health care system. Statistical models have helped to answer some of the key questions concerning areas in which there is lack of empirical data. Current models need to be refined with new clinical and epidemiological information, such as the UKPDS results (200). In addition, future models need to include better information on the natural history
Buffa, Roberto; Floris, Giovanni; F. Putzu, Paolo; Carboni, Luciano; Marini, Elisabetta
Somatotyping is a practical technique for the description of physique. Individuals with Type 2 diabetes are characterized by physical peculiarities, such as overweight, obesity and a central pattern of body fat distribution. Somatotype applications to diabetes are limited. The objective of this study is to describe the somatotype of elderly type 2 diabetes patients. The sample consisted of 110 patients with type 2 diabetes (45 men, mean age 69.4±7.0 years; 65 women, mean age 72.9±...
S.F.E. Praet (Stephan); L.J.C. van Loon (Luc)
textabstractStructured exercise is considered an important cornerstone to achieve good glycemic control and improve cardiovascular risk profile in Type 2 diabetes. Current clinical guidelines acknowledge the therapeutic strength of exercise intervention. This paper reviews the wide pathophysiologica
Murat Atmaca; İsmail Acar; Engin Gönültaş; İsmet Seven; Rıfkı Üçler; Senar Ebinç; Murat Alay; Zehra Candan
Purpose: The present study aims to investigate the effect of blood sugar regulation and vitamin D levels on calcium metabolism and parathormone levels in patients with type 2 diabetes mellitus. Material and Method: We included 132 patients with type 2 diabetes mellitus who presented to our outpatient clinic for regular check up between August 2013 and October 2013. Fasting blood glucose, HbA1c, calcium, phosphorus, magnesium, albumin, creatinine, parathormone, 25-Hydroxy vitamin D [25(OH)D...
In order to study the effect of plasma adiponectin on type 2 diabetes patients, the correlation between plasma adiponectin, serum glucose, insulin and plasma lipid of the patients with type 2 diabetes was analyzed. 32 subjects with normal glucose, 105 with type 2 diabetes, including 53 subjects without obesity (BMI2) and 52 with obesity (BMI≥25kg/m2) were involved into this study. The fasting plasma adiponectin, serum glucose, insulin and plasma lipid were measured by RIA. The results showed that the mean plasma adiponectin in normal, non-obesity and obesity group was 9.46±0.89 mg/L, 5.83±1.06mg/L and 3.17± 0.56mg/L, respectively. The plasma adiponectin levels in the type 2 diabetes group were significantly lower than that in normal group (P<0.05), especially in obesity group. The adiponectin level was significantly correlated with serum glucose and triglyceride, r value was -0.59 and -0.76, respectively. Adiponectin may be a kind of protective factor. It takes part in the pathogenesis of type 2 diabetes, and is close correlated with insulin resistance. The plasma adiponectin might be an effective index in the early diagnosis, prevention and treatment of type 2 diabetes. (authors)
Rabøl, Rasmus; Boushel, Robert; Dela, Flemming
discussed. Several studies show reduced activity of oxidative enzymes in skeletal muscle of type 2 diabetics. The reductions are independent of muscle fiber type, and are accompanied by visual evidence of damaged mitochondria. In most studies, the reduced oxidative enzyme activity is explained by decreases...... in mitochondrial content; thus, evidence of a functional impairment in mitochondria in type 2 diabetes is not convincing. These impairments in oxidative function and mitochondrial morphology could reflect the sedentary lifestyle of the diabetic subjects, and the influence of physical activity on...... insulin stimulation. The decreased basal ATP production does not affect overall lipid or glucose oxidation, and no studies linking changes in oxidative activity and insulin sensitivity in type 2 diabetes have been published. It is concluded that evidence of a functional impairment in mitochondria in type...
Buffa, Roberto; Floris, Giovanni; Putzu, Paolo F; Carboni, Luciano; Marini, Elisabetta
Somatotyping is a practical technique for the description of physique. Individuals with Type 2 diabetes are characterized by physical peculiarities, such as overweight, obesity and a central pattern of body fat distribution. Somatotype applications to diabetes are limited. The objective of this study is to describe the somatotype of elderly type 2 diabetes patients. The sample consisted of 110 patients with type 2 diabetes (45 men, mean age 69.4 +/- 7.0 years; 65 women, mean age 72.9 +/- 7.1 years). The pathological subjects were compared with a control group consisting of 280 healthy individuals (134 men, mean age 74.2 +/- 7.3 years; 146 women, mean age 74.9 +/- 7.4 years). The Heath-Carter somatotype was applied. Diabetic men and women (mean somatotype, respectively: 6.8-5.6-0.6 and 8.6-6.4-0.2) presented significantly higher values of endomorphy than the controls (p = 0.043 in men, p = 0.003 in women); men also had a lower mesomorphic component (p = 0.000). The somatotype method revealed physical peculiarities in type 2 diabetes patients. The marked endomorphy in the pathological individuals can be related to general fatness, which is a well known disease risk factor. The somatotype appears to be a suitable technique for the assessment of physique in type 2 diabetes patients. PMID:18041381
... can't prove that psoriasis causes type 2 diabetes or obesity or vice versa, Lonnberg added. However, the study ... Services, or federal policy. More Health News on: Diabetes Type 2 Obesity Psoriasis Recent Health News Related MedlinePlus Health Topics ...
van Dijk, Jan-Willem; Tummers, Kyra; Stehouwer, Coen D.A.; Hartgens, Fred; Luc J. C. Van Loon
OBJECTIVE Given the transient nature of exercise-induced improvements in insulin sensitivity, it has been speculated that daily exercise is preferred to maximize the benefits of exercise for glycemic control. The current study investigates the impact of daily exercise versus exercise performed every other day on glycemic control in type 2 diabetic patients. RESEARCH DESIGN AND METHODS Thirty type 2 diabetic patients (age 60 ± 1 years, BMI 30.4 ± 0.7 kg/m2, and HbA1c 7.2 ± 0.2%) participated i...
Christensen, Mikkel; Knop, Filip K; Vilsbøll, Tina;
Introduction: Type 2 diabetes mellitus (T2DM) is an increasing health problem worldwide. Glucagon-like peptide-1 (GLP-1) receptor agonists are an expanding drug class that target several of the pathophysiological traits of T2DM. Lixisenatide is a GLP-1 receptor agonist in development for once...
Gaede, Peter; Pedersen, Oluf
intensive integrated therapy has, however, only been investigated in a few studies of patients with type 2 diabetes. One of these trials, the Steno-2 Study, showed that intensive intervention for an average of 7.8 years cuts cardiovascular events as well as nephropathy, retinopathy, and autonomic neuropathy...
Maalouf, Naim M.
Type 2 diabetes is associated with an increased propensity for uric acid nephrolithiasis. In individuals with diabetes, this increased risk is due to a lower urine pH that results from obesity, dietary factors, and impaired renal ammoniagenesis. The epidemiology and pathogenesis of uric acid stone disease in patients with diabetes are hereby reviewed, and potential molecular mechanisms are proposed.
Scheen, A J
Type 2 diabetes is a progressive chronic disease resulting from a dynamic interaction between defects in insulin secretion and insulin action. New molecules have recently been launched and many others are under clinical investigation. Besides classical sulfonylureas and glinides, new insulin secretagogues are now available, which target the incretin gut hormone glucagon-like peptide-1 (GLP-1). Indeed, oral incretin enhancers acting as antagonists of the enzyme DPP-4 (dipeptidylpeptidase-4), which inactivates natural GLP-1,and injectable incretin mimetics (exenatide) or analogues (liraglutide), which reproduce the actions of GLP-1 while resisting to DPP-4, represent new opportunities to stimulate insulin secretion, without increasing the risk of hypoglycaemia and weight gain. Among insulin sensitizers, metformin remains unequivocally the first drug of choice for the treatment of type 2 diabetes, whereas promising drugs as thiazolidinediones (glitazones) were recently challenged because of various safety issues. When insulin is required, insulin analogues, both short-acting and basal ones, may offer some advantages regarding better control of postprandial hyperglycaemia, reduced risk of hypoglycaemia and/or lower weight gain in patients with type 2 diabetes. Emphasis should be put on early detection and intensive management of type 2 diabetes, individualized glucose lowering treatments and goals, stepwise pharmacological strategy avoiding therapeutic inertia, and multiple cardiovascular risk--targeted approach. PMID:19170358
Solomon, Thomas; Thyfault, J P
The incidence of type 2 diabetes (T2D) continues to skyrocket across the industrialized world leading to soaring medical costs, reduced quality of life and increased mortality rates. Therefore, a more firm understanding of the development of the disease and effective, low cost therapies for preve...
Zander, Mette; Hansen, Caroline Raun; Koefoed, Birgitte Gade;
In general, type 2 diabetes is more common among immigrants than among the inhabitants with a Western background. The higher prevalence among ethnic minorities is probably due to a complex correlation between genetic factors, diet, exercise, linguistic and cultural obstacles, low birthweight and...
Fuchsberger, Christian; Flannick, Jason; Teslovich, Tanya M;
The genetic architecture of common traits, including the number, frequency, and effect sizes of inherited variants that contribute to individual risk, has been long debated. Genome-wide association studies have identified scores of common variants associated with type 2 diabetes, but in aggregate...
Taghreed Mohamed El-Shafie ,Entesar Omar A. El-Saghier and Iman ,Kamal Ramadan
Full Text Available Background & Objectives: Diabetes and depression are highly prevalent conditions and have significant impact on health outcomes. The combination of depression with type 2 diabetes is a public health problem. Therefore, we aimed to assess some socio-demographic characteristics of type 2 diabetes and to investigate the relationship between type 2 diabetes and depression among patients aged from 40 to 60 years old. Methods: 125 patients diagnosed with type 2 diabetes attending diabetes clinics in the Al-Zahraa hospital were invited to participate in this cross-sectional study. Patients were interviewed using structured questionnaires to gather data on socio-demographics, clinical, self care compliance, medication usage, and diabetes complications. The MADRS was administered as a screening tool for depression level evaluation. Binary logistic regression model was used to examine association between predictor variables and risk of depression among diagnosed type 2 diabetes at 95% C.I. and P < 0.05. Results: One hundred and twenty five participants completed the interview. More than half of participants were females (58.4% and the mean age was 48 (sd = 5.9, 47.2% hypertensive, and 59.2% on insulin. More than two third (74.4% of patients were depressed; (24.8% mild, 37.6% moderate and 12% severely depressed. Almost four out of five patients (88.8% had diabetes complications, Depression was strongly associated with neuropathy, age, retinopathy, sex and cardiac complications. However, the likelihood of depression was not associated with nephropathy, hypertension and sexual dysfunction. Conclusion: The current study demonstrates a strong correlation between depression and diabetes particularly complications. In particular, patients who are depressed tended to have poorer self-care, more severe physical symptoms and were less likely to adhere to prescribed care regimens. These findings raise the possibility that improving the mental health as part of a
Reusch, Jane E. B.; Bridenstine, Mark; Regensteiner, Judith G
Limitations in physical fitness, a consistent finding in individuals with both type I and type 2 diabetes mellitus, correlate strongly with cardiovascular and all-cause mortality. These limitations may significantly contribute to the persistent excess cardiovascular mortality affecting this group. Exercise impairments in VO2 peak and VO2 kinetics manifest early on in diabetes, even with good glycemic control and in the absence of clinically apparent complications. Subclinical cardiac dysfunct...
Yang-wei Wang; Guang-dong Sun; Jing Sun; Shu-jun Liu; Ji Wang; Xiao-hong Xu; Li-ning Miao
Diabetes mellitus, especially type 2 diabetes (T2DM), is one of the most common chronic diseases and continues to increase in numbers with large proportion of health care budget being used. Many animal models have been established in order to investigate the mechanisms and pathophysiologic progress of T2DM and find effective treatments for its complications. On the basis of their strains, features, advantages, and disadvantages, various types of animal models of T2DM can be divided into spont...
Kolb, H; Mandrup-Poulsen, Thomas
Subclinical, low-grade systemic inflammation has been observed in patients with type 2 diabetes and in those at increased risk of the disease. This may be more than an epiphenomenon. Alleles of genes encoding immune/inflammatory mediators are associated with the disease, and the two major...... environmental factors the contribute to the risk of type 2 diabetes-diet and physical activity-have a direct impact on levels of systemic immune mediators. In animal models, targeting of immune genes enhanced or suppressed the development of obesity or diabetes. Obesity is associated with the infiltration and...... proinflammatory activity of macrophages in adipose tissue, and immune mediators may be important regulators of insulin resistance, mitochondrial function, ectopic lipid storage and beta cell dysfunction or death. Intervention studies targeting these pathways would help to determine the contribution of an...
Holm, Astrid Ledgaard; Andersen, Anne Friis; Avlund, Kirsten;
INTRODUCTION: Type 2 diabetes is a chronic disease that challenges the Danish health care system and health behaviour is important in connection with rehabilitation. Foreign research shows that social relations are associated with a healthy lifestyle, but this effect has not yet been examined...... 2000'', published by The National Institute of Public Health; 264 respondents with type 2 diabetes were included in the final study population. Social relations were measured in terms of civil status, social contact and functional network. Health behaviour reflects whether the respondents comply with...... the official Danish recommendations for physical activity, diet, alcohol and smoking. Adjustments were made for sex, age, income, self-rated health, functional ability, stress and Body Mass Index. RESULTS: Social relations measured as civil status and functional network are positively associated with...
Sanghera, Dharambir K.; Blackett, Piers R.
The global epidemic of type 2 diabetes mellitus (T2D) is one of the most challenging problems of the 21st century leading cause of and the fifth death worldwide. Substantial evidence suggests that T2D is a multifactorial disease with a strong genetic component. Recent genome-wide association studies (GWAS) have successfully identified and replicated nearly 75 susceptibility loci associated with T2D and related metabolic traits, mostly in Europeans, and some in African, and South Asian populat...
Reiling, Hendrik Willem
Type 2 Diabetes (T2D) is a chronic disease, characterized by hyperglycaemia, caused by decreased insulin secretion by beta-cells and insulin resistance of target tissues of insulin. Several risk factors are known, like decreased exercise, ageing and western diet. Also genetic variance can alter susceptibility to develop T2D. Until recently only four T2D susceptibility genes were identified (PPARG, KCNJ11, CAPN10 and TCF7L2). However, recent Genome Wide Association Studies (GWAS) have increase...
Papelbaum Marcelo; Moreira Rodrigo de O.; Coutinho Walmir; Kupfer Rosane; Zagury Leão; Freitas Silvia; Appolinário José C
Abstract Background Comorbid depression in diabetes has been suggested as one of the possible causes of an inadequate glycemic control. The purpose of this study was to investigate the association between major depression and the glycemic control of type 2 diabetes mellitus (T2DM). Methods Seventy T2DM patients were evaluated. They underwent a psychiatric examination using the following instruments: Structured Clinical Interview for DSM-IV and Beck Depression Inventory. The diabetes status wa...
Luchsinger, José A.; Gustafson, Deborah R
This manuscript provides a comprehensive review of the epidemiologic evidence linking the continuum of adiposity and type 2 diabetes (T2D) with Alzheimer's disease (AD). The mechanisms relating adiposity and T2D to AD may include hyperinsulinemia, advanced products of glycosilation, cerebrovascular disease, and products of adipose tissue metabolism. Elevated adiposity in middle age is related to a higher risk of AD but the data on this association in old age is conflicting. Several studies ha...
BACKGROUND AND OBJECTIVES: The relationship between diabetes and hearing loss has been debated for many years. Hyperglycemia appears to have an effect on hearing loss and the proposed mechanisms are microangiopathy, neuropathy or a combination of both. The objective of this study was to evaluate a cross section of hyperglycemic subjects with age- and sex-matched normoglycemic controls with pure tone audiometry and compare the differences. MATERIALS AND METHODS: Forty-one type 2 diabetes melli...
In recent years is has become clear that type 2 diabetes affects the central nervous system. These long-term complications manifest as structural changes on brain imaging, cognitive decrements and a 1.5-2 fold increased risk for the development of dementia, in particular in the elderly. The pathogenesis of diabetes-induced brain damage is not completely understood. Both vascular and metabolic disturbances may play an important role in the impact of diabetes on the brain. The course of develop...
Tsasis P; Wu J; An A; Wong HJ; An X; Mei Z; Hains T
Peter Tsasis,1 Jianhong Wu,2 Aijun An,3 Hannah J Wong,1 Xiandong An,3,4 Zhen Mei,4 Ted Hains4 1School of Health Policy and Management, York University, Toronto, ON, Canada; 2Centre for Disease Modelling, York University, Toronto, ON, Canada; 3Department of Electrical Engineering of Computer Science, York University, Toronto, ON, Canada; 4Manifold Data Mining Inc., Toronto, ON, Canada Abstract: Type 2 diabetes is growing worldwide due to population growth, increased rates of obesity, unhealth...
Jenkins, David J A; Kendall, Cyril W C; Marchie, Augustine; Jenkins, Alexandra L; Augustin, Livia S A; Ludwig, David S; Barnard, Neal D; Anderson, James W
Based on what is known of the components of plant-based diets and their effects from cohort studies, there is reason to believe that vegetarian diets would have advantages in the treatment of type 2 diabetes. At present there are few data on vegetarian diets in diabetes that do not in addition have weight loss or exercise components. Nevertheless, the use of whole-grain or traditionally processed cereals and legumes has been associated with improved glycemic control in both diabetic and insulin-resistant individuals. Long-term cohort studies have indicated that whole-grain consumption reduces the risk of both type 2 diabetes and cardiovascular disease. In addition, nuts (eg, almonds), viscous fibers (eg, fibers from oats and barley), soy proteins, and plant sterols, which may be part of the vegetarian diet, reduce serum lipids. In combination, these plant food components may have a very significant impact on cardiovascular disease, one of the major complications of diabetes. Furthermore, substituting soy or other vegetable proteins for animal protein may also decrease renal hyperfiltration, proteinuria, and renal acid load and in the long term reduce the risk of developing renal disease in type 2 diabetes. The vegetarian diet, therefore, contains a portfolio of natural products and food forms of benefit for both the carbohydrate and lipid abnormalities in diabetes. It is anticipated that their combined use in vegetarian diets will produce very significant metabolic advantages for the prevention and treatment of diabetes and its complications. PMID:12936955
Fuchsberger, Christian; Flannick, Jason; Teslovich, Tanya M; Mahajan, Anubha; Agarwala, Vineeta; Gaulton, Kyle J; Ma, Clement; Fontanillas, Pierre; Moutsianas, Loukas; McCarthy, Davis J; Rivas, Manuel A; Perry, John R B; Sim, Xueling; Blackwell, Thomas W; Robertson, Neil R; Rayner, N William; Cingolani, Pablo; Locke, Adam E; Fernandez Tajes, Juan; Highland, Heather M; Dupuis, Josee; Chines, Peter S; Lindgren, Cecilia M; Hartl, Christopher; Jackson, Anne U; Chen, Han; Huyghe, Jeroen R; van de Bunt, Martijn; Pearson, Richard D; Kumar, Ashish; Müller-Nurasyid, Martina; Grarup, Niels; Stringham, Heather M; Gamazon, Eric R; Lee, Jaehoon; Chen, Yuhui; Scott, Robert A; Below, Jennifer E; Chen, Peng; Huang, Jinyan; Go, Min Jin; Stitzel, Michael L; Pasko, Dorota; Parker, Stephen C J; Varga, Tibor V; Green, Todd; Beer, Nicola L; Day-Williams, Aaron G; Ferreira, Teresa; Fingerlin, Tasha; Horikoshi, Momoko; Hu, Cheng; Huh, Iksoo; Ikram, Mohammad Kamran; Kim, Bong-Jo; Kim, Yongkang; Kim, Young Jin; Kwon, Min-Seok; Lee, Juyoung; Lee, Selyeong; Lin, Keng-Han; Maxwell, Taylor J; Nagai, Yoshihiko; Wang, Xu; Welch, Ryan P; Yoon, Joon; Zhang, Weihua; Barzilai, Nir; Voight, Benjamin F; Han, Bok-Ghee; Jenkinson, Christopher P; Kuulasmaa, Teemu; Kuusisto, Johanna; Manning, Alisa; Ng, Maggie C Y; Palmer, Nicholette D; Balkau, Beverley; Stancáková, Alena; Abboud, Hanna E; Boeing, Heiner; Giedraitis, Vilmantas; Prabhakaran, Dorairaj; Gottesman, Omri; Scott, James; Carey, Jason; Kwan, Phoenix; Grant, George; Smith, Joshua D; Neale, Benjamin M; Purcell, Shaun; Butterworth, Adam S; Howson, Joanna M M; Lee, Heung Man; Lu, Yingchang; Kwak, Soo-Heon; Zhao, Wei; Danesh, John; Lam, Vincent K L; Park, Kyong Soo; Saleheen, Danish; So, Wing Yee; Tam, Claudia H T; Afzal, Uzma; Aguilar, David; Arya, Rector; Aung, Tin; Chan, Edmund; Navarro, Carmen; Cheng, Ching-Yu; Palli, Domenico; Correa, Adolfo; Curran, Joanne E; Rybin, Denis; Farook, Vidya S; Fowler, Sharon P; Freedman, Barry I; Griswold, Michael; Hale, Daniel Esten; Hicks, Pamela J; Khor, Chiea-Chuen; Kumar, Satish; Lehne, Benjamin; Thuillier, Dorothée; Lim, Wei Yen; Liu, Jianjun; van der Schouw, Yvonne T; Loh, Marie; Musani, Solomon K; Puppala, Sobha; Scott, William R; Yengo, Loïc; Tan, Sian-Tsung; Taylor, Herman A; Thameem, Farook; Wilson, Gregory; Wong, Tien Yin; Njølstad, Pål Rasmus; Levy, Jonathan C; Mangino, Massimo; Bonnycastle, Lori L; Schwarzmayr, Thomas; Fadista, João; Surdulescu, Gabriela L; Herder, Christian; Groves, Christopher J; Wieland, Thomas; Bork-Jensen, Jette; Brandslund, Ivan; Christensen, Cramer; Koistinen, Heikki A; Doney, Alex S F; Kinnunen, Leena; Esko, Tõnu; Farmer, Andrew J; Hakaste, Liisa; Hodgkiss, Dylan; Kravic, Jasmina; Lyssenko, Valeriya; Hollensted, Mette; Jørgensen, Marit E; Jørgensen, Torben; Ladenvall, Claes; Justesen, Johanne Marie; Käräjämäki, Annemari; Kriebel, Jennifer; Rathmann, Wolfgang; Lannfelt, Lars; Lauritzen, Torsten; Narisu, Narisu; Linneberg, Allan; Melander, Olle; Milani, Lili; Neville, Matt; Orho-Melander, Marju; Qi, Lu; Qi, Qibin; Roden, Michael; Rolandsson, Olov; Swift, Amy; Rosengren, Anders H; Stirrups, Kathleen; Wood, Andrew R; Mihailov, Evelin; Blancher, Christine; Carneiro, Mauricio O; Maguire, Jared; Poplin, Ryan; Shakir, Khalid; Fennell, Timothy; DePristo, Mark; Hrabé de Angelis, Martin; Deloukas, Panos; Gjesing, Anette P; Jun, Goo; Nilsson, Peter; Murphy, Jacquelyn; Onofrio, Robert; Thorand, Barbara; Hansen, Torben; Meisinger, Christa; Hu, Frank B; Isomaa, Bo; Karpe, Fredrik; Liang, Liming; Peters, Annette; Huth, Cornelia; O'Rahilly, Stephen P; Palmer, Colin N A; Pedersen, Oluf; Rauramaa, Rainer; Tuomilehto, Jaakko; Salomaa, Veikko; Watanabe, Richard M; Syvänen, Ann-Christine; Bergman, Richard N; Bharadwaj, Dwaipayan; Bottinger, Erwin P; Cho, Yoon Shin; Chandak, Giriraj R; Chan, Juliana C N; Chia, Kee Seng; Daly, Mark J; Ebrahim, Shah B; Langenberg, Claudia; Elliott, Paul; Jablonski, Kathleen A; Lehman, Donna M; Jia, Weiping; Ma, Ronald C W; Pollin, Toni I; Sandhu, Manjinder; Tandon, Nikhil; Froguel, Philippe; Barroso, Inês; Teo, Yik Ying; Zeggini, Eleftheria; Loos, Ruth J F; Small, Kerrin S; Ried, Janina S; DeFronzo, Ralph A; Grallert, Harald; Glaser, Benjamin; Metspalu, Andres; Wareham, Nicholas J; Walker, Mark; Banks, Eric; Gieger, Christian; Ingelsson, Erik; Im, Hae Kyung; Illig, Thomas; Franks, Paul W; Buck, Gemma; Trakalo, Joseph; Buck, David; Prokopenko, Inga; Mägi, Reedik; Lind, Lars; Farjoun, Yossi; Owen, Katharine R; Gloyn, Anna L; Strauch, Konstantin; Tuomi, Tiinamaija; Kooner, Jaspal Singh; Lee, Jong-Young; Park, Taesung; Donnelly, Peter; Morris, Andrew D; Hattersley, Andrew T; Bowden, Donald W; Collins, Francis S; Atzmon, Gil; Chambers, John C; Spector, Timothy D; Laakso, Markku; Strom, Tim M; Bell, Graeme I; Blangero, John; Duggirala, Ravindranath; Tai, E Shyong; McVean, Gilean; Hanis, Craig L; Wilson, James G; Seielstad, Mark; Frayling, Timothy M; Meigs, James B; Cox, Nancy J; Sladek, Rob; Lander, Eric S; Gabriel, Stacey; Burtt, Noël P; Mohlke, Karen L; Meitinger, Thomas; Groop, Leif; Abecasis, Goncalo; Florez, Jose C; Scott, Laura J; Morris, Andrew P; Kang, Hyun Min; Boehnke, Michael; Altshuler, David; McCarthy, Mark I
The genetic architecture of common traits, including the number, frequency, and effect sizes of inherited variants that contribute to individual risk, has been long debated. Genome-wide association studies have identified scores of common variants associated with type 2 diabetes, but in aggregate, these explain only a fraction of the heritability of this disease. Here, to test the hypothesis that lower-frequency variants explain much of the remainder, the GoT2D and T2D-GENES consortia performed whole-genome sequencing in 2,657 European individuals with and without diabetes, and exome sequencing in 12,940 individuals from five ancestry groups. To increase statistical power, we expanded the sample size via genotyping and imputation in a further 111,548 subjects. Variants associated with type 2 diabetes after sequencing were overwhelmingly common and most fell within regions previously identified by genome-wide association studies. Comprehensive enumeration of sequence variation is necessary to identify functional alleles that provide important clues to disease pathophysiology, but large-scale sequencing does not support the idea that lower-frequency variants have a major role in predisposition to type 2 diabetes. PMID:27398621
Linder, Barbara; Imperatore, Giuseppina
Major research trials have provided insight into the scope of type 2 diabetes in youth. The National Diabetes Education Program offers resources to help school nurses support children with or at risk for type 2 diabetes.
... Steps, Big Rewards": You Can Prevent Type 2 Diabetes Past Issues / Winter 2008 Table of Contents For ... million Americans are at risk for type 2 diabetes." "Fifty four million Americans are at risk for ...
... and a reduced risk of developing type 2 diabetes. A diet rich in magnesium was associated with a 15 percent reduced risk of developing type 2 diabetes, a 2007 meta-analysis found. Safety No serious ...
Zhang, Man; Fu, Guangzhen; Lei, Ting
Objective To monitor of type 2 diabetes more simply, conveniently and noninvasively, we are trying to identify the potential urinary peptides that associated with different stages of glucose control in type 2 diabetes mellitus. Methods Firstly, we collected urine samples from type 2 diabetic patients and normal controls. These type 2 diabetic patients were divided into two groups according to fasting plasma glucose (FPG) and hemoglobin A1c% (HbA1c), respectively. Magnetic beads based weak cat...
Full Text Available Background: Diabetes Mellitus (DM is a common but complex metabolic disorder affecting various systems in the body. Oral cavity is no exception as this chronic condition exerts a huge impact on oral health. Salivary dysfunction has been reported to be a frequent oral complication in Type 2 diabetics which in turn leads to an array of oral complications because oral health is to a greater extent dependent on the quality and quantity of saliva. Aim: The aim of the present study was to evaluate and compare the salivary flow rate and prevalence of subjective symptoms of xerostomia in diabetics and non-diabetics. Materials and Methods: The study was conducted on 100 type 2 diabetic patients and 50 non-diabetic subjects. Random non-fasting plasma glucose and glycosylated hemoglobin levels were used to determine the diabetic status of the individuals. Unstimulated saliva was collected using “Spit technique”. Stimulated saliva was collected using 2% citric acid. Unstimulated and Stimulated Salivary Flow Rate (USFR and SSFR was calculated for every patient and expressed as ml/min. Xerostomia was evaluated using a multi-item inventory comprising 19 questions. Results: In our study, both whole unstimulated and stimulated salivary flow rates were decreased in diabetics compared to non-diabetics and this difference was statistically significant (p = 0.000. A greater percentage of diabetic patients perceived xerostomia symptoms compared to non-diabetics. Conclusion: Type 2 diabetics have higher prevalence of xerostomia and significantly reduced salivary flow rate compared to non-diabetics. Alterations in salivary flow create an imbalance in the homeostasis of oral environment leading to spectrum of oral ailments in these individuals
Moran, Chris; Phan, Thanh G.; Chen, Jian; Blizzard, Leigh; Beare, Richard; Venn, Alison; Münch, Gerald; Wood, Amanda G.; Forbes, Josephine; Greenaway, Timothy M.; Pearson, Susan; Srikanth, Velandai
OBJECTIVE Type 2 diabetes (T2DM) is associated with brain atrophy and cerebrovascular disease. We aimed to define the regional distribution of brain atrophy in T2DM and to examine whether atrophy or cerebrovascular lesions are feasible links between T2DM and cognitive function. RESEARCH DESIGN AND METHODS This cross-sectional study used magnetic resonance imaging (MRI) scans and cognitive tests in 350 participants with T2DM and 363 participants without T2DM. With voxel-based morphometry, we s...
Madsbad, Sten; Hermansen, Kjeld
The variable pathogenesis and progressive nature of type 2 diabetes emphasise the need for new antidiabetic treatments. The long acting glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors have improved the treatment. Novel approaches include inhibitors of sodium glucose...... co-transporter 2, which increase renal glucose elimination, G-protein-coupled receptor agonists, which potentiate insulin and incretin hormone secretion. Proof of principle has been shown for glucagon receptor agonists, glucokinase activators and treatment with dual intestinal peptides, which all...
Zander, Mette; Hansen, Caroline Raun; Koefoed, Birgitte Gade; Perrild, Hans
In general, type 2 diabetes is more common among immigrants than among the inhabitants with a Western background. The higher prevalence among ethnic minorities is probably due to a complex correlation between genetic factors, diet, exercise, linguistic and cultural obstacles, low birthweight and...... high catch up weight as well as socio-economic factors. Ethnic minorities are heterogeneous, and individual initiatives within the different groups are needed. The evidence regarding the effect of initiatives targeted at ethnic minorities in Denmark is sparse. In future, clinically controlled studies...
Grimaldi, A; Hartemann-Heurtier, A
GOAL OF TREATMENT: Prevention of diabetic micro and macroangiopathy is the goal of treatment in type 2 diabetes mellitus. A well-controlled glucose level is the key to prevention of microangiopathy; there is no threshold level. Antihypertensive treatment, with the goal of blood pressure below 130/80 mmHg is also beneficial in preventing aggravation of microangiopathy. For macroangiopathy, prevention is based in priority on treatment of other risk factors for cardiovascular disease; the threshold level for drug treatment and the therapeutic objective are those defined for secondary prevention in non-diabetic patients, i.e. blood pressure below 140/80 mmHg and LDL cholesterol under 1.30 g/l. The beneficial effect of lower glucose levels on preventing macrovascular risk was not formally demonstrated by the UKPDS, probably because the difference between the control and the treatment group HbA1c levels was minimal, 0.9 points. REVISITING STRATEGY: It is thus time to revisit the preventive strategy for type 2 diabetes mellitus, i.e. step-by-step increments, as currently proposed for worsening glucose levels. Metformine should be prescribed if the HbA1c is above normal in order to achieve the demonstrated benefit in prevention of microangiopathy and in the hope, motivated by pathophysiology data, of preventing insulin failure. Slow-release insulin at bedtime should be added to the oral hypoglycemiants if fasting glucose exceeds 1.60 or 1.80 g/l, even if the HbA1c remains below 8%. NEW HYPOGLYCEMIANTS: The role of these new agents in this more "aggressive" strategy remains to be defined. Glinides will have to demonstrate their superiority over sulfamides (fewer episodes of hypoglycemia with comparable efficacy) to justify their high cost. Glitazones will have to demonstrate a beneficial effect in second intention combination with metformine on cardiovascular morbidity mortality in type 2 diabetes patients with a metabolic insulin-resistance syndrome and visceral obesity
Iepsen, Eva Pers Winning; Torekov, Signe Sørensen; Holst, Jens Juul
Subcutaneous liraglutide (Victoza, Novo Nordisk) was approved for the treatment of Type 2 diabetes mellitus (T2DM) in Europe in 2009 and in the USA in 2010. In December 2014, liraglutide 3.0 mg was approved by the Food and Drug Administration (FDA) and in March 2015 by the European Medicines Agency...... different areas in the hind brain and possibly by preserving free leptin levels. Recently, liraglutide has been suggested to protect against prediabetes and seems to prevent bone loss by increasing bone formation following diet-induced weight loss in obesity. This article not only covers the major clinical...
Gyldenl�ve, Mette; Knop, Filip Krag; Vilsb�ll, Tina;
Psoriasis is a chronic inflammatory skin disease with a global prevalence of 2-3%. In recent years it has been established that patients with psoriasis carry an increased risk of type 2 diabetes, but the underlying pathophysiological mechanisms remain unclear. The association is most likely due to...... a combination of shared genes, immunoinflammatory mechanisms and a number of diabetes risk factors in patients with psoriasis. The current review summarises the evidence in the field and calls for attention on diabetes risk assessment, preventive measures and treatment in patients with psoriasis....
Wu, Hongyu; Bertrand, Kimberly A; Choi, Anna L;
BACKGROUND: Prospective data regarding persistent organic pollutants (POPs) and risk of type 2 diabetes (T2D) are limited, and the results for individual POPs are not entirely consistent across studies. OBJECTIVES: To prospectively examine plasma POP concentrations in relation to incident T2D and...... participated in two case-control studies in the Nurses' Health Study. We identified 48 incident T2D cases through June 30, 2008. We conducted a literature search in MEDLINE and EMBASE through December 2011 to identify prospective studies on POPs in relation to diabetes. We used a fixed-effects model to...
Reusch, Jane E B; Bridenstine, Mark; Regensteiner, Judith G
Limitations in physical fitness, a consistent finding in individuals with both type I and type 2 diabetes mellitus, correlate strongly with cardiovascular and all-cause mortality. These limitations may significantly contribute to the persistent excess cardiovascular mortality affecting this group. Exercise impairments in VO2 peak and VO2 kinetics manifest early on in diabetes, even with good glycemic control and in the absence of clinically apparent complications. Subclinical cardiac dysfunction is often present but does not fully explain the observed defect in exercise capacity in persons with diabetes. In part, the cardiac limitations are secondary to decreased perfusion with exercise challenge. This is a reversible defect. Similarly, in the skeletal muscle, impairments in nutritive blood flow correlate with slowed (or inefficient) exercise kinetics and decreased exercise capacity. Several correlations highlight the likelihood of endothelial-specific impairments as mediators of exercise dysfunction in diabetes, including insulin resistance, endothelial dysfunction, decreased myocardial perfusion, slowed tissue hemoglobin oxygen saturation, and impairment in mitochondrial function. Both exercise training and therapies targeted at improving insulin sensitivity and endothelial function improve physical fitness in subjects with type 2 diabetes. Optimization of exercise functions in people with diabetes has implications for diabetes prevention and reductions in mortality risk. Understanding the molecular details of endothelial dysfunction in diabetes may provide specific therapeutic targets for the remediation of this defect. Rat models to test this hypothesis are under study. PMID:23299658
Objective: To determine the periodontal status in well controlled and poorly controlled type 2 diabetic patients compared with normal healthy individuals. Methodology: Forty well controlled and forty poorly controlled type 2 diabetic subjects having good oral hygiene (scored according to simplified oral hygiene index) were compared with a control group of forty normal healthy individuals. Probing depth (PD), gingival recession (GR), and attachment loss (AL) were recorded to obtain the periodontal status of each tooth, using a Michigan probe '0' with Williams marking. Glycemic control was evaluated by glycated Hb value. Using ANOVA and independent sample t-test, mean probing depth and attachment loss in each tooth type (incisors, canines, premolars and molars) were compared. Results: Mean age of diabetic subjects was 58.86 +- 6.21 years and that of control group was 56.92 +- 6.91 years; 60% were females. Probing depth was greater in patients with poorly controlled diabetes compared to well controlled diabetic patients and non-diabetic controls (4.21 mm vs. 3.72 mm and 2.93 mm respectively, p 0.05). Number of sites and mean percentage of sites with attachment loss of greater or equal to 4 and greater or equal to 6 mm was also significantly higher in poorly controlled diabetes compared to the control group (p < 0.05 and p < 0.001 respectively). Conclusion: Periodontal status as estimated by probing depth and degree of attachment loss deteriorates significantly with poor glycemic control in diabetes. (author)
Full Text Available Diabetes mellitus, especially type 2 diabetes (T2DM, is one of the most common chronic diseases and continues to increase in numbers with large proportion of health care budget being used. Many animal models have been established in order to investigate the mechanisms and pathophysiologic progress of T2DM and find effective treatments for its complications. On the basis of their strains, features, advantages, and disadvantages, various types of animal models of T2DM can be divided into spontaneously diabetic models, artificially induced diabetic models, and transgenic/knockout diabetic models. Among these models, the spontaneous rodent models are used more frequently because many of them can closely describe the characteristic features of T2DM, especially obesity and insulin resistance. In this paper, we aim to investigate the current available spontaneous rodent models for T2DM with regard to their characteristic features, advantages, and disadvantages, and especially to describe appropriate selection and usefulness of different spontaneous rodent models in testing of various new antidiabetic drugs for the treatment of type 2 diabetes.
Wang, Yang-Wei; Sun, Guang-Dong; Sun, Jing; Liu, Shu-Jun; Wang, Ji; Xu, Xiao-Hong; Miao, Li-Ning
Diabetes mellitus, especially type 2 diabetes (T2DM), is one of the most common chronic diseases and continues to increase in numbers with large proportion of health care budget being used. Many animal models have been established in order to investigate the mechanisms and pathophysiologic progress of T2DM and find effective treatments for its complications. On the basis of their strains, features, advantages, and disadvantages, various types of animal models of T2DM can be divided into spontaneously diabetic models, artificially induced diabetic models, and transgenic/knockout diabetic models. Among these models, the spontaneous rodent models are used more frequently because many of them can closely describe the characteristic features of T2DM, especially obesity and insulin resistance. In this paper, we aim to investigate the current available spontaneous rodent models for T2DM with regard to their characteristic features, advantages, and disadvantages, and especially to describe appropriate selection and usefulness of different spontaneous rodent models in testing of various new antidiabetic drugs for the treatment of type 2 diabetes. PMID:23671868
Diabetes Mellitus type 2 , formerly non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes, is a metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency1. The development of Diabetes Mellitus type 2 is associated with multiple risk factors, co-morbid medical conditions as well as psychosocial determinants. These psychosocial factors, which differ from population to population, can be identified and controlled to reduce the incidence of type 2 Diabetes Mellitus. Objective: To identify various psychosocial factors associated with type 2 Diabetes Mellitus. Design: Case-control study. Place and Duration: Diabetic clinic and Medical Units Mayo Hospital Lahore . July to December, 2012. Subjects and Methods: A population based case-control study with 1:1 case to control ratio was conducted. A total of 100 subjects (50 cases and 50 controls) having age above 35 years were recruited in the study. Selection was made on laid down criteria from patients coming to Mayo Hospital Lahore after taking consent. Interviews were conducted through a pretested questionnaire. Data was collected, compiled and analyzed through IBM SPSS version 20. Results: Out of 100 study subjects 67% were males and 33% were females. Among cases of Diabetes mellitus type 2, 64% were males, 70% in the age group 35-50 years, 96% were married, 36% were illiterates. Mean age was found 49.24, standard deviation 10.915. In bivariate analysis, Diabetes Mellitus type II was found significantly associated with Anxiety(OR: 5.348, 95% CI: 2.151-13.298) Depression(OR: 5.063, 95% CI: 1.703-15.050), High fat diet, (OR: 2.471, 95% CI: 1.100-5.547) Sedentary Lifestyle(OR: 4.529, 95% CI: 1.952-10.508) and Psychological Stress(OR:4.529, 95% CI: 1.952-10.508). However, in multivariate analysis while controlling all other risk factors, Anxiety(OR: 6.066, 95% CI: 1.918-19.191), High fat diet(OR: 3.648, 95% CI: 1
Rigalleau, Vincent; Gonzalez, Concepcion; Raffaitin, Christelle; Gin, Henri
The dietary advice is a part of the global care for type 2 diabetes. First, overweight implies a caloric restriction. When poor glucose control is associated with weight gain, important errors are obvious (excess fat and sugar), providing more pills or insulin without correcting them is poorly effective, but promotes further weight gain. Normal body weight, or poor glucose control despite loss of weight, needs to reappraise the diagnosis: diabetes type, intercurrent disease. The cofactors of the "metabolic syndrom" are usually present, so saturated fat has to be reduced, while maintaining fish, fruits, vegetables and whole grain cereals. Blood pressure and dyslipidemia may need further counselling about dietary sodium, carbohydrates, cholesterol. When insulin, sulfonylurea or glinids are indicated, the dietary intake of carbohydrates has to be regular to avoid hypoglycemia. PMID:20465121
Full Text Available Purpose: The present study aims to investigate the effect of blood sugar regulation and vitamin D levels on calcium metabolism and parathormone levels in patients with type 2 diabetes mellitus. Material and Method: We included 132 patients with type 2 diabetes mellitus who presented to our outpatient clinic for regular check up between August 2013 and October 2013. Fasting blood glucose, HbA1c, calcium, phosphorus, magnesium, albumin, creatinine, parathormone, 25-Hydroxy vitamin D [25(OHD], spot urinary calcium and creatinine levels were studied for each patient. Results: Vitamin D levels were below 30 ng/mL in 96.9% (n=128 and below 20 ng/mL in 78.7% (n=102 of the patients included in the study. Patients with impaired blood sugar regulation (HbA1c >10% had lower levels of PTH, albumin and 25(OHD levels and higher phosphorus levels compared to patients with HbA1c levels below 10% (p=0.018, p=0.043, p=0.002, p=0.01, respectively. The rates of functional hypoparathyroidism (parathormone <65 ng/mL in patients with vitamin D levels below 30 ng/mL and 20 ng/mL were 63.2% and 59.6%, respectively. Among the diabetic patients with vitamin D levels <30 ng/mL, magnesium levels were significantly lower in those with functional hypoparathyroidism (parathormone <65 ng/mL compared to those with secondary hyperparathyroidism (p=0.015. Comparative statistical analysis of patients with HbA1c levels above and below 10% demonstrated higher proportion of patients with functional hypoparathyroidism in the group with impaired blood sugar regulation (p=0.035 for patients with vitamin levels below 30 ng/mL, and p=0.031 for patients with vitamin levels below 20 ng/mL. Discussion: Impaired blood sugar regulation leads to functional hypoparathyroidism with secondary hypomagnesemia in type 2 diabetes mellitus, as was previously described for subjects with type 1 diabetes mellitus.
Objective was to assess blood pressure BP control in patients with diabetes mellitus type 2 DM type treated in primary health care. A cross-sectional study was conducted in primary health care at King Fahd Military Complex Hospital in Dhahran, Kingdom of Saudi Arabia, between August 2003 and February 2004, to assess blood control in type 2 diabetics. A sample of 403 medical records of type 2 diabetic patients was selected using systematic random sampling after ordering the medical record numbers. The data were collected through the pre-coded checklist. Hypertension was found in 57.8% of diabetic patients with no statistically significant difference between males and females. The mean age of diabetic patients was significantly highly in hypertensive than non-hypertensive p=0.001. The mean duration of hypertension was significantly higher in females p=0.02. There were only 14.2% of hypertensive diabetic patients in whom blood pressure was controlled. Poor control was significantly associated with obesity and a high rate of complications. Blood pressure control correlated positively and significantly with the age of patients and negatively with duration of diabetes and hypertension. The most commonly prescribed antihypertensive were angiotensin converting enzyme inhibitors in 29.3%, followed by angiotensin receptors blockers in 24.1%, and the least prescribed drug was thiazide diuretic. Blood pressure in diabetic patients needs to be given particular attention from all health care professionals, especially primary care family physicians, who should follow the new guideline for better control of blood pressure, and fewer complications. Patient's awareness should be increased, through continuous health education with different modalities. (author)
Dalsgaard, Else-Marie; Vestergaard, Mogens; Skriver, Mette V;
Dette studie undersøger, om psykisk belastning øger risikoen for kardiovaskulær sygdom og død blandt personer med type 2-diabetes. Forfatterne ser også nærmere på, om forskelle i metabolisk kontrol og indtag af ordineret medicin kan forklare dele af en eventuel sammenhæng. Studiet fandt, at 18% a...
Puig-Domingo, Manuel; Pellitero, Silvia
The increasing prevalence of obesity and type 2 diabetes mellitus (T2DM) has led to a growing interest in the investigation of new therapies. Treatment of T2DM has focused on the insulinopenia and insulin resistance. However, in the last 10 years, new lines of research have emerged for the treatment of T2DM and preclinical studies appear promising. The possibility of using these drugs in combination with other currently available drugs will enhance the antidiabetic effect and promote weight loss with fewer side effects. The data provided by post-marketing monitoring will help us to better understand their safety profile and potential long-term effects on target organs, especially the cardiovascular risk. PMID:25194974
Hansen, Lars; Pedersen, Oluf
Throughout the last decade, molecular genetic studies of non-autoimmune diabetes mellitus have contributed significantly to our present understanding of this disease's complex aetiopathogenesis. Monogenic forms of diabetes (maturity-onset diabetes of the young, MODY) have been identified and...... classified into MODY1-6 according to the mutated genes that by being expressed in the pancreatic beta-cells confirm at the molecular level the clinical presentation of MODY as a predominantly insulin secretory deficient form of diabetes mellitus. Genomewide linkage studies of presumed polygenic type 2...... diabetic populations indicate that loci on chromosomes 1q, 5q, 8p, 10q, 12q and 20q contain susceptibility genes. Yet, so far, the only susceptibility gene, calpain-10 (CAPN10), which has been identified using genomewide linkage studies, is located on chromosome 2q37. Mutation analyses of selected...
O'Connor, Jason C; Johnson, Daniel R; Freund, Gregory G
A sizable body of knowledge has arisen demonstrating that type 2 diabetes (T2D) is associated with alterations in the innate immune system. The resulting proinflammatory-leaning imbalance is implicated in the development of secondary disease complications and comorbidities, such as delayed wound healing, accelerated progress of atherosclerosis, and retinopathy, in people who have T2D. New experimental data and the results of recently published health-related quality-of-life surveys indicate that individuals who have T2D experience diminished feelings of happiness, well being, and satisfaction with life. These emotional and psychological consequences of T2D point to altered neuroimmunity as a previously unappreciated complication of T2D. This article discusses recent data detailing the impact of T2D on a person's PNI response. PMID:19389586
Jespersen, Maria J; Knop, Filip K; Christensen, Mikkel
Within recent years, glucagon-like peptide 1 receptor agonists (GLP-1-RA) have emerged as a new treatment option for type 2 diabetes. The GLP-1-RA are administered subcutaneously and differ substantially in pharmacokinetic profiles. AREAS COVERED: This review describes the pharmacokinetics and...... safety aspects of the currently available GLP-1 receptor agonists, liraglutide (based on the structure of native GLP-1), exenatide twice daily and exenatide once weekly (based on exendin-4) in relation to the kinetics and toxicology of native GLP-1. The review is based on electronic literature searches...... and legal documents in the form of assessment reports from the European Medicines Agency and the United States Food and Drug Administration. EXPERT OPINION: GLP-1-based therapy combines several unique mechanisms of action and have the potential to gain widespread use in the fight against diabetes and...
Lindberg, Søren; Jensen, Jan Skov; Bjerre, Mette;
BACKGROUND: Adiponectin is viewed as an insulin-sensitizing hormone with anti-inflammatory effects. In accordance, plasma adiponectin is decreased in metabolic disorders including type 2 diabetes mellitus (T2DM). However, in spite of the apparently beneficially effects, recent data from large...... prospective studies have consistently linked high adiponectin levels with increased cardiovascular (CV) disease and mortality, thus questioning the positive view on adiponectin. Accordingly, we investigated the relationship between adiponectin, incident T2DM and subsequently CV events. METHODS: We...... prospectively followed 5349 randomly selected men and women from the community, without T2DM or CV disease. Plasma adiponectin was measured at study entry. Median follow-up time was 8.5 years (IQR 8.0-9.1 years). During follow up, 136 participants developed T2DM. Following their diagnosis, 36 of the 136...
Abstract Type 2 diabetes is associated with significant cardiovascular morbidity and mortality. Although low-density lipoprotein cholesterol levels may be normal in patients with type 2 diabetes, insulin resistance drives a number of changes in lipid metabolism and lipoprotein composition that render low-density lipoprotein cholesterol and other lipoproteins more pathogenic than species found in patients without type 2 diabetes. Dyslipidemia, which affects almost 50% of patients with type 2 d...
Type 2 diabetes mellitus is emerging as a new clinical problem within pediatric practice. Recent reports indicate an increasing prevalence of type 2 diabetes mellitus in children and adolescents around the world in all ethnicities, even if the prevalence of obesity is not increasing any more. The majority of young people diagnosed with type 2 diabetes mellitus was found in specific ethnic subgroups such as African-American, Hispanic, Asian/Pacific Islanders and American Indians. Clinicians sh...
Sarah M. Westberg, PharmD, BCPS; Phoua Xiong, Pharm.D.
The primary goal of the study was to determine perceptions the Hmong population has about Type 2 diabetes. Specific information to be gathered from the Hmong participants were: reactions after being diagnosed with Type 2 diabetes, knowledge and beliefs about medications, and how pharmacists can help them with their diabetes care. Learning the beliefs of this population related to Type 2 diabetes will help identify methods to improve diabetes care and education for Hmong patients. A focus grou...
The incidence of type 2 diabetes has increased rapidly worldwide. Obesity is one of the most important modifiable risk factors of type 2 diabetes: weight gain increases and weight loss decreases the risk. However, the effects of weight fluctuation are unclear. Reactive oxygen species are presumably part of the complicated mechanism for the development of insulin resistance and beta-cell destruction in the pancreas. The association of antioxidants with the risk of incident type 2 diabetes...
Tushuizen, M.E.; Diamant, M.; Heine, R. J.
The worldwide prevalence of type 2 diabetes mellitus has reached epidemic proportions. The so-called traditional risk factors cannot fully explain the excessive cardiovascular disease risk of type 2 diabetic patients. Numerous studies indicate that postprandial metabolic derangements, most notably hyperglycaemia and hypertriglyceridaemia, which are exaggerated and prolonged in type 2 diabetes, are important cardiovascular disease risk factors since they induce oxidative stress and endothelial...
Raghavani, Pratik Hasmukhrai; Sirajwala, Habibunnisha B.
Aim: To measure the level of Serum Ferritin, Fasting and Postprandial Blood Sugar & Lipid Profiles in patient with Type-2 Diabetes Mellitus with and without cardiovascular involvement.Material and methods: 50 patients of Type-2 Diabetes Mellitus (DM) patients without any cardiovascular involvement, 50 patients of Type-2 Diabetes Mellitus patients with cardiovascular involvement and 50 age and sex matched normal healthy control were studied. Blood samples were analyzed for ferritin estimat...
Michael E Bowen
Full Text Available Michael E Bowen1,2, Russell L Rothman2,31Veterans Affairs Quality Scholars Fellowship Program, Tennessee Valley Healthcare System, Tennessee Valley Geriatric Research Education Clinical Center, Nashville, TN, USA; 2Division of General Internal Medicine and Public Health, Department of Medicine, 3Vanderbilt Eskind Diabetes Center, Vanderbilt University School of Medicine, Nashville, TN, USAAbstract: Although once considered a disease of adults, the prevalence of type 2 diabetes in youth is increasing at a significant rate. Similar to adults, youth with type 2 diabetes are at increased risk for developing hypertension, lipid abnormalities, renal disease, and other diabetes-related complications. However, children and adolescents with type 2 diabetes also face many unique management challenges that are different from adults with type 2 diabetes or children with type 1 diabetes. To deliver safe, effective, high-quality, cost-effective health care to adolescents with type 2 diabetes, reorganization and redesign of health care systems are needed. Multidisciplinary health care teams, which allow individuals with specialized training to maximally utilize their skills within an organized diabetes treatment team, may increase efficiency and effectiveness and may improve outcomes in children with type 2 diabetes. This review article provides a brief review of type 2 diabetes in children and adolescents, provides an overview of multidisciplinary health care teams, and discusses the role of multidisciplinary health care management in youth with type 2 diabetes.Keywords: adolescent, type 2 diabetes, multidisciplinary
Borg Eva; Perrild Hans; Frølich Anne; Vadstrup Eva S; Røder Michael
Abstract Background Current guidelines recommend education, physical activity and changes in diet for type 2 diabetes patients, yet the composition and organization of non-pharmacological care are still controversial. Therefore, it is very important that programmes aiming to improve non-pharmacological treatment of type 2 diabetes are developed and evaluated. The Copenhagen Type 2 Diabetes Rehabilitation Project aims to evaluate the effectiveness of a new group-based lifestyle rehabilitation ...
Prateek Chaudhary; Demitrost Laloo; Ranabir Salam
Introduction: Obesity has always been thought to be a risk factor for diabetes; however, some studies in India have reported that even lean people are prone to diabetes. We conducted this study to see if this holds true for this part of the country. Objectives: To determine the prevalence of lean type 2 diabetes mellitus (DM) in recently diagnosed type 2 DM in Manipur. Materials and Methods: All recently diagnosed type 2 DM patients, within a period of 24 weeks, who attended the endocrine cli...
Ma, Ronald Ching Wan; Lin, Xu; Jia, Weiping
The prevalence of diabetes in China has increased substantially over recent decades, with more than 100 million people estimated to be affected by the disease presently. During this period there has been an increase in the rates of obesity and a reduction in physical activity. Many of the changes in lifestyle and diet are a result of increased economic development and urbanisation. In addition to an increasingly westernised diet, the traditional Chinese diet also plays a part, with the quantity and quality of rice intake linked to the risk of type 2 diabetes. Familial factors including inherited genetic variants are important, although differences in the genetic architecture suggest a different combination of genetic variants could be most relevant in Chinese when compared with Europeans. Recent advances have also emphasised the role of early life factors in the epidemic of diabetes and non-communicable diseases: maternal undernutrition, maternal obesity, and gestational diabetes are all linked to increased risk of diabetes in offspring. A mismatch between developmentally programmed biology and the modern environment is relevant for countries like China where there has been rapid economic transformation. Multisectoral efforts to address the risks will be needed at different stages throughout the lifecourse to reduce the burden of diabetes. PMID:25218727
Hepcidin is a peptide hormone with both paracrine andendocrine functions that help in maintaining body ironstores. Type 2 diabetes （T2D） is one of the sequelae ofexcess body iron stores; thus, iron regulatory hormonehepcidin may have a direct or at least an indirect role inthe aetiopathogenesis of T2D. Both human and animalstudies at molecular and genetic levels have attemptedto establish a role for hepcidin in the development ofT2D, and a few epidemiologic studies have also showeda link between hepcidin and T2D at population level,but the findings are still inconclusive. Recent data havesuggested different pathways in which hepcidin could beassociated with T2D with much emphasis on its primaryor secondary role in insulin resistance. Some of thesuggested pathways are via transcription modulator ofhepcidin （STAT3）; ferroportin 1 expression on the cellsinvolved in iron transport; transmembrane protease 6enzyme; and pro-inflammatory cytokines, interleukin（IL）-1, IL-6, tumor necrosis factor-α and IL-10. Thisreview briefly reports the existing evidence on thepossible links between hepcidin and T2D and concludesthat more data are needed to confirm or refute hepcidin＇srole in the development of T2D. Examining this rolecould provide a further evidence base for iron in theaetiopathogenesis of T2D.
Bowen, Michael E; Rothman, Russell L
Although once considered a disease of adults, the prevalence of type 2 diabetes in youth is increasing at a significant rate. Similar to adults, youth with type 2 diabetes are at increased risk for developing hypertension, lipid abnormalities, renal disease, and other diabetes-related complications. However, children and adolescents with type 2 diabetes also face many unique management challenges that are different from adults with type 2 diabetes or children with type 1 diabetes. To deliver safe, effective, high-quality, cost-effective health care to adolescents with type 2 diabetes, reorganization and redesign of health care systems are needed. Multidisciplinary health care teams, which allow individuals with specialized training to maximally utilize their skills within an organized diabetes treatment team, may increase efficiency and effectiveness and may improve outcomes in children with type 2 diabetes. This review article provides a brief review of type 2 diabetes in children and adolescents, provides an overview of multidisciplinary health care teams, and discusses the role of multidisciplinary health care management in youth with type 2 diabetes. PMID:21197360
Haase, Christiane L; Tybjærg-Hansen, Anne; Nordestgaard, Børge G;
Observationally, low levels of HDL cholesterol are consistently associated with increased risk of type 2 diabetes. Therefore, plasma HDL cholesterol increasing has been suggested as a novel therapeutic option to reduce the risk of type 2 diabetes. Whether levels of HDL cholesterol are causally...... associated with type 2 diabetes is unknown. In a prospective study of the general population (n = 47,627), we tested whether HDL cholesterol-related genetic variants were associated with low HDL cholesterol levels and, in turn, with an increased risk of type 2 diabetes. HDL cholesterol-decreasing gene scores...... and allele numbers associated with up to -13 and -20% reductions in HDL cholesterol levels. The corresponding theoretically predicted hazard ratios for type 2 diabetes were 1.44 (95% CI 1.38-1.52) and 1.77 (1.61-1.95), whereas the genetic estimates were nonsignificant. Genetic risk ratios for type 2...
Meeuwisse-Pasterkamp, Susanne H; van der Klauw, Melanie M; Wolffenbuttel, Bruce H R
Type 2 diabetes mellitus is a disease that affects a rapidly increasing number of patients. Most patients with Type 2 diabetes will develop vascular complications. This may be microvascular disease, such as nephropathy, retinopathy or polyneuropathy, and also macrovascular disease, such as coronary
Dinarello, Charles A; Donath, Marc Y; Mandrup-Poulsen, Thomas
To understand the role of inflammation as the fundamental cause of type 2 diabetes and specifically to examine the contribution of IL-1beta.......To understand the role of inflammation as the fundamental cause of type 2 diabetes and specifically to examine the contribution of IL-1beta....
Afzal, Shoaib; Bojesen, Stig E; Nordestgaard, Børge G
Vitamin D deficiency has been implicated in decreased insulin secretion and increased insulin resistance, hallmarks of type 2 diabetes mellitus. We tested the hypothesis that low plasma 25-hydroxyvitamin D [25(OH)D] is associated with increased risk of type 2 diabetes in the general population....
Molsted, S; Tribler, J; Snorgaard, O
The aims were to investigate the prevalence of musculoskeletal pain in patients with type 2 diabetes and demonstrate possible associated factors.......The aims were to investigate the prevalence of musculoskeletal pain in patients with type 2 diabetes and demonstrate possible associated factors....
... Medicare & Medicaid Services HealthSense Alternate Language URL Español It’s Not Too Late to Prevent Type 2 Diabetes ... a greater chance of getting type 2 diabetes? It’s true. You have a greater chance of getting ...
Type 2 diabetes mellitus is emerging as a new clinical problem within pediatric practice. Recent reports indicate an increasing prevalence of type 2 diabetes mellitus in children and adolescents around the world in all ethnicities, even if the prevalence of obesity is not increasing any more. The majority of young people diagnosed with type 2 diabetes mellitus was found in specific ethnic subgroups such as African-American, Hispanic, Asian/Pacific Islanders and American Indians. Clinicians should be aware of the frequent mild or asymptomatic manifestation of type 2 diabetes mellitus in childhood. Therefore, a screening seems meaningful especially in high risk groups such as children and adolescents with obesity, relatives with type 2 diabetes mellitus, and clinical features of insulin resistance (hypertension, dyslipidemia, polycystic ovarian syndrome, or acanthosis nigricans). Treatment of choice is lifestyle intervention followed by pharmacological treatment (e.g., metformin). New drugs such as dipeptidyl peptidase inhibitors or glucagon like peptide 1 mimetics are in the pipeline for treatment of youth with type 2 diabetes mellitus. However, recent reports indicate a high dropout of the medical care system of adolescents with type 2 diabetes mellitus suggesting that management of children and adolescents with type 2 diabetes mellitus requires some remodeling of current healthcare practices. PMID:24379917
Wolford, Johanna K; de Courten, Barbora
Type 2 diabetes mellitus represents a multifactorial, heterogeneous group of disorders, which result from defects in insulin secretion, insulin action, or both. The prevalence of type 2 diabetes has increased dramatically worldwide over the past several decades, a trend that has been heavily...... influenced by the relatively recent changes in diet and physical activity levels. There is also strong evidence supporting a genetic component to type 2 diabetes susceptibility and several genes underlying monogenic forms of diabetes have already been identified. However, common type 2 diabetes is likely to...... result from the contribution of many genes interacting with different environmental factors to produce wide variation in the clinical course of the disease. Not surprisingly, the etiologic complexity underlying type 2 diabetes has made identification of the contributing genes difficult. Current therapies...
Bhaktha Geetha; Nayak Shivananda; Shantaram Manjula
The objective of our study was to determine the role of fenugreek seed powder in the management of newly diagnosed type 2 diabetes. We selected 38 patients with newly diagnosed type 2 diabetes, aged between 30-45 years, without any significant diabetes complications and were grouped as: Group I (n=19) consumed 25 g. fenugreek twice daily (before breakfast and dinner) and on moderate exercise for two months, Group II (n=19) subjects were on dietary control. Blood sample collected before and af...
Burness, Celeste B; Scott, Lesley J
Dulaglutide (Trulicity™) is a once-weekly subcutaneously administered glucagon-like peptide-1 (GLP-1) receptor agonist produced by recombinant DNA technology and approved in numerous countries as an adjunct to diet and exercise for the treatment of adults with type 2 diabetes (T2DM). In randomized controlled trials in patients with T2DM, dulaglutide monotherapy was noninferior to once-daily subcutaneous liraglutide monotherapy and significantly more effective than oral metformin monotherapy in improving glycemic control at 26 weeks. When used in combination with other agents (including metformin, metformin and a sulfonylurea, metformin and oral pioglitazone, and prandial insulin ± metformin), dulaglutide was noninferior to once-daily liraglutide and significantly more effective than once-daily oral sitagliptin, twice-daily subcutaneous exenatide, and once-daily subcutaneous insulin glargine in terms of improvements in glycated hemoglobin from baseline at 26 or 52 weeks, in trials of 26-104 weeks' duration. Moreover, dulaglutide 1.5 mg once weekly, but not 0.75 mg once weekly, was associated with consistent reductions form baseline in bodyweight. Improvements in glycemic control and bodyweight were maintained during long-term treatment (up to 2 years). Dulaglutide was generally well tolerated, with a low inherent risk of hypoglycemia. The most frequently reported adverse events in clinical trials were gastrointestinal-related (e.g., nausea, vomiting, and diarrhea). Thus, dulaglutide is a useful option for the treatment of adult patients with T2DM. PMID:26423061
... for Teens: Lower Your Risk for Type 2 Diabetes Page Content Today, more teens are getting type ... being more active and making healthy food choices. Diabetes is a serious disease. Food we eat is ...
Poulsen, Pernille; Grunnet, Louise G.; Pilgaard, Kasper; Storgaard, Heidi; Alibegovic, Amra; Sonne, Mette P.; Carstensen, Bendix; Beck-Nielsen, Henning; Vaag, Allan
OBJECTIVE Genetic susceptibility, low birth weight (LBW), and aging are key etiological factors in the development of type 2 diabetes. LBW is common among twins. It is unknown whether twin status per se is associated with risk of type 2 diabetes, and valid concordance rates of type 2 diabetes in twins on a lifetime perspective are lacking. RESEARCH DESIGN AND METHODS A clinical study was done on a population-based cohort of same-sex elderly monozygotic (MZ) and dizygotic (DZ) twins (n = 297) ...
Mulnier, H.E.; Seaman, H.E.; Raleigh, V S; Soedamah-Muthu, S.S.; Colhoun, H M; Lawrenson, R A
Aims Under-reporting of diabetes on death certificates contributes to the unreliable estimates of mortality as a result of diabetes. The influence of obesity on mortality in Type 2 diabetes is not well documented. We aimed to study mortality from diabetes and the influence of obesity on mortality in Type 2 diabetes in a large cohort selected from the General Practice Research Database (GPRD). Methods A cohort of 44 230 patients aged 35–89 years in 1992 with Type 2 diabetes was identified. A c...
Punyakrit Deb Barma; Salam Ranabir; Lallan Prasad; Thangjam Premchand Singh
Background: Type 2 diabetes mellitus is the most prevalent form of diabetes worldwide. In western countries majority of the cases are obese. The scenario may be different in certain parts of India. Various studies have reported a high prevalence of lean type 2 diabetes mellitus with a body mass index < 19 kg/m 2 . Materials and Methods: We evaluated 100 cases of lean type 2 diabetes mellitus (62 males and 38 females). Results and Conclusion: The mean duration of diabetes was 51.7 months (rang...
Gram-Kampmann, Eva-Marie; Olsen, Michael Hecht; Beck-Nielsen, Henning
Recently, low-carbohydrate diets have increased in popularity as a method to achieve glycaemic control and weight loss in Type 2 diabetes patients. However, there is a lack of consistency and long-term results in existing studies on patients with Type 2 diabetes. In this review, we address current...... knowledge of low-carbohydrate diets and how they affect glycaemic control, diabetic dyslipidaemia, weight and markers of cardiovascular risk, and our aim is to aid medical practitioners in guiding patients with Type 2 diabetes who wish to try a low-carbohydrate diet in order to take control of their disease....
Gregersen, Søren; Jeppesen, Per B; Holst, Jens Juul;
Stevioside is present in the plant Stevia rebaudiana Bertoni (SrB). Extracts of SrB have been used for the treatment of diabetes in, for example, Brazil, although a positive effect on glucose metabolism has not been unequivocally demonstrated. We studied the acute effects of stevioside in type 2...... glucose levels in type 2 diabetic patients, indicating beneficial effects on the glucose metabolism. Stevioside may be advantageous in the treatment of type 2 diabetes....
... page: https://medlineplus.gov/news/fullstory_159814.html Study Suggests Type 2 Diabetes-Cancer Link It hints ... screening tests following a diagnosis of diabetes," said study author Dr. Iliana Lega, of the University of ...
Over the last years, the therapeutic aims for patients with type 2 diabetes have changed and several novel drugs have been introduced. In this Mini-Review we discuss these aims and how to achieve them. PMID:27269776
Egan, A M
Although regular exercise is a critical component of the management of type 2 diabetes, many patients do not meet their exercise targets. Lack of exercise is associated with obesity and adverse cardiovascular outcomes.
Hare, Kristine J; Knop, Filip Krag
This chapter focuses on the incretin hormones, glucagon-like peptide-1 (GLP-1), and glucose-dependent insulinotropic polypeptide (GIP), and their therapeutic potential in treating patients with type 2 diabetes. Type 2 diabetes is characterized by insulin resistance, impaired glucose-induced insulin...... secretion, and inappropriately regulated glucagon secretion which in combination eventually result in hyperglycemia and in the longer term microvascular and macrovascular diabetic complications. Traditional treatment modalities--even multidrug approaches--for type 2 diabetes are often unsatisfactory at....... Two new drug classes based on the actions of the incretin hormones have been approved for therapy of type 2 diabetes: injectable long-acting stable analogs of GLP-1, incretin mimetics, and orally available inhibitors of dipeptidyl peptidase 4 (DPP4; the enzyme responsible for the rapid degradation of...
Bowker, Samantha L.; Richardson, Kathryn; Marra, Carlo A.; Johnson, Jeffrey A.
OBJECTIVE To examine the risk of breast cancer in pre- and postmenopausal women with type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS This was a population-based retrospective cohort study. Cox regression, stratified by pre- (
Avery, L.; Flynn, D.; Wersch, A.; Sniehotta, F. F.; Trenell, M. I.
OBJECTIVE Behavioral interventions targeting “free-living” physical activity (PA) and exercise that produce long-term glycemic control in adults with type 2 diabetes are warranted. However, little is known about how clinical teams should support adults with type 2 diabetes to achieve and sustain a physically active lifestyle. RESEARCH DESIGN AND METHODS We conducted a systematic review of randomized controlled trials (RCTs) (published up to January 2012) to establish the effect of behavioral ...
Hemmingsen, Bianca; Schroll, Jeppe B; Lund, Søren;
Type 2 diabetes mellitus (T2DM) is a growing health problem worldwide. Whether sulphonylureas show better, equal or worse therapeutic effects in comparison with other antidiabetic interventions for patients with T2DM remains controversial.......Type 2 diabetes mellitus (T2DM) is a growing health problem worldwide. Whether sulphonylureas show better, equal or worse therapeutic effects in comparison with other antidiabetic interventions for patients with T2DM remains controversial....
Parkner, Tina; Nielsen, Jannik Kruse; Sandahl, Thomas Damgaard; Bibby, Bo Martin; Jensen, Birgit Schelde; Christiansen, Jens Sandahl
Abstract Objectives: To evaluate if an improved daily glycaemic profile could be achieved in patients with type 2 diabetes by withholding breakfast, but maintaining the same total daily intake of calorie and the same composition of carbohydrates, fat, and protein. Methods: Thirteen type 2 diabetic patients participated in this randomised crossover study. Following an initial fasting night the study consisted of 4 consecutive days. Patients were randomised to diets including brea...
Xie, Xi-tao; Liu, Qiang; Wu, Jie; Wakui, Makoto
Many patients with type 2 diabetes mellitus (DM2) are at risk for micro and macro vascular complications, which could be observed in heavy smokers. Cigarette smoking increases the risk for type 2 diabetes incidence. Nicotine, acknowledged as the major pharmacologically active chemical in tobacco, is responsible for the association between cigarette smoking and development of diabetes. This minireview summarized recent studies on nicotine effects on insulin action and insulin secretion, indica...
Nsiah, Kwabena; Shang, V Owusua; Boateng, K Agyenim; Mensah, FO
Background: The diabetic condition is influenced by several factors, some of which can accelerate the disease's progression to various complications that aggravate the morbidity. Aims: This study aimed at determining the prevalence of metabolic syndrome (MetS) and its individual components and the most critical predictive risk factors of MetS in type 2 diabetic patients. Materials and Methods: This cross-sectional study involved 150 type 2 diabetes mellitus patients and was conducted at the D...
Trans fatty acids (TFA) could affect cell membrane functions, and may therefore influence peripheral insulin sensitivity and the risk of developing type 2 diabetes. It is important to understand whether low amounts of TFA consumed during long periods may promote insulin resistance and have clinically relevant effects on diabetes risk. Data from controlled intervention studies examining the effects of TFA on insulin sensitivity and type 2 diabetes are reviewed. The results show no consistent e...
Guedes, Erika Paniago; Hohl, Alexandre; de Melo, Thais Gomes; Lauand, Felipe
Type 2 diabetes mellitus (T2DM) has a high prevalence and incidence around the world. The complex pathophysiology mechanism is among the barriers for diabetes treatment. Type 2 diabetes patients have dysfunction in incretin hormones (as glucagon-like peptide-1 or GLP-1, and glucose-dependent insulinotropic polypeptide or GIP). By inhibiting the dipeptidyl peptidase-4 (DPP-4) enzyme, it is possible to slow the inactivation of GLP-1 and GIP, promoting blood glucose level reduction in a glucose-...
St. Onge, Erin L.; Motycka, Carol A.; Rose, Renee L.
In the pediatric population, type 2 diabetes has become a growing concern. A correlation appears to exist among type 2 diabetes in children, obesity, and a sedentary lifestyle. If obesity and diabetes are left untreated, conditions such as cardiovascular disease, nephropathy, and retinopathy may result as well. These conditions indicate the incredible strain on the health care system caused by diabetes and obesity. This strain may be eased by logical treatments such as exercise and healthy ea...
Sarita Bajaj; Lokendra Rekwal; SP Misra; Vatsala Misra; Rakesh Kumar Yadav; Anubha Srivastava
Introduction: Helicobacter pylori (H. pylori) infection has been associated with increased levels of inflammatory cytokines and subsequent insulin resistance and epidemiologically linked to type 2 diabetes. Objectives: To study the prevalence rate of H. pylori infection in type 2 diabetes and its relation with HbA1C levels. Materials and Methods: In this cross-sectional case-control study, 80 patients (≥18 years) who met the Americans with Disabilities Act (ADA) criteria for diabetes were rec...
Levit, S.; Yu I Philippov; A S Gorelyshev
Diabetes mellitus is a heterogeneous group of diseases that, although unified by a number of characteristics, require a differential thera- peutic approach. Current review discusses key pathogenic features of type 2 diabetes mellitus that determine therapy goals and options in management. We further enunciate and pathogenetically substantiate a new "gravicentric" concept for treatment of type 2 diabetes mellitus that differs in many ways from the common contemporary approach.
Full Text Available Diabetes mellitus is a heterogeneous group of diseases that, although unified by a number of characteristics, require a differential thera- peutic approach. Current review discusses key pathogenic features of type 2 diabetes mellitus that determine therapy goals and options in management. We further enunciate and pathogenetically substantiate a new "gravicentric" concept for treatment of type 2 diabetes mellitus that differs in many ways from the common contemporary approach.
Jannetta, Peter J.; Fletcher, Lynn H.; Grondziowski, Peter M.; Casey, Kenneth F.; Sekula Jr, Raymond F.
Background: Insulin resistance (hyperinsulinemia) is said to be the signal event and causal in the development of type 2 diabetes mellitus. Pulsatile arterial compression of the right anterolateral medulla oblongata is associated with autonomic dysfunction, including “driving” the pancreas, which increases insulin resistance causing type 2 diabetes mellitus. In this prospective study, we hypothesize that decompressing the right cranial nerve X and medulla will result in better glycemic contro...
Feyza Engin; Truc Nguyen; Alena Yermalovich; Hotamisligil, Gökhan S.
The endoplasmic reticulum adapts to fluctuations in demand and copes with stress through an adaptive signaling cascade called the unfolded protein response (UPR). Accumulating evidence indicates that the canonical UPR is critical to the survival and function of insulin-producing pancreatic β-cells, and alterations in the UPR may contribute to the pathogenesis of type 2 diabetes. However, the dynamic regulation of UPR molecules in the islets of animal models and humans with type 2 diabetes rem...
Aryangat, Ajikumar V; Gerich, John E.
Ajikumar V Aryangat, John E GerichUniversity of Rochester, Rochester, New York, USAAbstract: Hyperglycemia is a major risk factor for both the microvascular and macrovascular complications in patients with type 2 diabetes. This review summarizes the cardiovascular results of large outcomes trials in diabetes and presents new evidence on the role of hyperglycemia, with particular emphasis on postprandial hyperglycemia, in adverse cardiovascular outcomes in patients with type 2 diabet...
Dulaglutide is a new once-weekly glucagon-like peptide-1 receptor agonist for the management of hyperglycemia in adult patients with type 2 diabetes. It stimulates dose-dependent insulin secretion and reduces glucagon secretion, both in a glucose-dependent manner. Efficacy on blood glucose control and safety were demonstrated in the large AWARD program in type 2 diabetic patients treated with diet, metformin, dual oral therapy or insulin lispro with or without metformin, confirming findings o...
Despite the availability of many other agents, insulin is widely used as a treatment for type 2 diabetes. In vitro, insulin stimulates the growth of cancer cells, through the interaction with insulin-like growth factor-1 (IGF-1) receptors and its own receptors. In observational surveys on type 2 diabetes, insulin therapy is associated with an increased incidence of several forms of cancer, although it is difficult to discriminate the effect of confounders from that of insulin itself. Randomiz...
Janssen, P. G. H.
The presented studies were conducted within the framework of the international ADDITION study (Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care), a randomised controlled trial in 3,057 screen-detected type 2 diabetic patients. The aim of ADDITION is to evaluate whether screening for type 2 diabetes in general practice is feasible and subsequent intensified, multifactorial treatment beneficial. Intensified treatment consisted of pharmacolo...
García-Solano, Beatriz; Esther C Gallegos-Cabriales; Gómez-Meza, Marco V; García-Madrid, Guillermina; Flores-Merlo, Marcela; García-Solano, Mauro
Families represent more than a set of individuals; family is more than a sum of its individual members. With this classification, nurses can identify the family health-illness beliefs obey family as a unit concept, and plan family inclusion into the type 2 diabetes treatment, whom is not considered in public policy, despite families share diet, exercise, and self-monitoring with a member who suffers type 2 diabetes. The aim of this study was to determine whether the characteristics, functiona...
Ng, Maggie C.Y.; Saxena, Richa; Li, Jiang; Nicholette D Palmer; Dimitrov, Latchezar; Xu, Jianzhao; Rasmussen-Torvik, Laura J; Zmuda, Joseph M; Siscovick, David S; Patel, Sanjay R.; Crook, Errol D.; Sims, Mario; Chen, Yii-Der I.; Bertoni, Alain G.; Li, Mingyao
Type 2 diabetes (T2D) disproportionally affects African Americans (AfA) but, to date, genetic variants identified from genome-wide association studies (GWAS) are primarily from European and Asian populations. We examined the single nucleotide polymorphism (SNP) and locus transferability of 40 reported T2D loci in six AfA GWAS consisting of 2,806 T2D case subjects with or without end-stage renal disease and 4,265 control subjects from the Candidate Gene Association Resource Plus Study. Our res...
Raciti, Gregory Alexander; Longo, Michele; Parrillo, Luca; Ciccarelli, Marco; Mirra, Paola; Ungaro, Paola; Formisano, Pietro; Miele, Claudia; Béguinot, Francesco
The known genetic variability (common DNA polymorphisms) does not account either for the current epidemics of type 2 diabetes or for the family transmission of this disorder. However, clinical, epidemiological and, more recently, experimental evidence indicates that environmental factors have an extraordinary impact on the natural history of type 2 diabetes. Some of these environmental hits are often shared in family groups and proved to be capable to induce epigenetic changes which alter the function of genes affecting major diabetes traits. Thus, epigenetic mechanisms may explain the environmental origin as well as the familial aggregation of type 2 diabetes much easier than common polymorphisms. In the murine model, exposure of parents to environmental hits known to cause epigenetic changes reprograms insulin sensitivity as well as beta-cell function in the progeny, indicating that certain epigenetic changes can be transgenerationally transmitted. Studies from different laboratories revealed that, in humans, lifestyle intervention modulates the epigenome and reverts environmentally induced epigenetic modifications at specific target genes. Finally, specific human epigenotypes have been identified which predict adiposity and type 2 diabetes with much greater power than any polymorphism so far identified. These epigenotypes can be recognized in easily accessible white cells from peripheral blood, indicating that, in the future, epigenetic profiling may enable effective type 2 diabetes prediction. This review discusses recent evidence from the literature supporting the immediate need for further investigation to uncover the power of epigenetics in the prediction, prevention and treatment of type 2 diabetes. PMID:25841587
Full Text Available Abstract Type 2 diabetes is associated with significant cardiovascular morbidity and mortality. Although low-density lipoprotein cholesterol levels may be normal in patients with type 2 diabetes, insulin resistance drives a number of changes in lipid metabolism and lipoprotein composition that render low-density lipoprotein cholesterol and other lipoproteins more pathogenic than species found in patients without type 2 diabetes. Dyslipidemia, which affects almost 50% of patients with type 2 diabetes, is a cardiovascular risk factor characterized by elevated triglyceride levels, low high-density lipoprotein cholesterol levels, and a preponderance of small, dense, low-density lipoprotein particles. Early, aggressive pharmacological management is advocated to reduce low-density lipoprotein cholesterol levels, regardless of baseline levels. A number of lipid-lowering agents, including statins, fibrates, niacin, and bile acid sequestrants, are available to target normalization of the entire lipid profile. Despite use of combination and high-dose lipid-lowering agents, many patients with type 2 diabetes do not achieve lipid targets. This review outlines the characteristics and prevalence of dyslipidemia in patients with type 2 diabetes and discusses strategies that may reduce the risk of cardiovascular disease in this population.
Meteran, Howraman; Backer, Vibeke; Kyvik, Kirsten Ohm; Skytthe, Axel; Thomsen, Simon Francis
the relationship between type 2 diabetes and chronic bronchitis and COPD in adult twins, and to examine to what extent comorbidity between these diseases is explained by shared genetic or environmental factors. METHODS: Questionnaire data on chronic bronchitis and hospital discharge data on diagnosed...... COPD in 13,649 twins, aged 50-71 years, from the Danish Twin Registry were cross-linked with hospital discharge diagnosis data on type 2 diabetes from the Danish National Patient Registry. RESULTS: The risk of type 2 diabetes was higher in persons with symptoms of chronic bronchitis than in those...... on chronic bronchitis and type 2 diabetes, and between genetic effects on diagnosed COPD and type 2 diabetes, respectively, were 0.33 (0.00-0.79), p = 0.103, and 0.43 (0.00-0.98), p = 0.154. Non-shared environmental correlations between chronic bronchitis and type 2 diabetes were -0.13 (-0.43 to 0...
Reynolds, Rebecca M; Strachan, Mark W. J.; Labad, Javier; Lee, Amanda J.; Frier, Brian M; Fowkes, F Gerald; Mitchell, Rory; Seckl, Jonathan R.; Deary, Ian J.; Walker, Brian R; Price, Jackie F; Edinburgh Type 2 Diabet Study
OBJECTIVE - People with type 2 diabetes are at increased risk of cognitive impairment, but the mechanism is uncertain. Elevated glucocorticoid levels in rodents and humans are associated with cognitive impairment. We aimed to determine whether fasting cortisol levels are associated with cognitive ability and estimated lifetime cognitive change in an elderly population with type 2 diabetes.RESEARCH DESIGN AND METHODS - This was a cross-sectional study of 1,066 men and women aged 60-75 years wi...
Full Text Available Abstract Background Current guidelines recommend education, physical activity and changes in diet for type 2 diabetes patients, yet the composition and organization of non-pharmacological care are still controversial. Therefore, it is very important that programmes aiming to improve non-pharmacological treatment of type 2 diabetes are developed and evaluated. The Copenhagen Type 2 Diabetes Rehabilitation Project aims to evaluate the effectiveness of a new group-based lifestyle rehabilitation programme in a Health Care Centre in primary care. Methods/Design The group-based diabetes rehabilitation programme consists of empowerment-based education, supervised exercise and dietary intervention. The effectiveness of this multi-disciplinary intervention is compared with conventional individual counselling in a Diabetes Outpatient Clinic and evaluated in a prospective and randomized controlled trial. During the recruitment period of 18 months 180 type 2 diabetes patients will be randomized to the intervention group and the control group. Effects on glycaemic control, quality of life, self-rated diabetes symptoms, body composition, blood pressure, lipids, insulin resistance, beta-cell function and physical fitness will be examined after 6, 12 and 24 months. Discussion The Copenhagen Type 2 Diabetes Rehabilitation Project evaluates a multi-disciplinary non-pharmacological intervention programme in a primary care setting and provides important information about how to organize non-pharmacological care for type 2 diabetes patients. Trail Registration ClinicalTrials.gov registration number: NCT00284609.
Mikkelsen, Kristian Hallundbæk; Knop, Filip Krag; Frost, Morten;
risk, slightly higher ORs for type 2 diabetes were seen with narrow-spectrum and bactericidal antibiotics (OR 1.55 and 1.48) compared to broad-spectrum and bacteriostatic types of antibiotics (OR 1.31 and 1.39), respectively. A clear dose-response effect was seen with increasing cumulative load of......CONTEXT AND OBJECTIVE: Evidence that bacteria in the human gut may influence nutrient metabolism is accumulating. We investigated whether use of antibiotics influences the risk of developing type 2 diabetes and whether the effect can be attributed to specific types of antibiotics. METHODS: We...... conducted a population-based case-control study of incident type 2 diabetes cases in Denmark (population 5.6 million) between January 1, 2000, and December 31, 2012. Data from the Danish National Registry of Patients, the Danish National Prescription Registry, and the Danish Person Registry were combined...
Huth, Cornelia; Heid, Iris M; Vollmert, Caren; Gieger, Christian; Grallert, Harald; Wolford, Johanna K; Langer, Birgit; Thorand, Barbara; Klopp, Norman; Hamid, Yasmin H; Pedersen, Oluf; Hansen, Torben; Lyssenko, Valeriya; Groop, Leif; Meisinger, Christa; Döring, Angela; Löwel, Hannelore; Lieb, Wolfgang; Hengstenberg, Christian; Rathmann, Wolfgang; Martin, Stephan; Stephens, Jeffrey W; Ireland, Helen; Mather, Hugh; Miller, George J; Stringham, Heather M; Boehnke, Michael; Tuomilehto, Jaakko; Boeing, Heiner; Möhlig, Matthias; Spranger, Joachim; Pfeiffer, Andreas; Wernstedt, Ingrid; Niklason, Anders; López-Bermejo, Abel; Fernández-Real, José-Manuel; Hanson, Robert L; Gallart, Luis; Vendrell, Joan; Tsiavou, Anastasia; Hatziagelaki, Erifili; Humphries, Steve E; Wichmann, H-Erich; Herder, Christian; Illig, Thomas
countries, making this the largest association analysis for type 2 diabetes reported to date. The GC and CC genotypes of IL6 -174G>C were associated with a decreased risk of type 2 diabetes (odds ratio 0.91, P = 0.037), corresponding to a risk modification of nearly 9%. No evidence for association was found......Several lines of evidence indicate a causal role of the cytokine interleukin (IL)-6 in the development of type 2 diabetes in humans. Two common polymorphisms in the promoter of the IL-6 encoding gene IL6, -174G>C (rs1800795) and -573G>C (rs1800796), have been investigated for association with type...... 2 diabetes in numerous studies but with results that have been largely equivocal. To clarify the relationship between the two IL6 variants and type 2 diabetes, we analyzed individual data on >20,000 participants from 21 published and unpublished studies. Collected data represent eight different...
Poulsen, Pernille; Grunnet, Louise G; Pilgaard, Kasper;
: 5.8 +/- 0.7, C: 5.6 +/- 0.3, P = 0.004) and 120-min post-oral glucose tolerance test plasma glucose levels (in mmol/l) (MZ: 8.6 +/- 4.6, DZ: 8.4 +/- 3.9, C: 6.8 +/- 2.4, P = 0.003) compared with singletons. Importantly, twins had a higher prevalence of type 2 diabetes (MZ: 17.5% [95% CI 14......OBJECTIVE: Genetic susceptibility, low birth weight (LBW), and aging are key etiological factors in the development of type 2 diabetes. LBW is common among twins. It is unknown whether twin status per se is associated with risk of type 2 diabetes, and valid concordance rates of type 2 diabetes in....... In addition, type 2 diabetes incidence cases in twins (n = 626) and singletons (n = 553) were identified through the National Diabetes Register. RESULTS: Twins were more abdominally obese, insulin resistant, and glucose intolerant, as evidenced by a higher A1C (%) (means +/- SD) (MZ: 6.0 +/- 1.0, DZ...
Guedes, Erika Paniago; Hohl, Alexandre; de Melo, Thais Gomes; Lauand, Felipe
Type 2 diabetes mellitus (T2DM) has a high prevalence and incidence around the world. The complex pathophysiology mechanism is among the barriers for diabetes treatment. Type 2 diabetes patients have dysfunction in incretin hormones (as glucagon-like peptide-1 or GLP-1, and glucose-dependent insulinotropic polypeptide or GIP). By inhibiting the dipeptidyl peptidase-4 (DPP-4) enzyme, it is possible to slow the inactivation of GLP-1 and GIP, promoting blood glucose level reduction in a glucose-dependent manner. Linagliptin is a highly specific and potent inhibitor of DPP-4 that is currently indicated for the treatment of type 2 diabetes. Clinical studies with linagliptin demonstrated efficacy in reducing glycated hemoglobin (HbA1c) levels in type 2 diabetes patients, while maintaining a placebo-like safety and tolerability profile. Linagliptin has an interesting pharmacokinetic profile in terms of its predominantly non-renal elimination and the main implication of this characteristic is that no dose adjustment is necessary in patients with renal disease. Also, no dose adjustment is required in patients with hepatic insufficiency, as well in elderly or obese patients. This article will review the pharmacokinetic profile, efficacy data and safety aspects of linagliptin in type 2 diabetes patients. PMID:23697612
Schou, Jesper; Tybjærg-Hansen, Anne; Møller, Holger J; Nordestgaard, Børge; Frikke-Schmidt, Ruth
risk of type 2 diabetes in the general population is unknown. RESEARCH DESIGN AND METHODS: We tested whether genetic variation in the promoter and coding regions of ABCA1 and ABCG1 predicted risk of type 2 diabetes in the general population. Twenty-seven variants, identified by previous resequencing of...... of the variants examined, ABCG1 g.-530A>G, predicted a decreased risk of type 2 diabetes in the CCHS (P for trend = 0.05). Furthermore, when validated in the CGPS or in the CCHS and CGPS combined (n = 40,600), neither the two loss-of-function mutations (ABCA1 N1800H, ABCG1 g.-376C>T) nor ABCG1 g.-530......A>G were associated with type 2 diabetes (P values >0.57 and >0.30, respectively). CONCLUSIONS: Genetic variations in ABCA1 and ABCG1 were not associated with increased risk of type 2 diabetes in the general population. These data were obtained in general population samples harboring the largest...
Marcelo Macedo Rogero
Full Text Available The initial observations linking vitamin D to type 2 diabetes in humans came from studies showing that both healthy and diabetic subjects had a seasonal variation of glycemic control. Currently, there is evidence supporting that vitamin D status is important to regulate some pathways related to type 2 diabetes development. Since the activation of inflammatory pathways interferes with normal metabolism and disrupts proper insulin signaling, it is hypothesized that vitamin D could influence glucose homeostasis by modulating inflammatory response. Human studies investigating the impact of vitamin D supplementation on inflammatory biomarkers of subjects with or at high risk of developing type 2 diabetes are scarce and have generated conflicting results. Based on available clinical and epidemiological data, the positive effects of vitamin D seem to be primarily related to its action on insulin secretion and sensitivity and secondary to its action on inflammation. Future studies specifically designed to investigate the role of vitamin D on type 2 diabetes using inflammation as the main outcome are urgently needed in order to provide a more robust link between vitamin D, inflammation and type 2 diabetes.
Forte, Giovanni; Bocca, Beatrice; Peruzzu, Angela; Tolu, Francesco; Asara, Yolande; Farace, Cristiano; Oggiano, Riccardo; Madeddu, Roberto
Mechanisms for the onset of diabetes and the development of diabetic complications remain under extensive investigations. One of these mechanisms is abnormal homeostasis of metals, as either deficiency or excess of metals, can contribute to certain diabetic outcomes. Therefore, this paper will report the blood levels of chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), mercury (Hg), nickel (Ni), lead (Pb), selenium (Se), and zinc (Zn) in subjects with type 1 diabetes (n = 192, mean age 48.8 years, mean disease duration 20.6 years), type 2 diabetes (n = 68, mean age 68.4 years, mean disease duration 10.2 years), and in control subjects (n = 59, mean age 57.2 years), and discuss the results indicating their possible role in diabetes. The metal concentrations were measured by sector field inductively coupled plasma mass spectrometry after microwave-induced acid digestion of blood samples. The accuracy was checked using a blood-based certified reference material, and recoveries of all elements were in the range of 92-101 % of certified values. Type 1 diabetes was found to be associated with Cr (p = 0.02), Mn (p < 0.001), Ni (p < 0.001), Pb (p = 0.02), and Zn (p < 0.001) deficiency, and type 2 diabetes with Cr (p = 0.014), Mn (p < 0.001), and Ni (p < 0.001) deficiency. These deficiencies were appreciated also subdividing the understudied patients for gender and age groups. Furthermore, in type 1 diabetes, there was a positive correlation between Pb and age (p < 0.001, ρ = 0.400) and Pb and BMI (p < 0.001, ρ = 0.309), while a negative correlation between Fe and age (p = 0.002, ρ = -0.218). In type 2 diabetes, there was a negative correlation between Fe and age (p = 0.017, ρ = -0.294) and Fe and BMI (p = 0.026, ρ = -0.301). Thus, these elements may play a role in both forms of diabetes and combined mineral supplementations could have beneficial effects. PMID:24222606
... gets too high and diabetes can then damage your body. What types of diabetes do kids get? In type 1 ... to see how you are doing. Kids with type 2 diabetes may need to take insulin or pills to ... doctor will tell you what blood glucose level is good for you and ...
Ubink-Veltmaat, L. J.; Kleefstra, N.; Kollen, B. J.; Bilo, H. J. G.; Landman, G.
Background: It is unclear whether there is a relationship between type two diabetes and cancer mortality. It also is unclear whether obesity and body mass index (BMI) are associated with cancer in type 2 diabetes patients. Patients and Methods: In 1998, 1,145 patients with type two diabetes mellitus
Owen, Katharine R
It is increasingly recognised that diabetes in young adults has a wide differential diagnosis. There are many monogenic causes, including monogenic beta-cell dysfunction, mitochondrial diabetes and severe insulin resistance. Type 2 diabetes in the young is becoming more prevalent, particularly after adolescence. It's important to understand the clinical features and diagnostic tools available to classify the different forms of young adult diabetes. Classic type 1 diabetes is characterised by positive β-cell antibodies and absence of endogenous insulin secretion. Young type 2 diabetes is accompanied by metabolic syndrome with obesity, hypertension and dyslipidaemia. Monogenic β-cell dysfunction is characterised by non-autoimmune, C-peptide positive diabetes with a strong family history, while mitochondrial diabetes features deafness and other neurological involvement. Severe insulin resistance involves a young-onset metabolic syndrome often with a disproportionately low BMI. A suspected diagnosis of monogenic diabetes is confirmed with genetic testing, which is widely available in specialist centres across the world. Treatment of young adult diabetes is similarly diverse. Mutations in the transcription factors HNF1A and HNF4A and in the β-cell potassium ATP channel components cause diabetes which responds to low dose and high dose sulfonylurea agents, respectively, while glucokinase mutations require no treatment. Monogenic insulin resistance and young-onset type 2 diabetes are both challenging to treat, but first line management involves insulin sensitisers and aggressive management of cardiovascular risk. Outcomes are poor in young-onset type 2 diabetes compared to both older onset type 2 and type 1 diabetes diagnosed at a similar age. The evidence base for treatments in monogenic and young-onset type 2 diabetes relies on studies of moderate quality at best and largely on extrapolation from work conducted in older type 2 diabetes subjects. Better quality
Mitchell, Murray D.; Illanes, Sebastian E.; Rice, Gregory E.
The aim of this paper is to consider the relative benefits of screening for type two diabetes mellitus in women with a previous pregnancy complicated by gestational diabetes mellitus. Recent studies suggest that women who experience GDM are at a greater risk of developing type 2 diabetes within 10–20 years of their index pregnancy. If considered as a stand-alone indicator of the risk of developing type 2 diabetes, GDM is a poor diagnostic test. Most women do not develop GDM during pregnancy a...
Win, Htet Htet Ne
Although both conditions are relatively common, there are very few descriptions of type 2 diabetes mellitus coexisting with Charcot-Marie-Tooth disease (CMT). This case report and literature review describes a 53-year-old Irish man who presented with type 2 diabetes and significant neuropathy, and who was subsequently diagnosed with CMT type 1A. This case report will also discuss how to differentiate diabetic neuropathy from a progressive hereditary neuropathy and how coexistence aggravates the progression of neuropathy thus necessitating early diagnosis.
Win, Htet Htet Ne
Although both conditions are relatively common, there are very few descriptions of type 2 diabetes mellitus coexisting with Charcot-Marie-Tooth disease (CMT). This case report and literature review describes a 53-year-old Irish man who presented with type 2 diabetes and significant neuropathy, and who was subsequently diagnosed with CMT type 1A. This case report will also discuss how to differentiate diabetic neuropathy from a progressive hereditary neuropathy and how coexistence aggravates the progression of neuropathy thus necessitating early diagnosis.
Grarup, Niels; Sandholt, Camilla H; Hansen, Torben; Pedersen, Oluf
During the past 7 years, genome-wide association studies have shed light on the contribution of common genomic variants to the genetic architecture of type 2 diabetes, obesity and related intermediate phenotypes. The discoveries have firmly established more than 175 genomic loci associated with...... these phenotypes. Despite the tight correlation between type 2 diabetes and obesity, these conditions do not appear to share a common genetic background, since they have few genetic risk loci in common. The recent genetic discoveries do however highlight specific details of the interplay between the...... pathogenesis of type 2 diabetes, insulin resistance and obesity. The focus is currently shifting towards investigations of data from targeted array-based genotyping and exome and genome sequencing to study the individual and combined effect of low-frequency and rare variants in metabolic disease. Here we...
Bacha, Fida; Gidding, Samuel S
Childhood obesity has been linked to cardiovascular disease (CVD) risk in adulthood. Of great concern is the expected increase in the population's CVD burden in relation to childhood obesity. This is compounded by the risk related to chronic hyperglycemia exposure in youth with type 2 diabetes. We herein provide an overview of the spectrum of early cardiovascular disease manifestation in youth with obesity and type 2 diabetes, in particular abnormalities in cardiac structure and function. Cardiac remodeling and adverse target organ damage is already evident in the pediatric age group in children with obesity and type 2 diabetes. This supports the importance of intensifying obesity prevention efforts and early intervention to treat comorbidities of obesity in the pediatric age group to prevent cardiac events in early adulthood. PMID:27168062
Reiling, E; Jafar-Mohammadi, B; van 't Riet, E;
to establish the true contribution of this variant and common variants in LARS2 (MAF > 5%) to type 2 diabetes risk. METHODS: We combined genome-wide association data (n = 10,128) from the DIAGRAM consortium with independent data derived from a tagging single nucleotide polymorphism (SNP) approach in...... Dutch individuals (n = 999) and took forward two SNPs of interest to replication in up to 11,163 Dutch participants (rs17637703 and rs952621). In addition, because inspection of genome-wide association study data identified a cluster of low-frequency variants with evidence of type 2 diabetes association......, we attempted replication of rs9825041 (a proxy for this group) and the previously identified H324Q variant in up to 35,715 participants of European descent. RESULTS: No association between the common SNPs in LARS2 and type 2 diabetes was found. Our replication studies for the two low...
Rasmussen, Ole Winther; Lauszus, Finn; Loekke, M
INTRODUCTION: Good metabolic control is important in type 2 diabetes mellitus to improve quality of life, work ability and life expectancy, and the use of telemedicine has proved efficient as an add-on to the usual treatment. However, few studies in type 2 diabetes patients have directly compared...... telemedicine with conventional outpatient treatment, and we wanted to evaluate whether telemedicine, compared with standard care, provides equivalent clinical outcomes. METHODS: Forty patients with type 2 diabetes mellitus allocated from October 2011-July 2012 were randomized to either treatment at home by...... video conferences only or standard outpatient treatment. Primary outcomes were HbA1c and blood glucose levels and secondary outcomes were 24-hour blood pressure, cholesterol levels and albuminuria. The video-telephone was a broadband solution installed and serviced by the Danish Telephone Company (TDC...
Nyberg, Solja T; Fransson, Eleonor I; Heikkilä, Katriina;
OBJECTIVE: The status of psychosocial stress at work as a risk factor for type 2 diabetes is unclear because existing evidence is based on small studies and is subject to confounding by lifestyle factors, such as obesity and physical inactivity. This collaborative study examined whether stress at......-European dataset suggest that job strain is a risk factor for type 2 diabetes in men and women independent of lifestyle factors....... work, defined as "job strain," is associated with incident type 2 diabetes independent of lifestyle factors. RESEARCH DESIGN AND METHODS: We extracted individual-level data for 124,808 diabetes-free adults from 13 European cohort studies participating in the IPD-Work Consortium. We measured job strain...
Vilsbøll, T; Holst, Jens Juul
the genes encoding their receptors have been deleted. In patients with Type 2 diabetes, the incretin effect is either greatly impaired or absent, and it is assumed that this could contribute to the inability of these patients to adjust their insulin secretion to their needs. In studies of the...... mechanism of the impaired incretin effect in Type 2 diabetic patients, it has been found that the secretion of GIP is generally normal, whereas the secretion of GLP-1 is reduced, presumably as a consequence of the diabetic state. It might be of even greater importance that the effect of GLP-1 is preserved...... whereas the effect of GIP is severely impaired. The impaired GIP effect seems to have a genetic background, but could be aggravated by the diabetic state. The preserved effect of GLP-1 has inspired attempts to treat Type 2 diabetes with GLP-1 or analogues thereof, and intravenous GLP-1 administration has...
... Cuidadores Hormones and Health Journey Through the Endocrine System Endocrine Glands and Types of Hormones Brainy Hormones What ... Health Hormones and Health Journey Through the Endocrine System Endocrine Glands and Types of Hormones Brainy Hormones What ...
Vadstrup, Eva S; Frølich, Anne; Perrild, Hans;
BACKGROUND: Current guidelines recommend education, physical activity and changes in diet for type 2 diabetes patients, yet the composition and organization of non-pharmacological care are still controversial. Therefore, it is very important that programmes aiming to improve non-pharmacological t......BACKGROUND: Current guidelines recommend education, physical activity and changes in diet for type 2 diabetes patients, yet the composition and organization of non-pharmacological care are still controversial. Therefore, it is very important that programmes aiming to improve non......-pharmacological treatment of type 2 diabetes are developed and evaluated. The Copenhagen Type 2 Diabetes Rehabilitation Project aims to evaluate the effectiveness of a new group-based lifestyle rehabilitation programme in a Health Care Centre in primary care. METHODS/DESIGN: The group-based diabetes rehabilitation....... During the recruitment period of 18 months 180 type 2 diabetes patients will be randomized to the intervention group and the control group. Effects on glycaemic control, quality of life, self-rated diabetes symptoms, body composition, blood pressure, lipids, insulin resistance, beta-cell function and...
Maedler, K.; Dharmadhikari, G.; Schumann, D.M.;
plays a role in various diseases, including autoimmune diseases such as rheumatoid arthritis, inflammatory bowel diseases and type 1 diabetes, as well as in diseases associated with metabolic syndrome such as atherosclerosis, chronic heart failure and type 2 diabetes. Macrophage are the primary source...
Clausen, Tine D; Mathiesen, Elisabeth; Ekbom, Pia; Hellmuth, Ellinor; Mandrup-Poulsen, Thomas; Damm, Peter
diabetes compared with women with type 1 diabetes. Multivariate logistic regression analysis in the pooled group of pregnancies with pregestational diabetes from 1996 to 2001 showed that high HbA(1c) at admission and type 2 diabetes were independently associated with a serious adverse fetal outcome...
The prevalence of type 2 diabetes is on the increase. Among the other factors, obesity is considered to be a major contributor in the occurrence of type 2 diabetes by disturbing the metabolic regulators of the body. These regulators are certain hormones and peptides produced in the adipocytes and control the intermediary metabolism of the body. These regulators regulate the lipid load up to a certain level and beyond that complication arises. Diabetes mellitus is one of the complications among others. This article reviews the roles and mechanisms of action of these regulators under the influence of lipid load and discusses the factors affecting the rehabilitation of the regulators.
The rising rates of obesity in youth have concurrently led to an increase in the rates of type 2 diabetes mellitus (T2DM) in this age group. However, there are limited data on the efficacy of different antidiabetic agents in youth. In this context, the Treatment Options for Type 2 Diabetes in Adolescents and Youth trial recently reported that the majority of obese children and adolescents 10-17-years old with newly diagnosed T2DM (T2DM duration less than 2 years) could not achieve HbA1c level...
Jovanovic, Ana; Gerrard, Jean; Taylor, Roy
OBJECTIVE In health, the rise in glucose after lunch is less if breakfast is eaten. We evaluated the second-meal effect in type 2 diabetes. RESEARCH DESIGN AND METHODS Metabolic changes after lunch in eight obese type 2 diabetic subjects were compared on 3 days: breakfast eaten, no breakfast, and no breakfast but intravenous arginine 1 h before lunch. RESULTS Despite comparable insulin levels, the rise in plasma glucose after lunch was considerably less if breakfast had been eaten (0.68 ± 1.4...
Holfort, Stig Kraglund; Jackson, Gregory R; Larsen, Michael
adaptometry was measured in one eye, chosen at random, using a computer-controlled dark adaptometer. Dark adaptation and capillary blood glucose were measured at baseline and 80 minutes into the OGTT/fasting test. Blood glucose remained stable throughout the examination in the 12 fasting subjects, whereas......It was the purpose of the present study to examine dark adaptation in subjects with type 2 diabetes during transient hyperglycemia. Twenty-four subjects with type 2 diabetes and minimal diabetic retinopathy were randomized to undergo an oral glucose tolerance test (OGTT) or to remain fasting. Dark...
Reiling, E.; Jafar-Mohammadi, B.; van ’t Riet, E.; Weedon, M.N.; Vliet-Ostaptchouk, J.V.; Hansen, T; R. Saxena; van Haeften, T W; Arp, P.A.; Das, S.; Nijpels, G; Groenewoud, M. J.; van Hove, E. C.; Uitterlinden, A G; Smit, J. W. A.
Aims/hypothesis LARS2 has been previously identified as a potential type 2 diabetes susceptibility gene through the low-frequency H324Q (rs71645922) variant (minor allele frequency [MAF] 3.0%). However, this association did not achieve genome-wide levels of significance. The aim of this study was to establish the true contribution of this variant and common variants in LARS2 (MAF > 5%) to type 2 diabetes risk. Methods We combined genome-wide association data (n = 10,128) from the DIAGRAM cons...
Green, Anders; Hirsch, Niels Christian; Pramming, Stig Krøger
In recent years it has been estimated that the current global prevalence of type 2 diabetes amounts to about 150 million patients. Projections suggest that by the year 2025 the number of prevalent patients in the world will reach approximately 300 million. It is assumed that the increase in the...... indicators. We suggest that the currently available methods for the estimation of the future global burden of type 2 diabetes mellitus yield underestimates. Further modifications and validity tests of the modelling techniques are necessary in order to develop a reliable instrument to globally monitor the...
Mora, Samia; Kamstrup, Pia R; Rifai, Nader; Nordestgaard, Børge G; Buring, Julie E; Ridker, Paul M
BACKGROUND: Previous studies have demonstrated that cardiovascular risk is higher with increased lipoprotein (a) [Lp(a)]. Whether Lp(a) concentration is related to type 2 diabetes is unclear. METHODS: In 26 746 healthy US women (mean age 54.6 years), we prospectively examined baseline Lp......(a) concentrations and incident type 2 diabetes (n = 1670) for a follow-up period of 13 years. We confirmed our findings in 9652 Danish men and women with prevalent diabetes (n = 419). Analyses were adjusted for risk factors that included age, race, smoking, hormone use, family history, blood pressure, body mass...
Husemoen, L L N; Skaaby, T; Thuesen, B H; Jørgensen, Torben; Fenger, R V; Linneberg, A
Mild to moderate vitamin D insufficiency has been proposed as a risk factor for several common chronic diseases including type 2 diabetes. This study aimed to examine the association between serum 25-hydroxy vitamin D (25(OH)D) and incident diabetes.......Mild to moderate vitamin D insufficiency has been proposed as a risk factor for several common chronic diseases including type 2 diabetes. This study aimed to examine the association between serum 25-hydroxy vitamin D (25(OH)D) and incident diabetes....
Du, X.; Ninomiya, T.; Galan, B.E. de; Abadir, E.; Chalmers, J.; Pillai, A.; Woodward, M.; Cooper, M.; Harrap, S.; Hamet, P.; Poulter, N.; Lip, G.Y.; Patel, A.
AIMS: The aim of this study was to investigate serious clinical outcomes associated with atrial fibrillation (AF) and the effects of routine blood pressure lowering on such outcomes in the presence or absence of AF, among individuals with type 2 diabetes. METHODS AND RESULTS: About 11 140 patients w
Weight loss is recommended for overweight or obese patients with type 2 diabetes on the basis of short-term studies, but long-term effects on cardiovascular disease remain unknown. We examined whether an intensive lifestyle intervention for weight loss would decrease cardiovascular morbidity and mor...
Brandt, Claus; Nielsen, Anders R; Fischer, Christian P;
Myostatin is a secreted growth factor expressed in skeletal muscle tissue, which negatively regulates skeletal muscle mass. Recent animal studies suggest a role for myostatin in insulin resistance. We evaluated the possible metabolic role of myostatin in patients with type 2 diabetes and healthy...
Hansen, J; Rinnov, Anders Rasmussen; Krogh-Madsen, Rikke;
Plasma follistatin is elevated in patients with low-grade inflammation and insulin resistance as observed with polycystic ovary syndrome. In the present study, we evaluated plasma follistatin in patients with type 2 diabetes characterised by low-grade inflammation and assessed the acute effects of...... hyperglycemia, hyperinsulinemia and LPS on plasma follistatin....
The aim off this thesis was to study the effectiveness of some of the self-care interventions in patients with type 2 diabetes mellitus (T2DM). The self-care interventions that were studied were chromium and cinnamon supplements, a device that aims to lower blood pressure (device guided breathing ex
The presented studies were conducted within the framework of the international ADDITION study (Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care), a randomised controlled trial in 3,057 screen-detected type 2 diabetic patients. The aim of ADDITIO
Type 2 diabetes mellitus (T2DM) develops over many years, providing an opportunity to consider early prognostic tools that guide interventions to thwart disease. Advancements in analytical chemistry enable quantitation of hundreds of metabolites in biofluids and tissues (metabolomics), providing in...
Ronald W. Alfa
Full Text Available Mechanisms of glucose homeostasis are remarkably well conserved between the fruit fly Drosophila melanogaster and mammals. From the initial characterization of insulin signaling in the fly came the identification of downstream metabolic pathways for nutrient storage and utilization. Defects in these pathways lead to phenotypes that are analogous to diabetic states in mammals. These discoveries have stimulated interest in leveraging the fly to better understand the genetics of type 2 diabetes mellitus in humans. Type 2 diabetes results from insulin insufficiency in the context of ongoing insulin resistance. Although genetic susceptibility is thought to govern the propensity of individuals to develop type 2 diabetes mellitus under appropriate environmental conditions, many of the human genes associated with the disease in genome-wide association studies have not been functionally studied. Recent advances in the phenotyping of metabolic defects have positioned Drosophila as an excellent model for the functional characterization of large numbers of genes associated with type 2 diabetes mellitus. Here, we examine results from studies modeling metabolic disease in the fruit fly and compare findings to proposed mechanisms for diabetic phenotypes in mammals. We provide a systematic framework for assessing the contribution of gene candidates to insulin-secretion or insulin-resistance pathways relevant to diabetes pathogenesis.
... is defined as a BMI of 35 to 39.9. As an example, a 5-foot-8 person who weighs 240 pounds has a BMI of 36.5, the CDC says. Weight-loss surgery should also be considered to treat type 2 diabetes in people with a BMI of 30 to ...
LI Ming-zhen; YU De-min; YU Pei; LIU De-min; WANG Kun; TANG Xin-zhi
Background Numerous mitochondrial DNA mutations are significantly correlated with development of diabetes. This study investigated mitochondrial gene, point mutations in patients with type 2 diabetes and their families. Methods Unrelated patients with type 2 diabetes(n=826)were randomly recruited; unrelated and nondiabetic subjects (n=637)served as controls. The clinical and biochemical data of the participants were collected. Total genome was extracted from peripheral leucocytes. Polymerase chain reaction, restriction fragment length polymorphism (PCR-RFLP)and clonig techniques were used to screen mitochondrial genes including np3316,np3394 and np3426 in the ND1 region and np3243 in the tRNALeu (UUR). Results In 39 diabetics with one or more mitochondrial gene point mutations, the prevalence(4.7%,39/826)of mtDNA mutations was higher than that(0.7%,5/637)in the controls. The identical mutation was found in 23 of 43 tested members from three pedigrees. Affected family members presented with variable clinical features ranging from normal glucose tolerance to impaired glucose tolerance (IGT)(n=2),impaired fasting glucose(IFG)(n=1)to type 2 diabetes (n=13)with 3 family members suffering from hearing loss. Conclusions Type 2 diabetes in China is associated with several mitochondrial gene mutations. Aged patients with diabetic family history had a higher prevalence of mutation and various clinical pictures. Mitochondrial gene mutation might be one of the genetic factors contributing to diabetic familial clustering.
INTRODUCTION Diabetes is a worldwide epidemic, causing a high disease and economic burden. Type 2 diabetes, the most common form of diabetes, is associated with overweight and obesity and an unfavourable lifestyle, including unhealthy diet and physical inactivity. Over the last two
Sluijs, I.; Cadier, E.; Beulens, J. W J; van der A, D. L.; Spijkerman, A. M W; van der Schouw, Y. T.
Background and aims: Carotenoids may reduce diabetes risk, due to their antioxidant properties. However, the association between dietary carotenoids intake and type 2 diabetes risk is still unclear. Therefore, the objective of this study was to examine whether higher dietary carotenoid intakes assoc
Bourcelot, Emilie; Combes, Jérôme
Obesity and type 2 diabetes are two complex and multifactorial chronic diseases. Nutritional management is based on an educational and bio-psycho-sensory approach centred on the patient using cognitive-behavioural and emotionally-focused therapy tools. PMID:27157552
Childhood obesity has been linked to cardiovascular disease (CVD) risk in adulthood. Of great concern is the expected increase in the population's CVD burden in relation to childhood obesity. This is compounded by the risk related to chronic hyperglycemia exposure in youth with type 2 diabetes. We h...
The styd objectives were to identify differences in amount and distribution of fat and lean soft tissue in a cross-sectional study of subjects with and without type 2 diabetes, and to determine whether any differences are affected by race/ethnicity or sex. Participants were overweight and obese (bod...
Iyer, S R
The 'U' turn in Type 2 Diabetes Express Highway probably lies in lifestyle modifications--going back to traditional lifestyle with use of modern technology to achieve happiness. There is a difference between technology for comfort and technology for happiness. PMID:12974434
Full Text Available BACK GROUND: The objective of this study is to estimate microalbumin in type - 2 diabetes mellitus patients. METHODS: The sensitive marker for the detection of urine albumin excretion was done by estimation of morning urine sample by semi quantitative procedure by Bayerclinitek50 urine chemistry analyzer. For creatinine jaffes method , fasting blood sugar and post lunch blood sugar were estimated by glucometer and glycosylated hemoglobin ( HbA 1c was analyzed by Merck microlab 120 semi – automated analyzer. RESULTS: In the study significant increase in micro albumin was observed 193.50 ± 7 3.66 ( P<0.0001 in all the patients of type 2 diabetes mellitus which is the predictor of late development diabetic nephropathy. Para meters like fasting blood sugar , post lunch blood sugar , creatinine and glycosylated hemoglobin ( HbA 1c levels were increa sed above the normal range. CONCLUSION : In type 2 diabetes , microalbumin is the hallmark of subsequent diabetic nephropathy and a surrogate marker of cardiovascular diseases and increased cardiovascular mortality. In diabetic nephropathy patients , glomerular filtration rate is increased in early stage of the disease and glomerulopathy is an important renal structural change. Improving glycemic control in patients with type 2 diabetes may subsequently reduce the risk of complications
S. Pecioska (Slavica); M.C. Zillikens (Carola); P. Henneman (Peter); P.J. Snijders (Peter); B.A. Oostra (Ben); C.M. van Duijn (Cock); Y.S. Aulchenko (Yurii)
textabstractBackground: Type 2 diabetes (T2D) is a metabolic disorder characterized by disturbances of carbohydrate, fat and protein metabolism and insulin resistance. The majority of T2D patients are obese and obesity by itself may be a cause of insulin resistance. Our aim was to evaluate whether t
Danquah, Ina; Bedu-Addo, George; Mockenhaupt, Frank P.
A case–control study of 1,466 urban adults in Ghana found that patients with type 2 diabetes mellitus had a 46% increased risk for infection with Plasmodium falciparum. Increase in diabetes mellitus prevalence may put more persons at risk for malaria infection.
Mulnier, H.E.; Seaman, H.E.; Raleigh, V.S.; Soedamah-Muthu, S.S.; Colhoun, H.M.; Lawrenson, R.A.
Aims Under-reporting of diabetes on death certificates contributes to the unreliable estimates of mortality as a result of diabetes. The influence of obesity on mortality in Type 2 diabetes is not well documented. We aimed to study mortality from diabetes and the influence of obesity on mortality in
Dela, Flemming; Prats Gavalda, Clara; Helge, Jørn Wulff
Physical training is known to markedly increase insulin-mediated glucose uptake. This effect occurs predominantly in skeletal muscle and it has been shown in healthy individuals, people with impaired glucose tolerance and in patients with type 2 diabetes. The mechanism/s behind this adaptation in...
Beulens, J.W.J.; Stolk, R.P.; Schouw, van der Y.T.; Grobbee, D.E.; Hendriks, H.F.J.; Bots, M.L.
OBJECTIVE—This study aimed to investigate the relation between alcohol consumption and type 2 diabetes among older women. RESEARCH DESIGN AND METHODS—Between 1993 and 1997, 16,330 women aged 49–70 years and free from diabetes were enrolled in one of the Dutch Prospect-EPIC (European Prospective Stud
Reiling, E.; Jafar-Mohammadi, B.; van't Riet, E.; Weedon, M. N.; van Vliet-Ostaptchouk, J. V.; Hansen, T.; Saxena, R.; van Haeften, T. W.; Arp, P. A.; Das, S.; Nijpels, G.; Groenewoud, M. J.; van Hove, E. C.; Uitterlinden, A. G.; Smit, J. W. A.; Morris, A. D.; Doney, A. S. F.; Palmer, C. N. A.; Guiducci, C.; Hattersley, A. T.; Frayling, T. M.; Pedersen, O.; Slagboom, P. E.; Altshuler, D. M.; Groop, L.; Romijn, J. A.; Maassen, J. A.; Hofker, M. H.; Dekker, J. M.; McCarthy, M. I.; 't Hart, L. M.
LARS2 has been previously identified as a potential type 2 diabetes susceptibility gene through the low-frequency H324Q (rs71645922) variant (minor allele frequency [MAF] 3.0%). However, this association did not achieve genome-wide levels of significance. The aim of this study was to establish the t
E. Reiling (Erwin); B. Jafar-Mohammadi (Bahram); E. van 't Riet (Esther); M.N. Weedon (Michael); J.V. van Vliet-Ostaptchouk (Jana); T. Hansen (Torben); R. Saxena (Richa); T.W. van Haeften (Timon); P.P. Arp (Pascal); S. Das; M.G.A.A.M. Nijpels (Giel); M.J. Groenewoud (Marlous); E.C. van Hove (Els); A.G. Uitterlinden (André); J.W.A. Smit (Jan); A.D. Morris (Andrew); A.S.F. Doney (Alex); C.N.A. Palmer (Colin); C. Guiducci (Candace); A.T. Hattersley (Andrew); T.M. Frayling (Timothy); O. Pedersen (Oluf); P.E. Slagboom (Eline); D. Altshuler (David); L. Groop (Leif); J.A. Romijn; J.A. Maassen (Johannes); M.A. Hofker (Marten); J.M. Dekker (Jacqueline); M.I. McCarthy (Mark); L.M. 't Hart (Leen)
textabstractAims/hypothesis: LARS2 has been previously identified as a potential type 2 diabetes susceptibility gene through the low-frequency H324Q (rs71645922) variant (minor allele frequency [MAF] 3.0%). However, this association did not achieve genome-wide levels of significance. The aim of this
Hemmingsen, Bianca; Schroll, Jeppe B; Wetterslev, Jørn;
BACKGROUND: Guidelines recommend metformin as the first-line oral treatment for type 2 diabetes. We conducted a systematic review to assess whether the use of second- and third-generation sulfonylurea agents is associated with benefits and harms in terms of patient-important outcomes compared with...
Petersen, A B; Knop, F K; Christensen, M
patients with type 2 diabetes, treatment with lixisenatide alone and in combination with insulin and various oral antidiabetics conferred significant reductions in HbA1c, fasting and postprandial plasma glucose. In direct comparison with the other GLP-1R agonists on the market (exenatide and liraglutide...
Park, Jeong Rang; Jung, Tae Sik; Jung, Jung Hwa; Lee, Gyeong-Won; Kim, Me Ae; Park, Ki-Jong; Kim, Deok Ryong; Chang, Se-Ho; Chung, Soon Il; Hahm, Jong Ryeal
Primary hypothyroidism and type 2 diabetes are both typically associated with the increased level of triglycerides. To date, there have been only a few case reports of type 2 diabetes patients with both type V hyperlipoproteinemia and eruptive xanthomas, but there have been no reports of hypothyroidism patients associated with eruptive xanthomas. We report here on a case of a 48-yr old female patient who was diagnosed with type 2 diabetes and primary hypothyroidism associated with both type V...
Pawan Kumar Gupta
Full Text Available The present study was undertaken to observe altered TSH level in type 2 diabetes mellitus and simultaneously a co-relation study done by performing parameters like lipid and thyroid profile in type 2 diabetes mellitus subjects with that of controls. The samples analyzed were 200 which included 100 control group (52 males and 48 females and 100 type-2 diabetes patients (51 males and 49 females, whose fasting venous blood samples had been taken and analyzed for following parameters like blood sugar, serum cholesterol, serum HDL cholesterol, serum LDL cholesterol, calculated VLDL cholesterol, serum triglyceride, serum T3, serum T4, and serum TSH. It has been seen that hypothyroidism and hyperlipidemia had frequently encountered in type-2 diabetes mellitus. These parameters so far have been a better index for monitoring of type-2 diabetes mellitus. The study suggest that there is has been a negative co-relation with Total cholesterol compared to that of T3 and T4, whereas a positive co-relation was observed with TSH. HDL cholesterol had shown a positive co-relation with T3 and T4, and no significant co-relation with TSH. Similarly LDL-Cholesterol had a negative co-relation with T3 and no significant co-relation with T4 and TSH. It was noticed that VLDL had a decreasing co-relation with T3 and T4 but no significant co-relation with that of TSH. The Triglycerides has no significant relation with T3 but decreasing trend have been noticed. A significant negative co-relation with T4 but no co-relation with TSH.
Full Text Available To monitor of type 2 diabetes more simply, conveniently and noninvasively, we are trying to identify the potential urinary peptides that associated with different stages of glucose control in type 2 diabetes mellitus.Firstly, we collected urine samples from type 2 diabetic patients and normal controls. These type 2 diabetic patients were divided into two groups according to fasting plasma glucose (FPG and hemoglobin A1c% (HbA1c, respectively. Magnetic beads based weak cation exchange chromatography (MB-WCX was used to condense urinary peptides. The eluates were then analyzed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS. Subsequently, ClinProt was used to profile and screen the polypeptide patterns based on different methods of grouping in diabetic patients and normal controls. Finally, the amino acid sequences of differentially expressed peptides were identified by nano-liquid chromatography-tandem mass spectrometry and the protein sources of the corresponding peptide were matched in IPI Human database.Proteomics analysis found two up-regulated peptide (m/z 2756.1 and m/z 3223.2 representations in diabetic subjects, and the two peptides increased with increases in the amount of glycosylated hemoglobin. Further, the parallelism between m/z 3223.2 and glycosylated hemoglobin was better than the parallelism between m/z 2756.1 and glycosylated hemoglobin. Area under the receiver operating characteristic of the two peptides was 0.722 and 0.661, respectively. The above-mentioned peptide m/z 2756.1 was further identified as fragment of fibrinogen alpha chain precursor and m/z 3223.2 was fragment of prothrombin precursor.These results suggested the two urinary biomarkers enable monitor of type 2 diabetes patients with different stages of glucose control.
Bloomgarden, Zachary T.; Einhorn, Daniel
Hypoglycemia is well-recognized to limit the degree of glycemic control possible for many individuals for diabetes. Although the likelihood of hypoglycemia increases as A1c levels decrease in type 1 diabetes, insulin-treated type 2 diabetic persons with higher A1c appear paradoxically to have more hypoglycemia which may explain, in part, the adverse outcome reported in the ACCORD study. Approaches to glucose-lowering that cause lesser degrees of risk for hypoglycemia, technologies to better a...
Juul, Lise; Maindal, Helle T; Zoffmann, Vibeke;
Type 2-diabetes er en udbredt metabolisk lidelse, som kan medføre svære helbredsmæssige komplikationer. Forebyggelse kan forhindre mange følgesygdomme, men kræver ofte en stor indsats fra patientens side. Dette studie undersøgte effektiviteten af et uddannelseskursus for sygeplejersker i almen...... praksis. Kurset omhandlede, hvordan man inden for de aktuelle rammer for type 2 diabetes behandling kan anvende ”Self-determination Theory, en motivationsteori om underliggende årsager for handlinger. Effektiviteten blev evalueret i et cluster-randomiseret pragmatisk design, der inkluderede 40 danske...
Khazrai, Y M; Defeudis, G; Pozzilli, P
Type 2 diabetes mellitus is one of the fastest growing diseases; the number of people affected by diabetes will soon reach 552 million worldwide, with associated increases in complications and healthcare expenditure. Lifestyle and medical nutrition therapy are considered the keystones of type 2 diabetes prevention and treatment, but there is no definite consensus on how to treat this disease with these therapies. The American Diabetes Association has made several recommendations regarding the medical nutrition therapy of diabetes; these emphasize the importance of minimizing macrovascular and microvascular complications in people with diabetes. Four types of diets were reviewed for their effects on diabetes: the Mediterranean diet, a low-carbohydrate/high-protein diet, a vegan diet and a vegetarian diet. Each of the four types of diet has been shown to improve metabolic conditions, but the degree of improvement varies from patient to patient. Therefore, it is necessary to evaluate a patient's pathophysiological characteristics in order to determine the diet that will achieve metabolic improvement in each individual. Many dietary regimens are available for patients with type 2 diabetes to choose from, according to personal taste and cultural tradition. It is important to provide a tailor-made diet wherever possible in order to maximize the efficacy of the diet on reducing diabetes symptoms and to encourage patient adherence. Additional randomized studies, both short term (to analyse physiological responses) and long term, could help reduce the multitude of diets currently recommended and focus on a shorter list of useful regimens. PMID:24352832
van Esch, Suzanne C M; Nijkamp, Marjan D; Cornel, Martina C; Snoek, Frank J
In the fight against the type 2 diabetes epidemic, patients might be asked to discuss familial susceptibility to type 2 diabetes in their family. Illness representations of patients (N = 546) were assessed to explore their impact on perceived type 2 diabetes threat in relatives. Reporting high type 2 diabetes burden, emotional impact and perceiving type 2 diabetes as an inheritable disease seemed to increase patients' family risk perception and worries about relatives' future health. Patients with coherent illness understanding reported positive beliefs regarding type 2 diabetes prevention in relatives. Findings may give direction in how illness representations may be used to guide patients in the process of family risk disclosure. PMID:23399919
Type 2 diabetes is a fast-growing epidemic in industrialized countries, associated with obesity, lack of physical exercise, aging, family history, and ethnic background. Diagnostic criteria are elevated fasting or postprandial blood glucose levels, a consequence of insulin resistance. Early intervention can help patients to revert the progression of the disease together with lifestyle changes or monotherapy. Systemic glucose toxicity can have devastating effects leading to pancreatic beta cell failure, blindness, nephropathy, and neuropathy, progressing to limb ulceration or even amputation. Existing treatments have numerous side effects and demonstrate variability in individual patient responsiveness. However, several emerging areas of discovery research are showing promises with the development of novel classes of antidiabetic drugs.The mouse has proven to be a reliable model for discovering and validating new treatments for type 2 diabetes mellitus. We review here commonly used methods to measure endpoints relevant to glucose metabolism which show good translatability to the diagnostic of type 2 diabetes in humans: baseline fasting glucose and insulin, glucose tolerance test, insulin sensitivity index, and body type composition. Improvements on these clinical values are essential for the progression of a novel potential therapeutic molecule through a preclinical and clinical pipeline. PMID:27150090
Full Text Available Currently, type 2 diabetes mellitus and obesity behave as epidemic diseases. Medical treatment has not been able to achieve adequate metabolic control in a sufficient number of patients and is not exempt of complications. Meanwhile, the group of diabetics with severe and morbid obesity that have undergone bariatric surgery have mostly evolved with remission of their diabetes in the medium and long term, so that surgery has become the first choice of treatment. This early post operative remission is not explained by weight loss only, as other mechanisms linked to anatomic and functional changes mediated by surgery are under research. There is a great interest to explore new treatment options for type 2 diabetes including surgery in patients with mild to severe obesity, which has been denominated metabolic surgery.
Barnard, Neal D; Katcher, Heather I; Jenkins, David J A; Cohen, Joshua; Turner-McGrievy, Gabrielle
Vegetarian and vegan diets offer significant benefits for diabetes management. In observational studies, individuals following vegetarian diets are about half as likely to develop diabetes, compared with non-vegetarians. In clinical trials in individuals with type 2 diabetes, low-fat vegan diets improve glycemic control to a greater extent than conventional diabetes diets. Although this effect is primarily attributable to greater weight loss, evidence also suggests that reduced intake of saturated fats and high-glycemic-index foods, increased intake of dietary fiber and vegetable protein, reduced intramyocellular lipid concentrations, and decreased iron stores mediate the influence of plant-based diets on glycemia. Vegetarian and vegan diets also improve plasma lipid concentrations and have been shown to reverse atherosclerosis progression. In clinical studies, the reported acceptability of vegetarian and vegan diets is comparable to other therapeutic regimens. The presently available literature indicates that vegetarian and vegan diets present potential advantages for the management of type 2 diabetes. PMID:19386029
Jaacks, Lindsay M; Siegel, Karen R; Gujral, Unjali P; Narayan, K M Venkat
Around 415 million people around the world have diabetes (9% of adults), and the vast majority live in low- and middle-income countries. Over the next decade, this number is predicted to increase to 642 million people. Given that diabetes is a major cause of mortality, morbidity, and health care expenditures, addressing this chronic disease represents one of the greatest global health challenges of our time. The objectives of this article are three-fold: (1) to present data on the global burden of type 2 diabetes (which makes up 87-91% of the total diabetes burden), both in terms of prevalence and incidence; (2) to give an overview of the risk factors for type 2 diabetes, and to describe obesity and the developmental origins of disease risk in detail; and (3) to discuss the implications of the global burden and point out important research gaps. PMID:27432069
Faerch, Kristine; Hulman, Adam; Solomon, Thomas
Type 2 diabetes is a heterogeneous disease with large variation in the relative contributions of insulin resistance and beta cell dysfunction between subtypes and individuals. Some of these differences are reflected in the way people are diagnosed. However, differences in glucose regulation exist...... among individuals even in those with comparable diagnostic glucose levels. In this review we address the heterogeneity of pre-diabetes and type 2 diabetes with special emphasis on differences in the pathophysiology and treatment responses related to the diagnostic criteria. We also discuss whether novel...... glycaemic markers of diabetes risk can provide additional information to the established diagnostic criteria. A better understanding of the underlying mechanisms responsible for elevated fasting versus postprandial glucose concentration, as well as knowledge about the expected responsiveness to treatment...
Larsen, Claus M; Faulenbach, Mirjam; Vaag, Allan;
proliferation, and apoptosis. METHODS: In this double-blind, parallel-group trial involving 70 patients with type 2 diabetes, we randomly assigned 34 patients to receive 100 mg of anakinra (a recombinant human interleukin-1-receptor antagonist) subcutaneously once daily for 13 weeks and 36 patients to receive......BACKGROUND: The expression of interleukin-1-receptor antagonist is reduced in pancreatic islets of patients with type 2 diabetes mellitus, and high glucose concentrations induce the production of interleukin-1beta in human pancreatic beta cells, leading to impaired insulin secretion, decreased cell...... (P=0.03); C-peptide secretion was enhanced (P=0.05), and there were reductions in the ratio of proinsulin to insulin (P=0.005) and in levels of interleukin-6 (P<0.001) and C-reactive protein (P=0.002). Insulin resistance, insulin-regulated gene expression in skeletal muscle, serum adipokine levels...
Holfort, Stig Kragelund; Jackson, Gregory R; Larsen, Michael
adaptometry was measured in one eye, chosen at random, using a computer-controlled dark adaptometer. Dark adaptation and capillary blood glucose were measured at baseline and 80 minutes into the OGTT/fasting test. Blood glucose remained stable throughout the examination in the 12 fasting subjects, whereas......It was the purpose of the present study to examine dark adaptation in subjects with type 2 diabetes during transient hyperglycemia. Twenty-four subjects with type 2 diabetes and minimal diabetic retinopathy were randomized to undergo an oral glucose tolerance test (OGTT) or to remain fasting. Dark...... to rod-cone break -26%; time to rod intercept -16%, rod sensitivity recovery slope (log units/min) +35%), whereas no measurable change in cone adaptation was seen. The results are consistent with rod adaptation being limited by glycemia and with rod adaptation being delayed in subjects with diabetes...
Krabbe, K. S.; Nielsen, A. R.; Krogh-Madsen, R.;
Aims/hypothesis Decreased levels of brain-derived neurotrophic factor (BDNF) have been implicated in the pathogenesis of Alzheimer's disease and depression. These disorders are associated with type 2 diabetes, and animal models suggest that BDNF plays a role in insulin resistance. We therefore...... and a hyperinsulinaemic-euglycaemic clamp. Results Plasma levels of BDNF in Study 1 were decreased in humans with type 2 diabetes independently of obesity. Plasma BDNF was inversely associated with fasting plasma glucose, but not with insulin. No association was found between the BDNF G196A (Val66Met) polymorphism...... and diabetes or obesity. In Study 2 an output of BDNF from the human brain was detected at basal conditions. This output was inhibited when blood glucose levels were elevated. In contrast, when plasma insulin was increased while maintaining normal blood glucose, the cerebral output of BDNF was not inhibited...
once-daily dosing. Liraglutide use exploits the incretin effect to glucose-dependently stimulate insulin secretion. The LEAD (Liraglutide Effect and Action Diabetes) program evaluated the safety and efficacy of liraglutide and demonstrated an improved level of glycemic control relative to currently...... used oral antidiabetic drugs, including other GLP-1-based therapies. In these trials, liraglutide was shown to enable many patients to achieve hemoglobin A1c (HbA1c) targets and to improve several morbidities commonly associated with type 2 diabetes; liraglutide induced weight loss, reduced systolic...... control blood glucose levels in patients with type 2 diabetes, who commonly present with hypertension and overweight. It is expected to be approved by the U.S. Food and Drug Administration and the European Medicines Agency in Europe for use in 2009....
Objective: To select a subgroup of type-2 diabetics with two additional pre specified risk factors to see that whether there is any benefit of screening such patients. Methodology: Five hundred twenty six patients were sent for treadmill stress test or thallium scan. Those who had abnormal results were advised coronary angiography. The angiographically proven CAD was correlated with various risk factors to find the relationship between the disease and variables. Results: Two hundred thirty five (48%) patients had abnormal results and among them 158 (67%)underwent coronary angiography. Among these 21% had evidence of CAD. Coronary artery bypass grafting (CABG) was performed in 35(33%) patients, catheter based intervention (PCI) in 44(40%) patients and 30(27%) patients were not suitable for intervention. Duration of diabetes, smoking, diabetic retinopathy, albuminuria, and peripheral vascular disease were significant predictor of asymptomatic CAD. Conclusion: This study has demonstrated strong relationship between risk factors and asymptomatic CAD in type 2 diabetics. (author)
This podcast describes research done in Ghana examining a correlation between type 2 diabetes and a possible increased risk for malaria infection in adults. Dr. Manoj Menon, a medical officer in the Division of Parasitic Diseases and Malaria in the Center for Global Health, discusses questions the study raises. Created: 9/23/2010 by National Center for Emerging and Zoonotic Infectious Diseases; Center for Global Health. Date Released: 9/23/2010.
Gayotri Goswami; Nataliya Shinkazh; Nichola Davis
The prevalence of obesity has increased to pandemic levels worldwide and is related to increased risk of morbidity and mortality. Metabolic comorbidities are commonly associated with obesity and include metabolic syndrome, pre-diabetes, and type 2 diabetes. Even if the prevalence of obesity remains stable until 2030, the anticipated numbers of people with diabetes will more than double as a consequence of population aging and urbanization. Weight reduction is integral in the prevention of dia...
Physical activity improves glycemic control and reduces the risk of cardiovascular disease (CVD) and mortality in patients with type 2 diabetes (T2D). Moderate to vigorous physical activity is recommended to manage T2D; however, patients with T2D can be physically weak, making it difficult to engage in the recommended levels of physical activity. Daily physical activity includes various activities performed during both occupational and leisure time such as walking, gardening, and housework th...
Bhartia, Mithun; Tahrani, Abd A; Anthony H Barnett
The prevalence of type 2 diabetes is increasing worldwide. The majority of currently available glucose-lowering agents work via insulin-dependent mechanisms and have significant limitations. Hence, there is a need for newer treatments utilizing novel therapeutic targets. Drugs which inhibit the sodium glucose cotransporter in the renal tubules (SGLT-2 inhibitors), represent a novel class of drugs under development. By inhibiting SGLT-2, they promote increased renal glucose excretion and there...
Schernthaner, G.; Schernthaner, G.-H.
Prevention of cardiovascular morbidity and mortality remains the key factor in the treatment of type 2 diabetes (T2DM). In the early phase of T2DM, multifactorial intervention is mandatory and glucose levels should be near normal, in particular in younger patients presenting with the highest cardiovascular risk. Anti-diabetic drugs without any risk for hypoglycaemia should be preferred in order to reduce clinical inertia and increase the long-term adherence to the treatment. In patients alrea...
Højlund, Kurt; Mogensen, Martin; Sahlin, Kent;
Insulin resistance in skeletal muscle is a major hallmark of type 2 diabetes mellitus (T2D) and obesity that is characterized by impaired insulin-mediated glucose transport and glycogen synthesis and by increased intramyocellular content of lipid metabolites. Several studies have provided evidence...... the molecular mechanisms underlying insulin resistance in human skeletal muscle in T2D and obesity, with a focus on possible links between insulin resistance and mitochondrial dysfunction....
Lagger, G; Chambouleyron, M; Correia, J C; Sittarame, F; Miganne, G; Lasserre Moutet, A; Golay, A
Type 2 diabetes is a potentially reversible disease. Patient education encompasses a deep investment of the health care providers, who with the aid of pedagogic tools, help the pa tient commit to this path. This facilitates the learning of uncommon knowledge and skills required. Whether or not it leads to a complete remission of the disease may not be the main purpose. The main goal lies in the patient's motivation to learn and change on a long term basis. PMID:26027202
Harris, Stewart B; Stewart, Moira; Brown, Judith Belle; Wetmore, Stephen; Faulds, Catherine; Webster-Bogaert, Susan; Porter, Sheila
OBJECTIVE: To further knowledge of diabetes management in family practice. DESIGN Retrospective, observational chart audit study. SETTNG: Southwestern Ontario. PARTICIPANT: A random sample of non-academic family physicians and a random selection of their patients with type 2 diabetes mellitus. MAIN OUTCOME MEASURES: Glycemic control as measured by HbA1c and adherence to recommendations in clinical practice guidelines (CPGs). RESULTS: Eighty-four percent of patients had at least one HbA1c test...
Bharathi; Radhakishan; Naveen Kumar; Neetha; Srilatha
BACK GROUND: The objective of this study is to estimate microalbumin in type - 2 diabetes mellitus patients. METHODS: The sensitive marker for the detection of urine albumin excretion was done by estimation of morning urine sample by semi quantitative procedure by Bayerclinitek50 urine chemistry analyzer. For creatinine jaffes method , fasting blood sugar and post lunch blood sugar were estimated by glucometer and glycosylated hemoglobin (...
Through the lens of Type 2 diabetes this dissertation considers race and problems of difference and risk with developments in treatment, genomic science, and the conduct of research and research priorities. Based primarily on fieldwork in New York and California, I interrogate public health notions of outreach with biotechnology and clinical research concepts of biomedical translation as synonymous practices. Institutional relationships and marketing drivers, I argue, reflect relatedness back...
Chen, Yaojing; Liu, Zhen; Zhang, Junying; Tian, Guihua; Li, Linzi; Zhang, Sisi; Li, Xin; Chen, Kewei; Zhang, Zhanjun
Background The high prevalence of type 2 diabetes mellitus (T2DM) in individuals over 65 years old and cognitive deficits caused by T2DM have attracted broad attention. The pathophysiological mechanism of T2DM-induced cognitive impairments, however, remains poorly understood. Previous studies have suggested that the cognitive impairments can be attributed not only to local functional and structural abnormalities but also to specific brain networks. Thus, our aim is to investigate the chang...
Zhen Liu; Guihua Tian; Linzi Li; Kewei Chen
Background: The high prevalence of type 2 diabetes mellitus (T2DM) in individuals over 65 years old and cognitive deficits caused by T2DM have attracted broad attention. The pathophysiological mechanism of T2DM induced cognitive impairments, however, remains poorly understood. Previous studies have suggested that the cognitive impairments can be attributed not merely to local functional and structural abnormalities but also to specific brain networks. Thus, we aimed to investigate the changes...
Luchsinger, José A.
This manuscript provides a brief review of current concepts in the mechanisms potentially linking type-2-diabetes (T2D) with cognitive impairment. Existing epidemiologic studies, imaging studies, autopsy studies and clinical trials provide insights into the mechanisms linking T2D and cognitive impairment. There seems to be little dispute that T2D can cause cerebrovascular disease and thus cause vascular cognitive impairment (VCI). Whether T2D can cause late onset Alzheimer’s disease (LOAD) re...
Nelson, Peter T.; Smith, Charles D.; Abner, Erin A.; Schmitt, Frederick A.; Scheff, Stephen W.; Davis, Gregory J.; Jeffrey N. Keller; Jicha, Gregory A.; Davis, Daron; Wang, Wang-Xia; Hartman, A; Katz, Douglas G.; Markesbery, William R.
The cerebral neuropathology of Type 2 diabetes (CNDM2) has not been positively defined. This review includes a description of CNDM2 research from before the ‘Pubmed Era’. Recent neuroimaging studies have focused on cerebrovascular and white matter pathology. These and prior studies about cerebrovascular histopathology in diabetes are reviewed. Evidence is also described for and against the link between CNDM2 and Alzheimer’s disease pathogenesis. To study this matter directly, we evaluated dat...
Hoy, W; Light, A; Megill, D
Rates of both type 2 diabetes and cardiovascular disease have risen sharply in recent years among Navajo Indians, the largest reservation-based American Indian tribe, but the association between the two conditions is not entirely clear. Rates of cardiovascular disease and some possible associations in several hundred diabetic and non-diabetic Navajos were estimated. Nearly one-third (30.9 percent) of those with diabetes had formal diagnoses of cardiovascular disease--25.3 percent had heart di...
Brazeau, Anne-Sophie; Hajna, Samantha; Joseph, Lawrence; Dasgupta, Kaberi
Background Studies suggest a relationship between sitting time and cardiovascular disease mortality. Our aim was to identify socio-demographic, contextual, and clinical (e.g., body composition, diabetes duration) correlates of self-reported sitting time among adults with type 2 diabetes, a clinical population at high risk for cardiovascular disease. We sought to determine if there was an inverse relationship between sitting and step counts in a diabetes cohort in whom we had previously identi...
Bowen, Michael E; Rothman, Russell L.
Michael E Bowen1,2, Russell L Rothman2,31Veterans Affairs Quality Scholars Fellowship Program, Tennessee Valley Healthcare System, Tennessee Valley Geriatric Research Education Clinical Center, Nashville, TN, USA; 2Division of General Internal Medicine and Public Health, Department of Medicine, 3Vanderbilt Eskind Diabetes Center, Vanderbilt University School of Medicine, Nashville, TN, USAAbstract: Although once considered a disease of adults, the prevalence of type 2 diabetes in youth is inc...
Awadhesh Kumar Singh
Incretin-based therapy has clearly emerged as one of the most sought out strategy in managing type 2 diabetes, primarily because they generally do not causes hypoglycemia and possess weight-neutral or weight losing properties. Efficacy-wise too, these agents, are more or less similar to commonly used drugs metformin and sulfonylureas. Interestingly, some studies recently suggested that glycemic response to these incretin-based therapies could also differ ethnicity-wise. Subsequently, meta-ana...
Full Text Available Ischemia is one of the main epidemic factors and characteristics of diabetic chronic wounds, and exerts a profound effect on wound healing. To explore the mechanism of and the cure for diabetic impaired wound healing, we established a type 2 diabetic rat model. We used an 8 weeks high fat diet (HFD feeding regimen followed by multiple injections of streptozotocin (STZ at a dose of 10mg/kg to induce Wister rat to develop type 2 diabetes. Metabolic characteristics were assessed at the 5th week after the STZ injections to confirm the establishment of diabetes mellitus on the rodent model. A bipedicle flap, with length to width ratio 1.5, was performed on the back of the rat to make the flap area ischemic. Closure of excisional wounds on this bipedicle flap and related physiological and pathological changes were studied using histological, immunohistochemical, real time PCR and protein immunoblot approaches. Our results demonstrated that a combination of HFD feeding and a low dose of STZ is capable of inducing the rats to develop type 2 diabetes with noticeable insulin resistance, persistent hyperglycemia, moderate degree of insulinemia, as well as high serum cholesterol and high triglyceride levels. The excision wounds on the ischemic double pedicle flap showed deteriorative healing features comparing with non-ischemic diabetic wounds, including: delayed healing, exorbitant wound inflammatory response, excessive and prolonged ROS production and excessive production of MMPs. Our study suggested that HFD feeding combined with STZ injection could induce type 2 diabetes in rat. Our ischemic diabetic wound model is suitable for the investigation of human diabetic related wound repair; especically for diabetic chronic wounds.
Yang, Peilang; Pei, Qing; Yu, Tianyi; Chang, Qingxuan; Wang, Di; Gao, Min; Zhang, Xiong; Liu, Yan
Ischemia is one of the main epidemic factors and characteristics of diabetic chronic wounds, and exerts a profound effect on wound healing. To explore the mechanism of and the cure for diabetic impaired wound healing, we established a type 2 diabetic rat model. We used an 8 weeks high fat diet (HFD) feeding regimen followed by multiple injections of streptozotocin (STZ) at a dose of 10mg/kg to induce Wister rat to develop type 2 diabetes. Metabolic characteristics were assessed at the 5th week after the STZ injections to confirm the establishment of diabetes mellitus on the rodent model. A bipedicle flap, with length to width ratio 1.5, was performed on the back of the rat to make the flap area ischemic. Closure of excisional wounds on this bipedicle flap and related physiological and pathological changes were studied using histological, immunohistochemical, real time PCR and protein immunoblot approaches. Our results demonstrated that a combination of HFD feeding and a low dose of STZ is capable of inducing the rats to develop type 2 diabetes with noticeable insulin resistance, persistent hyperglycemia, moderate degree of insulinemia, as well as high serum cholesterol and high triglyceride levels. The excision wounds on the ischemic double pedicle flap showed deteriorative healing features comparing with non-ischemic diabetic wounds, including: delayed healing, exorbitant wound inflammatory response, excessive and prolonged ROS production and excessive production of MMPs. Our study suggested that HFD feeding combined with STZ injection could induce type 2 diabetes in rat. Our ischemic diabetic wound model is suitable for the investigation of human diabetic related wound repair; especically for diabetic chronic wounds. PMID:27028201
Vicky Cheng; Kashyap, Sangeeta R.
Obesity has been increasing in prevalence worldwide and the majority of patients with type 2 diabetes are either overweight or obese. Diabetes management in this population has been difficult since a number of antidiabetes agents are associated with weight gain. The effects of various antidiabetes agents and antiobesity agents on glycemic control and body weight will be reviewed. Briefly, sulfonylureas, thiazolidinediones, and insulin are associated with weight gain, whereas metformin and amy...
Xinli Jiang; Huijie Ma; Yan Wang; Yan Liu
Type 2 diabetes mellitus (T2DM) is a multifactorial disease, and its aetiology involves a complex interplay between genetic, epigenetic, and environmental factors. In recent years, evidences from both human and animal experiments have correlated early life factors with programming diabetes risk in adult life. Fetal and neonatal period is crucial for organ development. Many maternal factors during pregnancy may increase the risk of diabetes of offsprings in later life, which include malnutriti...
Hertel, J. K.; Johansson, S; Sonestedt, E; Jonsson, A; Lie, R. T.; Platou, C. G. P.; Nilsson, P. M.; Rukh, G.; Midthjell, K.; Hveem, K; Melander, O; Groop, L.; Lyssenko, V.; Molven, A.; Orho-Melander, M
This article contains Supplementary Data online at http://diabetes.diabetesjournals.org/lookup/suppl/doi:10.2337/db10-1340/-/DC1. OBJECTIVE—FTO is the most important polygene identified for obesity. We aimed to investigate whether a variant in FTO affects type 2 diabetes risk entirely through its effect on BMI and how FTO influences BMI across adult life span.RESEARCH DESIGN AND METHODS—Through regression models, we assessed the relationship between the FTO single nucleotide...
Landman, Gijs W.D.; Kleefstra, Nanne; van Hateren, Kornelis J.J.; Groenier, Klaas H; Gans, Rijk O. B.; Bilo, Henk J. G.
OBJECTIVE Several studies have suggested an association between specific diabetes treatment and cancer mortality. We studied the association between metformin use and cancer mortality in a prospectively followed cohort. RESEARCH DESIGN AND METHODS In 1998 and 1999, 1,353 patients with type 2 diabetes were enrolled in the Zwolle Outpatient Diabetes project Integrating Available Care (ZODIAC) study in the Netherlands. Vital status was assessed in January 2009. Cancer mortality rate was evaluate...
Hemminki, Kari; Li, Xinjun; Sundquist, Jan; Sundquist, Kristina
Objectives. Cancer and type 2 diabetes (T2D) are two common diseases that may share risk factors. We aimed at determining subsequent cancer risks in patients hospitalized for T2D in Sweden. Methods. T2D patients were obtained from the nationwide Hospital Discharge Register; cancers were recorded from the Swedish Cancer Registry. Standardized incidence ratios (SIRs) were calculated for cancer following last hospitalization for T2D. The comparison group was the general Swedish population. Resul...
Multiple myeloma is a malignant plasma cell disorder that accounts for approximately 10% of all hematologic cancers. It is characterized by accumulation of clonal plasma cells, predominantly in the bone marrow. The prevalence of type 2 diabetes is increasing; therefore, it is expected that there will be an increase in the diagnosis of multiple myeloma with concomitant diabetes mellitus. The treatment of multiple myeloma and diabetes mellitus is multifaceted. The coexistence of the two conditi...
Zwain, Akeel AMH; Hadi, Najah R.; Al-Mudhaffer, Ahmed M
Background: Conflicting reports exist on the effect of sildenafil on ophthalmic artery blood flow; many visual disturbances due to vascular insult were reported with the use of sildenafil in diabetic patients like nonarteritic ischemic optic neuropathy. Objectives: The present work aimed to investigate whether sildenafil modulates ophthalmic artery vasoreactivity in patients with type 2 diabetes mellitus. Literature reports on this aspect are lacking. Methods: A total of 35 male subjects were...
Type 2 diabetes is a chronic disease and maintaining a tight glycemic control is essential to prevent both microvascular and macrovascular complications, as demonstrated in previous studies. It is essential to monitor the glucose levels in order to achieve the targets. The blood glucose monitoring can be done by different methods: glycated haemoglobin A1c, self-monitoring of blood glucose (before and after meals) with a glucometer and continuous glucose monitoring with a system that measures ...
The medical treatment of retinopathy in type-2 diabetes should be considered as a major component in the overall management of diabetic retinal disease. It is clear that specific and timely interventions, such as glycemic and blood pressure control, are the basis for good management of diabetic retinopathy. The American Diabetes Association has developed specific recommendations concerning diabetic retinopathy for the primary care physician and diabetologist. The ophthalmologist must be aware...
Objective: To determine the frequency of erectile dysfunction in married male Type-2 diabetic patients. Methods: The cross-sectional observational study was carried out at the Endocrinology, Diabetes and Metabolic Diseases Unit Hayatabad Medical Complex, Peshawar, from July 2011 to Apr 2012, comprising 217 male married Type-2 diabetic patients. Serum samples were assayed for blood glucose, lipid profile and glycated haemoglobin A1c. Body mass index and waist-to-hip ratio was calculated. Erectile dysfunction was assessed by Sexual Health Inventory for Men questionnaire. SPSS 18 was used for statistical analysis. Results: A total of 217 patients were initially interviewed. The mean age was 43.1+-8.160 years. The frequency of drectile dysfunction increased with age, duration of patients and increased body mass index. Overall, 6 (2.8%) patients had no erectile dysfunction, 37 (17.1%) had mild, 82 (37.8%) mild to moderate; 47 (21.7%) moderate; and 45 (20.7%) severe. Higher HbA1c levels and atherogenic dyslipidaemia were associated with erectile dysfunction. Conclusion: Poor glycaemic control was associated with increased erectile dysfunction risk. Duration of diabetes, older age, increased body mass index are associated with increased incidence of the condition in patients with diabetes. Intensive lifestyle changes in the beginning can add to the better management of Type-2 diabetes and prevention of erectile dysfunction. (author)
Full Text Available Aims. Diabetes is considered a state of increased oxidative stress. This study evaluates blood concentrations of selected markers of antioxidant defense in patients with type 2 diabetes. Methods. The study included 80 type 2 diabetes patients and 79 apparently healthy controls. Measured markers included ferric reducing ability of plasma (FRAP, reduced glutathione (GSH, glutathione peroxidase (GPx, glutathione reductase (GR, γ-glutamyltransferase (GGT and uric acid serum, and plasma and/or hemolysate levels. Results. FRAP, uric acid, CRP, and GGT levels were significantly higher in patients with diabetes. Plasma and hemolysate GR was significantly higher whereas GPx activity was significantly lower in patients with diabetes. There were no significant differences in antioxidant defense markers between patients with and without chronic diabetes complications. Fasting serum glucose correlated with plasma GPx, plasma and hemolysate GR, FRAP, and serum GGT, and HbA1c correlated with serum GGT. Only FRAP and serum uric acid were significantly higher in obese (BMI>30 kg/m2 patients with diabetes than in nonobese patients. Conclusions. Some components of antioxidant defense such as GR, uric acid, and GGT are increased in patients with type 2 diabetes. However, the whole system cannot compensate for an enhanced production of ROS as reflected by the trend toward decreased erythrocytes GSH.
Full Text Available The prevalence of obesity has increased to pandemic levels worldwide and is related to increased risk of morbidity and mortality. Metabolic comorbidities are commonly associated with obesity and include metabolic syndrome, pre-diabetes, and type 2 diabetes. Even if the prevalence of obesity remains stable until 2030, the anticipated numbers of people with diabetes will more than double as a consequence of population aging and urbanization. Weight reduction is integral in the prevention of diabetes among obese adults with pre-diabetes. Lifestyle intervention and weight reduction are also key in the management of type 2 diabetes. Weight loss is challenging for most obese patients, but for those with diabetes, it can pose an even greater challenge due to the weight gain associated with many treatment regimens. This article will review optimal treatment strategies for patients with comorbid obesity and type 2 diabetes. The role of anti-obesity agents in diabetes will also be reviewed. This literature review will provide readers with current strategies for the pharmacologic treatment of obesity and diabetes with a focus on the weight outcomes related to diabetes treatments.
Full Text Available As in other countries, type 2 diabetes is major health concern in Korea. A dramatic increase in the prevalence of type 2 diabetes and its chronic complications has led to an increase in health costs and economic burdens. Early detection of high risk individuals, hidden diabetic patients, and improvement in the quality of care for the disease are the first steps to mitigate the increase in prevalence. The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the '3rd Clinical Practice Guidelines' at the end of 2010. In the guidelines, the committee recommended active screening of high risk individuals for early detection and added the hemoglobin A1c level to the diagnostic criteria for type 2 diabetes based on clinical studies performed in Korea. Furthermore, the committee members emphasized that integrating patient education and self-management is an essential part of care. The drug treatment algorithm based on the degree of hyperglycemia and patient characteristics were also updated.
Full Text Available Eric Dietrich,1 Jason Powell,2 James R Taylor2 1University of Florida College of Medicine, Department of Community Health and Family Medicine, 2University of Florida College of Pharmacy, Department of Pharmacotherapy and Translational Research, Gainesville, FL, USA Abstract: Type 2 diabetes continues to be a challenging disease to manage. The addition of new agents with a positive risk–benefit ratio could potentially assist clinicians and patients in achieving adequate diabetes control. Canagliflozin, the first sodium-glucose cotransporter 2 inhibitor presently available on the market, offers a unique mechanism of action: it inhibits renal reabsorption of glucose, thereby increasing urinary glucose excretion. It reduces hemoglobin A1c by approximately 0.37%–1.16%; it also reduces the patient's weight and systolic blood pressure and has a low risk for hypoglycemia. Adverse effects include an increased risk of urinary tract infections and genital mycotic infections. In this manuscript we review canagliflozin and its potential role in management of type 2 diabetes mellitus. Keywords: canagliflozin, SGLT2 inhibitor, type 2 diabetes, oral hypoglycemic
Ozanne, Susan E; Hales, C Nick
Epidemiological studies have revealed strong and internationally reproducible links between early growth restriction and subsequent risk of developing type 2 diabetes and the metabolic syndrome (glucose intolerance, hypertension and hypertriglyceridaemia). This effect can exist independently of genetic factors. There is also direct evidence that poor maternal nutrition and maternal smoking cause both a reduction in birthweight and subsequent loss of glucose tolerance. High rates of growth in childhood may add to these effects. The 'thrifty phenotype' hypothesis attempts to explain these associations in terms of an altered programming of growth and metabolism that aids survival both pre- and postnatally. Type 2 diabetes is envisaged as a consequence of a clash of this programming with adult obesity. Tests of this hypothesis in animal models have shown that both the metabolic syndrome and type 2 diabetes can result from early growth restriction in rats consequent upon rat dams being fed a reduced protein, isocaloric diet (in which the protein is replaced by an equal quantity of nonprotein energy). A variety of other models of early growth restriction in rats lead to a similar phenotype. Several structural and gene expression changes have been shown in many tissues, including pancreas, liver, kidney, muscle and adipose tissue. Changes in gene expression include those concerned with hormone receptors, signalling and glycolytic enzymes. Many important questions remain for future research. PMID:14987383
The objective of the study was to estimate the most successful way of treating patients with type 2 diabetes mellitus. A total of 87 patients with type 2 diabetes mellitus were selected for a three-month study. The patients were divided into three groups comprising 29 patients in each group, based upon the treatment regimen. Group 1 (BMI 32.3+-3.6 kg/m2) was treated with glimepiride and metformin; group 2 (BMI 27.9+-3.9) was treated with daily doses of insulin mixture 30/70 and bed-time NPH insulin; and group 3 (BMI 30.02+-4.8) was treated with a combination of three daily doses of lispo and metformin.The groups did not differ significantly in terms of sex and age. Initially, there were significant statistical differences in HbA1c (P=0.035) between the three groups (9, 21%+-1.72%; 9.21%+-1.54%; and 10, 0%+-1.73% respectively). After three months there were no statistically differences in HbA1c (P=0.66) between the groups (8.52+-1.7%; 8.03%+-1.05%; and 8.0%+-0.63%, respectively. Decreases in HbA1c were significant in all groups, but most pronounced in patients treated with lispro and metaformin (17% on average). The study results suggest the need for establishing guidelines on how to treat type 2 diabetics. (author)
Reinhard, Henrik; Lajer, Maria Stenkil; Gall, Mari-Anne; Tarnow, Lise; Parving, Hans-Henrik; Rasmussen, Lars Melholt; Rossing, Peter
OBJECTIVE Plasma osteoprotegerin (OPG) is an emerging strong and independent predictor of cardiovascular disease (CVD) in high-risk populations. OPG is a bone-related glycopeptide produced by vascular smooth muscle cells, and increased plasma OPG levels may reflect arterial vascular damage. We ai...... predictor of all-cause mortality in type 2 diabetic patients. The effect of OPG on all-cause mortality was independent of conventional cardiovascular risk factors, UAER, and NT-proBNP levels....... aimed to investigate the prognostic value of OPG in relation to all-cause and cardiovascular mortality in a cohort of type 2 diabetic patients. RESEARCH DESIGN AND METHODS In a prospective observational follow-up study, 283 type 2 diabetic patients (172 men; aged 53.9 ± 8.8 years) were followed for a...... filtration rate, and conventional risk factors); hazard ratio (HR) 1.81 [95% CI 1.21-2.69]. The all-cause predictive effect of OPG was independent of NH(2)-terminal pro-brain natriuretic peptide (NT-proBNP) and was also useful within groups divided according to level of UAER. In total, 103 (73%) patients...
Monica Reddy, R P; Inzucchi, Silvio E
The glucose-lowering pharmacopeia continues to grow for patients with type 2 diabetes. The latest drug category, the SGLT2 inhibitors reduce glycated hemoglobin concentrations by increasing urinary excretion of glucose. They are used mainly in combination with metformin and other antihyperglycemic agents, including insulin. Their glucose-lowering potency is modest. Advantages include lack of hypoglycemia as a side effect, and mild reduction in blood pressure and body weight. Side effects include increased urinary frequency, owing to their mild diuretic action, symptoms of hypovolemia, genitourinary infections. There are also recent reports of rare cases of diabetic ketoacidosis occurring in insulin-treated patients. Recently, a large cardiovascular outcome trial reported that a specific SGLT2 inhibitor, empagliflozin, led to a reduction in the primary endpoint of major cardiovascular events. This effect was mainly the result of a surprising 38 % reduction in cardiovascular death, and the drug was also associated with nearly as large a reduction in heart failure hospitalization. These findings were notable because most drugs used in type 2 diabetes have not been shown to improve cardiovascular outcomes. Accordingly, there is growing interest in empagliflozin and the entire SGLT2 inhibitor class as drugs that could potentially change the manner in which we approach the management of hyperglycemia in patients with type 2 diabetes. PMID:27270407
Full Text Available Abstract Background It has been established that careful diabetes self-management is essential in avoiding chronic complications that compromise health. Disciplined diet control and regular exercise are the keys for the type 2 diabetes self-management. An ability to maintain one's blood glucose at a relatively flat level, not fluctuating wildly with meals and hypoglycemic medical intervention, would be the goal for self-management. Hemoglobin A1c (HbA1c or simply A1c is a measure of a long-term blood plasma glucose average, a reliable index to reflect one's diabetic condition. A simple regimen that could reduce the elevated A1c levels without altering much of type 2 diabetic patients' daily routine denotes a successful self-management strategy. Methods A relatively simple model that relates the food impact on blood glucose excursions for type 2 diabetes was studied. Meal is treated as a bolus injection of glucose. Medical intervention of hypoglycaemic drug or injection, if any, is lumped with secreted insulin as a damping factor. Lunch was used for test meals. The recovery period of a blood glucose excursion returning to the pre-prandial level, the maximal reach, and the area under the excursion curve were used to characterize one's ability to regulate glucose metabolism. A case study is presented here to illustrate the possibility of devising an individual-based self-management regimen. Results Results of the lunch study for a type 2 diabetic subject indicate that the recovery time of the post-prandial blood glucose level can be adjusted to 4 hours, which is comparable to the typical time interval for non-diabetics: 3 to 4 hours. A moderate lifestyle adjustment of light supper coupled with morning swimming of 20 laps in a 25 m pool for 40 minutes enabled the subject to reduce his A1c level from 6.7 to 6.0 in six months and to maintain this level for the subsequent six months. Conclusions The preliminary result of this case study is encouraging
Full Text Available Abstract Objective Increasing evidence indicates that type 2 diabetic patients are at elevated risk for developing different kinds of cancers. However, diabetes mellitus may be a protective factor for prostate cancer since both were found to be negatively associated. Based on the same genetic background, parents of diabetic patients might show similar risks concerning cancers. Research design and methods We conducted a case-control study, where familiy history of 794 type 2 diabetic cases and 775 non-diabetic controls was ascertained. Then, we expanded our study up to 801 type 2 diabetic cases and 1267 non-diabetic controls. Results Concerning the 794 type 2 diabetic patients and 775 controls, we observed that cancer of cervix uteri was elevated among mothers of controls (odds ratio (OR 0.19; 95% confidence interval (CI 0.02 to 0.88; p = 0.033. Mothers of diabetic patients showed an increased history of cancers of the liver and biliary tract (OR 5.23; 95% CI 1.87 to 19.9; p = 0.0009 and stomach (OR 3.84; 95% CI 1.47 to 12.4; p = 0.0049. Pancreatic cancers were found to be elevated in fathers of diabetic patients (OR 4.92; 95% CI 1.07 to 46.7; p = 0.039. Most notably, a lower number of prostate cancers was observed in fathers of diabetic patients (OR 0.47; 95% CI 0.22 to 0.94; p = 0.032. Since diabetic patients were 14.3 years older than the controls, higher levels of cancer history among parents of diabetic patients would have been expected. Thus, the observed lower level of history of prostate cancer can be regarded as highly reliable. The analysis of 801 type 2 diabetics and 1267 controls showed that cancer of stomach was elevated among mothers of controls (OR 2.67; p = 0.0106. In addition, stomach cancers were found to be elevated in fathers of diabetic patients (OR 2.10; p = 0.0141. In accordance with the previous investigation, we again obseved a lower number of prostate cancers in fathers of diabetic patients (OR 0.49; p = 0.0279. However
... being more active. Astudy of people at high risk for type 2 diabetes found that people could lower their ... inactive If you develop prediabetes, you’re at risk for type 2 diabetes and heart disease. But you can ...
... in the Right Direction: Lose Weight & Lower Your Risk for Type 2 Diabetes by the National Diabetes Education Program ... it comes to losing weight to lower your risk for type 2 diabetes. The National Diabetes Education Program (NDEP) ...
Rasmussen, K.L.; Laugesen, C.S.; Nielsen, Lene Ringholm;
We studied the progression of diabetic retinopathy during pregnancy in women with type 2 diabetes.......We studied the progression of diabetic retinopathy during pregnancy in women with type 2 diabetes....
BARUTÇUOGLU, Burcu; PARILDAR, Zuhal; MUTAF, M. Işıl; Özmen, Dilek; ALİOĞLU, Emin; HABİF, Sara; BAYINDIR, Oya
Hypertension and type 2 diabetes mellitus (DM) cause endothelial dysfunction and may result in cardiovascular disease. The aim of this study was to assess endothelial dysfunction in essential hypertensives, and normotensive and hypertensive type 2 diabetics and to evaluate the effect of telmisartan on endothelium in hypertensives. Materials and methods: Eighteen essential hypertensives (group 1), 16 type 2 diabetic hypertensives (group 2), 10 type 2 diabetic normotensives (group 3), and 10 c...
Qi, Qibin; Liang, Liming; Doria, Alessandro; Hu, Frank B.; Qi, Lu
Dyslipidemia has been associated with type 2 diabetes, but it remains unclear whether dyslipidemia plays a causal role in type 2 diabetes. We aimed to examine the association between the genetic predisposition to dyslipdemia and type 2 diabetes risk. The current study included 2,447 patients with type 2 diabetes and 3,052 control participants of European ancestry from the Nurses’ Health Study and the Health Professionals Follow-up Study. Genetic predisposition to dyslipidemia was estimated by...
Li, S; J. H. Zhao; Luan, J.; Langenberg, C.; Luben, R. N.; Khaw, K T; Wareham, N. J.; Loos, R. J. F.
Aims/hypothesis Obesity is a major risk factor for type 2 diabetes. Recent genome-wide association (GWA) studies have identified multiple loci robustly associated with BMI and risk of obesity. However, information on their associations with type 2 diabetes is limited. Such information could help increase our understanding of the link between obesity and type 2 diabetes. We examined the associations of 12 obesity susceptibility loci, individually and in combination, with risk of type 2 diabete...
Revdal, Anders; Hollekim-Strand, Siri Marte; Ingul, Charlotte Bjørk
Exercise is considered a cornerstone in the prevention and treatment of type 2 diabetes, but few individuals with type 2 diabetes exercise according to guidelines. We investigated the effect of two time efficient high intensity exercise interventions on exercise capacity, glycemic control and other cardiometabolic risk factors in patients with type 2 diabetes. Twenty-one individuals with type 2 diabetes were randomly assigned to low volume high intensity interval exercise...
Anders Revdal, Siri M. Hollekim-Strand, Charlotte B. Ingul
Exercise is considered a cornerstone in the prevention and treatment of type 2 diabetes, but few individuals with type 2 diabetes exercise according to guidelines. We investigated the effect of two time efficient high intensity exercise interventions on exercise capacity, glycemic control and other cardiometabolic risk factors in patients with type 2 diabetes. Twenty-one individuals with type 2 diabetes were randomly assigned to low volume high intensity interval exercise (HIIE; 27 minutes/bo...
Full Text Available ABSTRACT: CONTEXT: Individuals with morbid obesity and type 2 diabetes benefit from weight loss, as this allows better glycemic control and modifies the coexisting risk factors for coronary heart disease, namely hypertension, dyslipid emia, insulin resistance, sleep apnea, and other comorbidities that constitute the metabolic s yndrome. AIMS: The purpose of the present study was to investigate whether weight loss after bariatric surgery can correct glycemic control and reduces the need of anti-diabetic treat ment in morbidly obese patients with type 2 diabetes. SETTINGS AND DESIGN: This is a prospective cohort study performed in Sri Aurobindo Medical College & PG Institute, Indore. S ampling done was nonrandom and purposive. METHODS AND MATERIAL: Forty patients with body mass index (BMI > 35 and had known type 2 diabetes were enrolled in study, al l these patient undergone bariatric surgery. Their obesity status in terms of height, weight and BMI, Glycemic status in terms of fasting blood sugar (FBS, postprandial blood sugar (PPBS and glycosylated haemoglobin (HbA1c, and treatment status in terms of oral hypoglycemic a gents and insulin were noted in details preoperatively Statistical analysis used: Quantitative variables w ere tested using Chi square test and p values were calculated between two groups. p val ue of ≤ 0.05 was considered statistically significant. Averages were expressed between groups a s mean ± standard deviation or percentage. RESULTS: Our study shows good control of glycemic status af ter bariatric surgery with mean HbA1c within desired level after 6 months of bariatric surgery. CONCLUSIONS: In conclusion, our study shows that bariatric surgery is an effective option for morbidly obese patients with type 2 diabetes mellitus. Weight loss d ue to surgery is strongly associated with good glycemic control and improved treatment efficac y.
Seyed Esmaeil Managheb
Full Text Available Compiling clinical guidelines is one of the requirements of family physician plan and classification of health care services.1 The high prevalence of type 2 diabetes can easily be seen in general practice so that 2.5% of referrals to general practitioners are due to diabetes. More than half of the patients with Type 2 diabetes are left undiagnosed and most of them suffer from its complications at the time of diagnosis. For example, 6.2% of patients suffer from diabetic retinopathy at the time of diagnosis.2 Most patients diagnosed with diabetes take more than one type of medication to treat the complications; about 60% take only oral medications, and 14 percent take oral medications and insulin.3 Although the principles of care for people with Type 2 diabetes is well known, there is a gap between the quality of care in general practice and optimal care so that up to 50% of patients’ condition are weakly controlled.4 Chronic care model for patients with chronic diseases explains the necessary measures to improve the care of people with chronic diseases. These elements include supporting disease management by the patients themselves, patient care, and support teams. Consultation and training are often done in general practice while it is usually a brief consultation about weight, medication or exercise. There is little evidence that mere printed texts are effective in controlling the disease. Extensive training programs are designed to develop self-management skills for diabetes control.4 The implementation of clinical guidelines in medical practice is a challenging task. But, a number of evidences have been shown to accelerate effective clinical guideline implementation and care improvement.5 Management of diabetes mellitus type 2 is shown in Figure 1.
Palsgaard, Jane; Brøns, Charlotte; Friedrichsen, Martin;
BACKGROUND: Gene expression alterations have previously been associated with type 2 diabetes, however whether these changes are primary causes or secondary effects of type 2 diabetes is not known. As healthy first degree relatives of people with type 2 diabetes have an increased risk of developing...
Full Text Available INTRODUCTION: Sleep disorders are reported due to varied reasons and are on the rise. Diabetes is established as the one of the reasons for alterations in the quality of sleep. Studies have established that nicotine acts on the neurotransmitter system and influence the quality of sleep. Nicotine use by the diabetic patients is an added factor and will interfere with their quality of sleep. The objectives of the study were to assess the quality of sleep among uncontrolled and uncomplicated type 2 diabetics with and without nicotine dependence and to find out the effect of nicotine in the day time functioning of the study population. MATERIALS AND METHODS: This study was carried out in a tertiary care teaching hospital among 50 individuals without Nicotine dependence and 50 individuals with Nicotine dependence of uncontrolled and uncomplicated known type 2 Diabetes mellitus. A pretested questionnaire, Fagerstrom test form for Nicotine dependence for smokers, the Pittsburg Sleep Quality Index and Epworth Sleepiness Scale were used to collect data from the study subjects in order to assess the quality of sleep among the study group. RESULTS: The sleep quality among the smokers was different in terms of time of going to bed, time to sleep, hours of sleep, time taken to fall asleep, waking up in the middle of sleep, breathing problem, pain in the leg, and afternoon nap and cough or snore during sleep [p0.05]. In this study, 92% of the smokers belonged to the low to moderate dependence category as per the Fagerstrom test. DISCUSSION: The sleep quality of low and moderate nicotine dependent type 2 diabetics differed significantly from the non-nicotine users. Most of the study population belonged to low to moderate nicotine dependence [92%]. Health education and enforcement on prevention of smoking in public places is found to have an effect on the Nicotine use in Tamil Nadu.
Standl, Eberhard; Schnell, Oliver; McGuire, Darren K
Prevalent and incident heart failure (HF) is increased in people with type 2 diabetes mellitus, with risk directly associated with the severity of hyperglycemia. Furthermore, in patients with type 2 diabetes mellitus, mortality is increased ≈10-fold in patients with versus without HF. Reducing HF with antihyperglycemic therapies, however, has been unsuccessful until recently. In fact, HF as an important outcome in patients with type 2 diabetes mellitus seems to be heterogeneously modulated by antihyperglycemic medications, as evidenced by results from cardiovascular outcome trials (CVOTs) and large observational cohort studies. Appropriately powered and executed CVOTs are necessary to truly evaluate cardiovascular safety and efficacy of new antihyperglycemic medications, as reflected by the guidance of the US Food and Drug Administration and other regulatory agencies since 2008. In light of the best available evidence at present, metformin and the sodium-glucose-co-transporter 2-inhibitor empagliflozin seem to be especially advantageous with regard to HF effects, with their use associated with reduced HF events and improved mortality. Acarbose, the dipeptidyl-peptidase 4-inhibitor sitagliptin, the glucagon-like peptide 1-receptor agonist lixisenatide based on presently available CVOT results comprise reasonable additional options, as significant harm in terms of HF has been excluded for those drugs. Additions to this list are anticipated pending results of ongoing CVOTs. Although no HF harm was seen in CVOTs for insulin or sulfonylureas, they should be used only with caution in patients with HF, given their established high risk for hypoglycemia and some uncertainties on their safety in patients with HF derived from epidemiological observations. Pioglitazone is contraindicated in patients with HF>New York Heart Association I, despite some benefits suggested by CVOT subanalyses. PMID:27230644
Full Text Available Introduction: Helicobacter pylori (H. pylori infection has been associated with increased levels of inflammatory cytokines and subsequent insulin resistance and epidemiologically linked to type 2 diabetes. Objectives: To study the prevalence rate of H. pylori infection in type 2 diabetes and its relation with HbA1C levels. Materials and Methods: In this cross-sectional case-control study, 80 patients (≥18 years who met the Americans with Disabilities Act (ADA criteria for diabetes were recruited. Similarly, 60 age, sex, and education matched healthy controls were taken. They were tested for H. pylori infection by rapid urease test, histological examination of antral endoscopic biopsy specimens and serology. The relationship between H. pylori infection and levels of plasma glucose and HbA1C was assessed. Results: Out of the 80 patients of type 2 diabetes, H. pylori infection was found in 62 (77.5% while it was present in only 35 (58.3% of 60 controls, which was found to be significant (Chi-square test: 5.919, df = 1, P value = 0.015. Mean HbA1C among diabetics with H. pylori infection was 8.19 ± 1.16% and without H. pylori infection was 6.9 ± 0.84% (t = 4.3872, P value = 0.0001. Conclusions: Prevalence of H. pylori infection was significantly higher in diabetes as compared to controls. Presence of H. pylori infection significantly correlated with the level of HbA1C.
Lee, Shaun Wen Huey; Lee, Jun Yang; Tan, Christina San San; Wong, Chee Piau
Abstract Ramadan is the holy month for Muslims whereby they fast from predawn to after sunset and is observed by all healthy Muslim adults as well as a large population of type 2 diabetic Muslims. To determine the comparative effectiveness of various strategies that have been used for type 2 diabetic Muslim who fast during Ramadan. A systematic review and network meta-analysis of randomized controlled studies (RCT) as well as observational studies for patients with type 2 diabetes who fasted during Ramadan was conducted. Eight databases were searched from January 1980 through October 2015 for relevant studies. Two reviewers independently screened and assessed study for eligibility, assessed the risk of bias, and extracted relevant data. A network meta-analysis for each outcome was fitted separately, combining direct and indirect evidence for each comparison. Twenty-nine studies, 16 RCTs and 13 observational studies each met the inclusion criteria. The most common strategy used was drug changes during the Ramadan period, which found that the use of DPP-4 (Dipeptidyl peptidase inhibitor -4) inhibitors were associated with a reduction in incidence of experiencing hypoglycemia during Ramadan in both RCTs (pooled relative risk: 0.56; 95% confidence interval: 0.44–0.72) as well as in observational studies (pooled relative risk: 0.27; 0.09–0.75). Ramadan-focused education was shown to be beneficial in reducing hypoglycemia in observational studies but not RCTs (0.25 versus 1.00). Network meta-analyses suggest that incretin mimetics can reduce the risk of hypoglycemia by nearly 1.5 times. The newer antidiabetic agents appear to lower the risk of hypoglycemia and improved glycemic control when compared with sulfonylureas. Ramadan-focused education shows to be a promising strategy but more rigorous examination from RCTs are required. PMID:26765440
To evaluate ratios of serum triglycerides and cholesterol levels which may indicate postprandial lipid handling and to assess their role as prospective markers of dyslipidaemia in type 2 diabetes mellitus. The study comprised 160 subjects, including 83 known type 2 diabetics (45 males, 38 females) and 77 age-matched controls (45 males, 32 females). Fasting blood samples were analysed for serum triglycerides and total cholesterol, using automated chemistry analyzer. HDL-C was determined by precipitation method and LDL-C and VLDL-C were estimated by Friedewalds formula. LDL/HDL ratio and TG/HDL ratios were also calculated. The mean values for male and female diabetics were compared with that for the male and female non-diabetics respectively and tested for significance by paired t-test. Serum triglycerides and VLDL were raised in both male and female diabetics. No significant differences were observed in levels of serum total cholesterol, LDL, HDL and the LDL/HDL ratio. The mean value of the TG/HDL ratio for male diabetics was higher than that for the male non-diabetics (p=0.39). A statistically significant difference was found in the TG/HDL ratios for the female diabetics and non-diabetics (p<0.05). In this study, type 2 diabetics showed marked hypertriglyceridaemia and raised TG/HDL ratio. The dyslipidaemia of diabetes predisposes to development of coronary heart disease and therefore, evaluation of the TG:HDL ratio may provide a good tool to monitor and manage the lipid abnormalities in diabetics. (author)
Full Text Available Background: Sexual dysfunction (SD is one of the important problems in diabetic patients. The present study aimed to determine the prevalence of sexual problems in Iranian women with type 2 diabetes mellitus. Methods: A cross-sectional study was conducted among type 2 diabetic women who visited two outpatient endocrine clinics, namely Imam Hospital and Tuba clinic (Sari, Iran in 2012. Patients were asked to complete two validated questionnaires: Female Sexual Function Index (FSFI and The Hospital Anxiety and Depression Scale (HADS as well as a demographic questionnaire. Analysis was performed using descriptive and analytical tests. P<0.05 was considered to be significant. Results: One hundred and fifty women with type 2 diabetes were investigated. Most of the cases aged 40-44 years old. The mean of the total score of the FSFI questionnaire was 22. The prevalence of sexual dysfunction was 78.7% (CI: 71.4-84.4; among these, 58% (CI: 50.0-65.6 reported problems in lubrication, 50% (CI: 42.1-57.9 complained of decreased sexual desire, 50% (CI: 42.1-57.9 had problems with arousal, 47.3% (CI: 39.5-55.3 had dyspareunia, 32.7% (CI: 25.7-40.5 complained of orgasmic dysfunction and 42.7% (CI: 35.0-50.7 reported problems in sexual satisfaction. With regard to the results of the HADS questionnaire, 58.7% (CI: 50.7-66.2 of the patients had depression and 96.7% (CI: 92.4-98.6 had anxiety. Conclusion: This study showed the high prevalence of sexual dysfunction in diabetic women, especially among those complaining of depression. Health care professionals dealing with diabetic patients should be aware of possible presence of sexual dysfunction in female patients.
Background: Diabetes, Hypertension, Obesity and Ischaemic Heart Disease have become a problem of public health magnitude with substantial economic burden both in the developed as well as the developing countries. Obesity is quite frequent in Type 2 diabetics and also plays a central role in causing Metabolic Syndrome (MetS). Metabolic Syndrome significantly increases the incidence of cardiovascular complications. This study was done to determine the frequency of MetS in our Type 2 diabetic patients as most of the components of MetS can be modified and identifying/managing these at an early stage might be of considerable help in reducing cardiovascular complications. Methods: This cross-sectional study was done in Medical B and Medical A wards of Ayub Teaching Hospital, Abbottabad from Nov, 08 to April, 09. Type 2 Diabetic patients aged above 40 years who gave informed consent were included in the study. Data was collected through a structured proforma. Frequency of Metabolic Syndrome was estimated according to the IDF consensus worldwide definition of the MetS. Results: Of the 100 patients enrolled in this study 56 were females and 44 were males with a mean age of 59.9 years. Out of these 100 participants seventy six (76%) were diagnosed to have metabolic syndrome. Of the 56 females, forty eight (85.71%) were having metabolic syndrome while twenty eight (63.63%) of the 44 male participants were having the syndrome. The difference was statistically significant (p<0.05). Conclusion: Frequency of MetS was found to be significantly high in this study with female preponderance. All the components, except Hypertension were more frequent in females. Diabetic patients with metabolic syndrome need more aggressive approach in management so as to decrease the incidence of cardiovascular complications. (author)
Full Text Available ABSTRACT: INTRODUCTION: Diabetes mellitus is a multifunctional metabolic disorder affecting almost all the systems of the body. There is a strong relation between diabetes mellitus and hearing. The three main theories of pathogenesis of hearing impairment in diabetics are micro angiopathy, .neuropathy and combination of both. Even though studies have proved the occurrence of sensorineural hearing loss (SNHL in diabetes mellitus (DM , disagreement still exists among some about their relation. DESIGN : prospective design. AIM: Present study aimed 1 To find the prevalence of Sensorineural Hearing Loss in Type 2 Diabetes Mellitus 2 To study the association of hearing loss with the foll owing factors among type 2 DM (a Duration of Diabetes Mellitus (b Severity of hyperglycemia. 3 To evaluate the result of our study and to compare our data with similarly published studies. METHOD : 75 individuals (150 ears who have type 2 Diabetes Melli tus participated in the study. RESULTS : Prevalence of SNHL in type 2 DM was 80%. There was no association between SNHL and duration of DM but positive association was found between SNHL and severity of hyperglycemia. DISCUSSION: Globalization is rapidly tr ansforming India from a developing to a developed country. People have become more health conscious and they expect to add more socially and economically productive years to their life span and hence this disorder which manifests mainly in middle age and o lder years of life require consideration. Hence this study is the need of the hour.
Knop, Filip K; Vilsbøll, Tina; Holst, Jens J
This review article focuses on the therapeutic potential of the incretin hormones, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), in treating type 2 diabetes mellitus (T2DM). T2DM is characterized by insulin resistance, impaired glucose-induced insulin...... secretion and inappropriately regulated glucagon secretion which in combination eventually result in hyperglycemia and in the longer term microvascular and macrovascular diabetic complications. Traditional treatment modalities--even multidrug approaches--for T2DM are often unsatisfactory at getting patients...
Gabriela da Silva Xavier; Bellomo, Elisa A.; McGinty, James A.; French, Paul M.; Rutter, Guy A.
More than 65 loci, encoding up to 500 different genes, have been implicated by genome-wide association studies (GWAS) as conferring an increased risk of developing type 2 diabetes (T2D). Whilst mouse models have in the past been central to understanding the mechanisms through which more penetrant risk genes for T2D, for example, those responsible for neonatal or maturity-onset diabetes of the young, only a few of those identified by GWAS, notably TCF7L2 and ZnT8/SLC30A8, have to date been exa...
Abstract Background It has been established that careful diabetes self-management is essential in avoiding chronic complications that compromise health. Disciplined diet control and regular exercise are the keys for the type 2 diabetes self-management. An ability to maintain one's blood glucose at a relatively flat level, not fluctuating wildly with meals and hypoglycemic medical intervention, would be the goal for self-management. Hemoglobin A1c (HbA1c or simply A1c) is a measure of a long-t...
O'Sullivan, Eoin P
Osteoprotegerin (OPG), receptor activator for nuclear factor kappa beta ligand (RANKL) and tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) are newly discovered members of the tumour necrosis factor-alpha receptor superfamily. While their role in bone metabolism is well described, their function within the vasculature is poorly understood. OPG inhibits vascular calcification in vitro and high serum levels have been demonstrated in type 2 diabetes, but serum RANKL and TRAIL and their potential correlation with well-established biomarkers of subclinical vascular inflammation such as high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6) have not been described.
Kajantie, Eero; Osmond, Clive; Barker, David J.P.; Eriksson, Johan G.
OBJECTIVE The association between low birth weight and type 2 diabetes is well established. We studied whether preterm birth carries a similar risk. RESEARCH DESIGN AND METHODS The Helsinki Birth Cohort includes 13,345 men and women born between 1934 and 1944. Of them, 12,813 had adequate data on length of gestation, which we linked with data on special reimbursement for diabetes medication. RESULTS Of the subjects, 5.1% had received special reimbursement after age 40. In subjects born before...
Aleksandr Sergeevich Ametov; Marina Aleksandrovna Prudnikova
AimsThe aim of the present study was to investigate the role of chronic low-grade inflammation in the development of the diabetic neuropathy and the possibility of its medical treatment with fenofibrate (145 mg/day).Materials and MethodsThis trial included 60 patients with type 2 diabetes mellitus. The serum levels of several factors were measured: tumour necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), C-reactive protein (CRP), markers of oxidative stress (malondialde...
Langenberg, Claudia; Sharp, Stephen J; Franks, Paul W;
BACKGROUND: Understanding of the genetic basis of type 2 diabetes (T2D) has progressed rapidly, but the interactions between common genetic variants and lifestyle risk factors have not been systematically investigated in studies with adequate statistical power. Therefore, we aimed to quantify...... the genetic score and sex, diabetes family history, physical activity, or dietary habits assessed by a Mediterranean diet score. CONCLUSIONS: The relative effect of a T2D genetic risk score is greater in younger and leaner participants. However, this sub-group is at low absolute risk and would...
Subhash Chand Jain
Full Text Available Obesity and increases in body weight are among the most important risk factors for type 2 diabetes mellitus. Obesity contributes to the development of type 2 diabetes mellitus. Body mass index is also known as obesity index. Body mass index is a strong and independent risk factor for being diagnosed in cases of type 2 diabetes mellitus. There is a high risk of type 2 diabetes in those who have a higher body mass index. The present study has been done with the objective of finding correlation between BMI and type 2 diabetes. [Int J Res Med Sci 2014; 2(4.000: 1638-1641
Hee-Sook Kim; Hye-Jung Jang; Jeong-Eun Park; Moon-Young Kim; Sun-Young Ko; Sung-Hoon Kim
Background The purpose of this study was to evaluate maternal and neonatal outcomes in Korean women with type 1 diabetes and type 2 diabetes. Methods We performed a retrospective survey of 163 pregnancies in women with type 1 diabetes (n=13) and type 2 diabetes (n=150) treated from 2003 to 2010 at Cheil General Hospital & Women's Healthcare Center, Korea. We compared maternal characteristics as well as maternal and neonatal outcomes between groups. Results Differences in glycosylated hemoglob...
Damm, Julie Agner; Ásbjörnsdóttir, Björg; Callesen, Nicoline Foged; Mathiesen, Jonathan M.; Ringholm, Lene; Pedersen, Berit Woetmann; Mathiesen, Elisabeth R
OBJECTIVE To evaluate the prevalence of diabetic nephropathy and microalbuminuria in pregnant women with type 2 diabetes in comparison with type 1 diabetes and to describe pregnancy outcomes in these women following the same antihypertensive protocol. RESEARCH DESIGN AND METHODS Among 220 women with type 2 diabetes and 445 women with type 1 diabetes giving birth from 2007–2012, 41 women had diabetic nephropathy (albumin-creatinine ratio ≥300 mg/g) or microalbuminuria (albumin-creatinine ratio...
Damm, Julie Agner; Asbjörnsdóttir, Björg; Callesen, Nicoline Foged; Mathiesen, Jonathan Michael; Ringholm, Lene; Pedersen, Berit Woetmann; Mathiesen, Elisabeth R
To evaluate the prevalence of diabetic nephropathy and microalbuminuria in pregnant women with type 2 diabetes in comparison with type 1 diabetes and to describe pregnancy outcomes in these women following the same antihypertensive protocol.......To evaluate the prevalence of diabetic nephropathy and microalbuminuria in pregnant women with type 2 diabetes in comparison with type 1 diabetes and to describe pregnancy outcomes in these women following the same antihypertensive protocol....
van Bastelaar, Kim M.P.; Pouwer, François; Cuijpers, Pim; Riper, Heleen; Snoek, Frank J
OBJECTIVE Comorbid depression is common in patients with type 1 and type 2 diabetes, adversely affecting quality of life, diabetes outcomes, and mortality. Depression can be effectively treated with cognitive behavior therapy (CBT). The Internet is a new and attractive method for delivering CBT intervention on a large scale at relatively low costs. This study evaluated the effectiveness of Web-based CBT for depression treatment in adults with type 1 or type 2 diabetes, with minimal guidance. ...
Piťhová, P; Štechová, K; Piťha, J; Lánská, V; Kvapil, M
Diabetes mellitus type 2 ranks among the strongest predictors of cardiovascular diseases (CVD) while the association of type 1 diabetes with CVD is more complex. We studied differences between type 1 and 2 diabetic women regarding association of cardiovascular risk factors with preclinical atherosclerosis expressed as intima-media thickness of common carotid (IMT CCA) and femoral arteries (IMT CFA) measured by high resolution ultrasound. Women with type 1 (n=203) and type 2 diabetes (n=123) were examined with regard to the presence of cardiovascular risk factors. In type 1 diabetic women strong association between IMT CCA and body mass index, waist circumference, and total body fat was found in contrast to type 2 diabetic women. In type 2 diabetic women strong association between IMT CCA and fasting glucose, glycated hemoglobin, and atherogenic index of plasma (log TG/HDL cholesterol) was observed in contrast to type 1 diabetic women. In type 1 diabetic women, IMT CFA was associated with body fat in contrast to type 2 diabetic women. Preclinical atherosclerosis in type 1 diabetic women was strongly associated with factors reflecting body fat and its distribution, while in type 2 diabetic women preclinical atherosclerosis was associated with markers reflecting glucose and lipid metabolic disorders. PMID:26447509
Lerd Ng, Jia; Ortiz, Roberto; Hughes, Tyler; Abou Ghantous, Michel; Bouhali, Othmane; Arredouani, Abdelilah; Allen, Roland
We consider a scientific mystery which is of central importance in treating the most rapidly emerging national and global health threat: type 2 diabetes mellitus. The mystery involves a surprising effect of certain bariatric surgeries, and specifically Roux-en-Y gastric bypass (RYGB), a procedure which bypasses most of the stomach and upper intestine. An unanticipated result is that RYGB is usually found to contribute within only a few days to glucose homeostasis. This means the surgery can immediately cure patients even before they start losing weight. We are investigating this wondrous biochemical response with a quantitative model which includes the most important mechanisms. One of the major contributors is glucagon-like peptide 1 (GLP-1), an incretin whose concentration is found to increase by a large amount right after the RYGB surgical procedure. However, our results, in conjunction with the experimental and medical data, indicate that other substances must also contribute. If these substances can be definitively identified, it may be possible to replace the surgery with pharmaceuticals as the preferred treatment for type 2 diabetes.
Sarswat, Prashant; Free, Michael
Alpha-hydroxybutyrate (2-hydroxybutyrate or α-HB) is becoming more widely recognized as an important metabolic biomarker that has been shown to be highly correlated with prediabetes and other metabolic diseases. In 2012 there were 86 million Americans with prediabetes, many of whom are not aware they have prediabetes, but could be diagnosed and treated to prevent type 2 diabetes if a simple, low-cost, convenient test were available. We have developed new, low-cost, accurate α-HB detection methods that can be used for the detection and monitoring of diseases such as prediabetes, type 2 diabetes, β-cell dysfunction, and early hyperglycemia. The new sensing method utilizes a diol recognition moiety, additives and a photoinitiator to detect α-HB at levels near 1 micro g/l in the presence of serum compounds such as lactic acid, sodium pyruvate, and glucose. The objective of this research is to improve the understanding of the interactions that enhance α-HB detection to enable additional improvements in α-HB detection as well as improvements in other biosensor applications.
Review of: Zinnam, B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. New England Journal of Medicine. 2015; 373: 2117-2128. Patients were required to have a history of established cardiovascular disease, along with Type 2 Diabetes but were either not on antidiabetic therapy for the preceding 12 weeks, with a glycated hemoglobin level between 7% and 9%, or were on stable antidiabetic therapy for the preceding 12 weeks, with a glycated hemoglobin between 7.0% and 10.0%. Patients were randomized in a 1:1:1 ratio to either empagliflozin 10 mg or 25 mg or matching placebo. Antidiabetic therapy was not to be changed for the first 12 weeks after randomization, with intensification of antidiabetic therapy allowed if the patient had a confirmed glucose of >240 mg/dl (>13.3 mmol/l). Physicians were encouraged to treat other cardiac risk factors like hyperlipidemia according to local guidelines. The primary outcome was a composite of death from cardiovascular causes, non-fatal myocardial infarction, or nonfatal stroke. Results showed a significant reduction in the rates of death from cardiovascular causes, overall mortality, and in hospital admissions for heart failure, while there was no reduction in the rates of non-fatal myocardial infarction or stroke. PMID:27043258
Patel, Bhoomika M; Raghunathan, Suchi; Porwal, Urvashi
We have evaluated the effect of magnesium valproate (210 mg/kg/day, p.o.) in type 2 diabetes induced cardiovascular complications induced by streptozotocin (STZ, 90 mg/kg, i.p.) in neonatal wistar rats. Various biochemical, cardiovascular and hemodynamic parameters were measured at the end of 8 weeks of treatment. STZ produced significant hyperglycaemia, hypoinsulinemia and dyslipidemia, which was prevented by magnesium valproate treatment. STZ produced increase in Creatinine Kinase, C-reactive protein and lactate dehydrogenase levels and treatment with magnesium valproate produced reduction in these levels. STZ produced increase in cardiac and LV hypertrophy index, LV/RV ratio, LV collagen deposition and LV cardiomyocyte diameter which were decreased by magnesium valproate treatment. Magnesium valproate also prevented STZ induced hemodynamic alterations and oxidative stress. These results were further supported by histopathological studies in which magnesium valproate showed marked reduction in fibrosis and cardiac fiber disarray. In conclusion, our data suggests that magnesium valproate is beneficial as an anti-diabetic agent in type-2 diabetes mellitus and also prevents its cardiac complications. PMID:24530414
Full Text Available Hypertension in diabetes is a wellknown risk factor for cardiovascular diseases that should be taken seriously. Observational studies have shown a more or less linear relationship between systolic blood pressure levels and risk, but this does not correspond with the outcome results of intervention trials to lower blood pressure. In fact, tight blood pressure control has only been shown to be of general benefit in the range of 130135 mmHg systolic blood pressure, but not below except for stroke prevention. On the other hand, there might even exist an increased risk for coronary heart disease events and cardiovascular mortality at lower ranges based on data from observational studies. This fact, in combination with the increased costs and risk of serious adverse events, cautions clinicians not to lower systolic blood pressure too much in susceptible patients with longer diabetes duration, more comorbidities, and in older age groups. However, we should not lose sight of the challenge that still around half of all patients with type-2 diabetes are not even below the desired minimum goal of 140 mmHg systolic blood pressure. This calls for improved actions to control blood pressure as part of a general strategy to counteract all cardiovascular risk factors in patients with type-2 diabetes. The higher the risk, the more ambitious should be the approach to screen, detect, treat, and monitor these risk factors.
Coronado, Gloria D; Thompson, Beti; Tejeda, Silvia; Godina, Ruby
Hispanics in the United States have a disproportionately high risk for non-insulin-dependent diabetes mellitus (type 2 diabetes) compared with non-Hispanic whites. Little is known of the attitudes and beliefs about diabetes in this group. Using data from six focus groups of 42 Mexican Americans (14 men and 28 women), we characterized perceptions about the causes of and treatments for type 2 diabetes. Many participants believed diabetes is caused by having a family history of the disease, eating a diet high in fat or sugar, and engaging in minimal exercise. Experiencing strong emotions such as fright (susto), intense anger (coraje), or sadness and depression (tristeza) was also thought to precipitate diabetes. Nearly all participants expressed the belief that it is important to follow doctors' recommendations for diet and exercise, oral medication or insulin; many also cited herbal therapies, such as prickly pear cactus (nopal) and aloe vera (savila) as effective treatments. These findings may be useful in designing interventions to reduce the burden of diabetes in Hispanic populations. PMID:15531816
Mehmet Sargyn; Oya Uygur-Bayramicli; Haluk Sargyn; Ekrem Orbay; Dilek Yavuzer; Ali Yayla
AIM: To study the eradication rate of Helicobacter pylori (Hp) in a group of type 2 diabetes and compared it with an age and sex matched non-diabetic group.METHODS: 40 diabetic patients (21 females, 19 males;56±7 years) and 40 non-diabetic dyspeptic patients (20females, 20 males; 54±9 years) were evaluated. Diabetic patients with dyspeptic complaints were referred for upper gastrointestinal endoscopies; 2 corpus and 2 antral gastric biopsy specimens were performed on each patient. Patients with positive Hp results on histopathological examination comprised the study group. Non-diabetic dyspeptic patients seen at the Gastroenterology Outpatient Clinic and with the same biopsy and treatment protocol formed the control group.A triple therapy with amoxycillin (1 g b.i.d), clarithromycin (500 mg b.i.d) and omeprazole (20 mg b.i.d.) was given to both groups for 10 days. Cure was defined as the absence of Hp infection assessed by corpus and antrum biopsies in control upper gastrointestinal endoscopies performed 6weeks after completing the antimicrobial therapy.RESULTS: The eradication rate was 50 % in the diabetic group versus 85 % in the non-diabetic control group (P＜0.001).CONCLUSION: Type 2 diabetic patients showed a significantly lower eradication rate than controls which may be due to changes in microvasculature of the stomach and to frequent antibiotic usage because of recurrent bacterial infections with the development of resistant strains.
PURPOSE: The purpose of this study was to examine the relationship between psychological and social factors and diabetes outcomes in people with type 2 diabetes and their family members. METHODS: A total of 153 patients with type 2 diabetes were assessed at a diabetes outpatient clinic and postal questionnaires were sent to nominated family members. The measures examined were diabetes knowledge, social support, well-being, and illness perceptions. RESULTS: When compared with those with diabetes, family members reported lower positive well-being and lower levels of satisfaction with support. They also perceived diabetes as a more cyclical illness, which was controlled more by treatment than by the individual. Family members also reported that the person with diabetes was more emotionally distressed and knew more about diabetes than the patient had actually reported himself or herself. There were no differences between the family members of those in good or poor glycaemic control. CONCLUSIONS: This study reinforces the importance of understanding social context and illness beliefs in diabetes management. It also highlights the potential for including family members in discussions and education about diabetes management.
Belkis Vicente Sánchez
Full Text Available Background: diabetes mellitus accelerates atherosclerotic changes throughout the vascular tree and consequently increases the risk of developing fatal acute events. Objective: to estimate the global cardiovascular risk in patients with type 2 diabetes mellitus. Method: a cross-sectional study of a series of type 2 diabetic patients from the People's Council of Constancia, Abreus municipality, Cienfuegos province was conducted from July to December 2012. The universe comprised the 180 people with diabetes in the area. Variables studied were: age, sex, body mass index, nutritional assessment, blood pressure, toxic habits, associated chronic diseases, blood levels of glucose, lipids (total cholesterol and triglycerides and microalbuminuria. World Health Organization/International Society of Hypertension prediction charts specific to the region of the Americas, in which Cuba is included, were used to estimate the cardiovascular risk. Results: mean age was 61.63 years and females predominated. Relevant risk factors were hypertension followed by obesity, smoking and dyslipidemia. Mean body mass index was 27.66kg/m2; waist circumference was 94.45 cm in women and 96.86 cm in men. Thirty point six percent had more than two uncontrolled risk factors and 28.3 % of the total presented a high to very high cardiovascular risk. Conclusions: cardiovascular risk prediction charts are helpful tools for making clinical decisions, but their interpretation must be flexible and allow the intervention of clinical reasoning.
Mora, S.; Kamstrup, Pia R; Rifai, N.; Nordestgaard, Børge G; Buring, J.E.; Ridker, P.M.; Mora, Samia; Rifai, Nader; Buring, Julie E; Ridker, Paul M
(a) concentrations and incident type 2 diabetes (n = 1670) for a follow-up period of 13 years. We confirmed our findings in 9652 Danish men and women with prevalent diabetes (n = 419). Analyses were adjusted for risk factors that included age, race, smoking, hormone use, family history, blood pressure, body mass......BACKGROUND: Previous studies have demonstrated that cardiovascular risk is higher with increased lipoprotein (a) [Lp(a)]. Whether Lp(a) concentration is related to type 2 diabetes is unclear. METHODS: In 26 746 healthy US women (mean age 54.6 years), we prospectively examined baseline Lp...... index, hemoglobin A(1c) (Hb A(1c)), C-reactive protein, and lipids. RESULTS: Lp(a) was inversely associated with incident diabetes, with fully adjusted hazard ratios (HRs) and 95% CIs for quintiles 2-5 vs quintile 1 of 0.87 (0.75-1.01), 0.80 (0.68-0.93), 0.88 (0.76-1.02), and 0.78 (0.67-0.91); P for...
Full Text Available The main aim of this study is to assess the inflammatory markers in type 2 diabetes mellitus (T2DM by measuring some cytokines concentrations and lymphocytes subset and correlate them with other laboratory investigations. Fifty-seven patients with type-2 diabetes and 30 healthy volunteers were enrolled in this study. Data for the C-reactive protein (CRP, haemoglobin, HbA1c, and autoantibody levels were obtained from the patients files. The cytokine concentrations were measured in patient’s serum using commercially available ELISA assays. Lymphocytes subsets were measured by flow cytometric methods. The levels of IL-1β, IL-6, IL-15, and TNF-α were found to be decreased in T2DM patients, whereas the levels of IL-10, IFN-γ, and caspase-1 were increased, compared to normal controls. T2DM patients with hypertension show significantly decreased levels of IL-1β and caspase-1 compared to patients without hypertension. No significant differences in lymphocytes subset between cases and normal control were observed. Significant correlations were found between HbA1c and IL-6; body mass index (BMI was significantly correlated with CRP, TNF-α, and phosphate; the weight (Wt was associated with CRP and IFN-γ. In conclusion, an alteration in the function of the immune system was observed in T2DM patient.
Full Text Available Estela Wajcberg, Amatur AmarahPremier Nephrology and Hypertension, Internal Medicine Department, Trinitas Regional Medical Center, Elizabeth, New Jersey, USAAbstract: The pathophysiology of type 2 diabetes has been attributed to the classic triad of decreased insulin secretion, increased insulin resistance, and elevated hepatic glucose production. Research has shown additional mechanisms, including incretin deficiency or resistance in the gastrointestinal tract. Liraglutide is a modified form of human glucagon-like peptide-1. Liraglutide was obtained by substitution of lysine 34 for arginine near the NH2 terminus, and by addition of a C16 fatty acid at the e-amino group of lysine (at position 26 using a γ-glutamic acid spacer. Liraglutide has demonstrated glucose-dependent insulin secretion, improvements in β-cell function, deceleration of gastric emptying, and promotion of early satiety leading to weight loss. Liraglutide has the potential to acquire an important role, not only in the treatment of type 2 diabetes, but also in preservation of β-cell function, weight loss, and prevention of chronic diabetic complications.Keywords: diabetes mellitus, incretin, glucagon-like peptide, insulin resistance
Physical activity improves glycemic control and reduces the risk of cardiovascular disease (CVD) and mortality in patients with type 2 diabetes (T2D). Moderate to vigorous physical activity is recommended to manage T2D; however, patients with T2D can be physically weak, making it difficult to engage in the recommended levels of physical activity. Daily physical activity includes various activities performed during both occupational and leisure time such as walking, gardening, and housework that type 2 diabetic patients should be able to perform without considerable physical burden. This review focuses on the association between daily physical activity and T2D. Walking was the most common form of daily physical activity, with numerous studies demonstrating its beneficial effects on reducing the risk of T2D, CVD, and mortality. Walking for at least 30 min per day was shown to reduce the risk of T2D by approximately 50%. Additionally, walking was associated with a reduction in mortality. In contrast, evidence was extremely limited regarding other daily physical activities such as gardening and housework in patients with T2D. Recent studies have suggested daily physical activity, including non-exercise activity thermogenesis, to be favorably associated with metabolic risks and mortality. However, well-designed longitudinal studies are warranted to elucidate its effects on overall health. PMID:27350847
Vadstrup, Eva Soelberg; Frølich, Anne; Perrild, Hans Jørgen Duckert;
To compare the effectiveness of a group-based rehabilitation programme with an individual counselling programme at improving glycaemic control and cardiovascular risk factors among patients with type 2 diabetes.......To compare the effectiveness of a group-based rehabilitation programme with an individual counselling programme at improving glycaemic control and cardiovascular risk factors among patients with type 2 diabetes....
Oleg Viktorovich Kornyushin
Full Text Available High prevalence and insufficient efficacy of medical treatment in type 2 diabetes mellitus (T2DM poses a major challenge for medical care. Generally, only 30% of patients reach therapeutic goals, while remission occurs only in the minority of patients. In the obese (BMI>35 kg/m2, bariatric surgery provides an alternative to pharmacological treatment of T2DM, boosting remission/compensation rate up to 76.8%. A few recent clinical studies explored the anti-diabetic effect of ileal transposition (IT. This type of surgery targets restoration of incretin balance by proximal transposition of ileal segment. In this review, we discuss the salutary mechanisms of IT in T2DM based on the analysis of the pioneering clinical trials.
Background: The dyslipidaemia associated with type-2 diabetes is associated with raised plasma triglycerides, low high-density lipoprotein cholesterol, high low-density lipoprotein cholesterol and very low-density lipoprotein cholesterol levels and is a risk factor of cardiovascular disease. Objectives: To assess the lipid abnormalities in patients with type-2 diabetes. Study design and settings: A cohort study carried out at Diabetic Clinic of PMRC Research Centre, FJMC, Lahore, Pakistan. Patients and Methods Eight years case records of type-2 diabetic patients seen at the research centre from 1999-2006 were reviewed. The research centre is a specialized centre for diagnosing and treating diabetes mellitus. All the patients were recruited for their follow up check up and laboratory investigations for dislipidemia. Adult treatment panel III guidelines for dyslipidaemia were followed. A 12 hours fasting blood sample was collected from each patient for serum total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and glucose as well as glycosylated hemoglobin (HbA1c) by using standard methods at Biochemistry laboratory of the research centre. LDL-C/ HDL-C ratios, Very low-density lipoprotein cholesterol (VLDL-C) and body mass index was calculated after anthropometery body mass index (BMI) less than or equal to 25 was considered as overweight while less than or equal 30 obese. HbA1c40 mg/dl were seen in 67%. Raised VLDL-C (above 40 mg/dl) was seen in 32.9% cases. The group with high LDL and VLDL is at risk of developing cardiovascular disease. Hypertriglyceridaemia was found in 55% and hypercholesterolaemia in 45.4% cases. Obesity as indicated by body mass index was found in 53.7% patients. Statistically significant association of hypercholesterolemia, hypertriglyceridemia, hypo HDL cholesterolemia and VLDL-C was found with advancing age while only hypertriglyceridemia and VLDL-C showed a positive
To determine the factors predisposing patients with type-2 diabetes mellitus to gallstone disease. One hundred type 2 diabetic patients and 100 age and gender-matched controls underwent real time ultrasonography to study factors predisposing patients with type 2 diabetes mellitus to gallstone disease. The age, gender, body mass index (BMI), duration of diabetes mellitus and serum lipids were determined in the individuals enrolled for the study. Fifteen percent of the diabetic patients had ultrasound evidence of gallstone disease as compared to 7% in non-diabetic controls. There was a steady increase in the incidence of gallstone disease in diabetic patients with age with a peak incidence in the seventh decade i.e. 60-69 years, and a decline in the eighth decade i.e. 70 - 79 years. The average age of the diabetic patients with gallstone disease - 59.1+ 9.5 years was significantly higher than in those without gallstone disease - 51.8 + 10.5 years (p 0.014). The mean duration of disease in the diabetic patients with gallstone disease was 5.0 + 4.9 years compared with 4.5 + 3.8 years in the diabetic patients without gallstone disease (p=0.772). The mean serum cholesterol and triglyceride levels - 4.3 + 1.3 mmol/L and 1.5 + 0.8 mmol/L respectively in the diabetic patients with gallstone disease was higher than in those without gallstone disease - 3.4 + 0.5 mmol/L (p=0.0941) and 1.4 + 0.7 mmol/L (p=0.712) respectively. The mean body mass index for the diabetic patients with gallstone disease was 26.2 + 5.5 kg /m 2 compared with 25.7 + 6.7 kg/m2 in those without gallstone disease (p=0.755) . Increasing age is a risk factor for gallstone disease in diabetic patients. Hyperlipidaemia, female gender, heavier weight and a longer duration of diabetes mellitus appear to be associated risk factors. (author)
Full Text Available The plague of obesity afflicts an increasing group of people. Moreover type 2 diabetes, which is the most serious illness accompanying excessive weight, is becoming more and more common. Traditional methods of obesity treatment, such as diet and physical exercise, fail. This applies especially to people with class III obesity. The only successful way of treating obesity in their case is bariatric surgery. There are three types of bariatric surgery: restrictive procedures (reducing stomach volume, malabsorptive procedures, and mixed procedures, which combine both methods. In spite of the risk connected with the surgery and complications after it, bariatric procedures are advised to patients with class III obesity and class II with an accompanying illness which increases the probability of death. It has been proved that bariatric surgery not only eliminates obesity but also very frequently (in 90�0of cases leads to the remission of type 2 diabetes. Moreover, the remission occurs very fast – it takes place a long time before the patients reduce their weight, even within a few days after surgery. Detailed studies have shown that the remission of diabetes is caused mostly by the change of the gastro-intestinal hormones’ profile, resulting from the surgery. These hormones include GLP-1, GIP, peptide YY, ghrelin and oxyntomodulin. Additionally, the change of the amount of adipose tissue after the surgery influences the level of adipokines, i.e. the hormones of the adipose tissue, among which the most important are leptin, adiponectin and resistin. Thus, bariatric surgery not only changes the shape of the gastrointestinal tract but it also modulates the hormonal activity. Bariatric surgery is considered as therapy not only for the obese but also for diabetic patients.
Abdulfatai B. Olokoba
Full Text Available Type 2 diabetes mellitus (DM is a chronic metabolic disorder in which prevalence has been increasing steadily all over the world. As a result of this trend, it is fast becoming an epidemic in some countries of the world with the number of people affected expected to double in the next decade due to increase in ageing population, thereby adding to the already existing burden for healthcare providers, especially in poorly developed countries. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include type 2 diabetes mellitus, prevalence, current diagnosis, and current treatment. Only articles in English were included. Screening and diagnosis is still based on World Health Organization (WHO and American Diabetes Association (ADA criteria which include both clinical and laboratory parameters. No cure has yet been found for the disease; however, treatment modalities include lifestyle modifications, treatment of obesity, oral hypoglycemic agents, and insulin sensitizers like metformin, a biguanide that reduces insulin resistance, is still the recommended first line medication especially for obese patients. Other effective medications include non-sulfonylurea secretagogues, thiazolidinediones, alpha glucosidase inhibitors, and insulin. Recent research into the pathophysiology of type 2 DM has led to the introduction of new medications like glucagon-like peptide 1 analogoues: dipeptidyl peptidase-IV inhibitors, inhibitors of the sodium-glucose cotransporter 2 and 11ß-hydroxysteroid dehydrogenase 1, insulin-releasing glucokinase activators and pancreatic-G-protein-coupled fatty-acid-receptor agonists, glucagon-receptor antagonists, metabolic inhibitors of hepatic glucose output and quick-release bromocriptine. Inhaled insulin was licensed for use in 2006 but has been withdrawn from the market because of low patronage.
Previously, we reported high hepatotoxic sensitivity of type 2 diabetic (DB) rats to three dissimilar hepatotoxicants. Additional work revealed that a normally nonlethal dose of CCl4 was lethal in DB rats due to inhibited compensatory tissue repair. The present study was conducted to investigate the importance of compensatory tissue repair in determining the final outcome of hepatotoxicity in diabetes, using another structurally and mechanistically dissimilar hepatotoxicant, thioacetamide (TA), to initiate liver injury. A normally nonlethal dose of TA (300 mg/kg, ip), caused 100% mortality in DB rats. Time course studies (0 to 96 h) showed that in the non-DB rats, liver injury initiated by TA as assessed by plasma alanine or aspartate aminotransferase and hepatic necrosis progressed up to 48 h and regressed to normal at 96 h resulting in 100% survival. In the DB rats, liver injury rapidly progressed resulting in progressively deteriorating liver due to rapidly expanding injury, hepatic failure, and 100% mortality between 24 and 48 h post-TA treatment. Covalent binding of 14C-TA-derived radiolabel to liver tissue did not differ from that observed in the non-DB rats, indicating similar bioactivation-based initiation of hepatotoxicity. S-phase DNA synthesis measured by [3H]-thymidine incorporation, and advancement of cells through the cell division cycle measured by PCNA immunohistochemistry, were substantially inhibited in the DB rats compared to the non-DB rats challenged with TA. Thus, inhibited cell division and compromised tissue repair in the DB rats resulted in progressive expansion of liver injury culminating in mortality. In conclusion, it appears that similar to type 1 diabetes, type 2 diabetes also increases sensitivity to dissimilar hepatotoxicants due to inhibited compensatory tissue repair, suggesting that sensitivity to hepatotoxicity in diabetes occurs in the absence as well as presence of insulin
Lopez Vicchi, Felicitas; Luque, Guillermina Maria; Brie, Belen; Nogueira, Juan Patricio; Garcia Tornadu, Isabel; Becu-Villalobos, Damasia
The importance of dopamine in central nervous system function is well known, but its effects on glucose homeostasis and pancreatic β cell function are beginning to be unraveled. Mutant mice lacking dopamine type 2 receptors (D2R) are glucose intolerant and have abnormal insulin secretion. In humans, administration of neuroleptic drugs, which block dopamine receptors, may cause hyperinsulinemia, increased weight gain and glucose intolerance. Conversely, treatment with the dopamine precursor l-DOPA in patients with Parkinson's disease reduces insulin secretion upon oral glucose tolerance test, and bromocriptine improves glycemic control and glucose tolerance in obese type 2 diabetic patients as well as in non diabetic obese animals and humans. The actions of dopamine on glucose homeostasis and food intake impact both the autonomic nervous system and the endocrine system. Different central actions of the dopamine system may mediate its metabolic effects such as: (i) regulation of hypothalamic noradrenaline output, (ii) participation in appetite control, and (iii) maintenance of the biological clock in the suprachiasmatic nucleus. On the other hand, dopamine inhibits prolactin, which has metabolic functions; and, at the pancreatic beta cell dopamine D2 receptors inhibit insulin secretion. We review the evidence obtained in animal models and clinical studies that posited dopamine receptors as key elements in glucose homeostasis and ultimately led to the FDA approval of bromocriptine in adults with type 2 diabetes to improve glycemic control. Furthermore, we discuss the metabolic consequences of treatment with neuroleptics which target the D2R, that should be monitored in psychiatric patients to prevent the development in diabetes, weight gain, and hypertriglyceridemia. PMID:26748034
Hewston, Patricia; Deshpande, Nandini
Older adults with type 2 diabetes have significantly higher incidence of falls than those without type 2 diabetes. The devastating consequences of falls include declines in mobility, activity avoidance, institutionalization and mortality. One of the most commonly identified risk factors associated with falls is impaired balance. Balance impairments and subsequent increased fall risk in older adults with type 2 diabetes are most commonly associated with diabetic peripheral neuropathy (DPN). Consequently, DPN has been the central focus of falls prevention research and interventions for older adults with type 2 diabetes. However, isolated studies have identified adults with type 2 diabetes without overt complications of DPN to also be at increased fall risk. It is known that the ability to maintain balance is a complex skill that requires the integration of multiple sensorimotor and cognitive processes. Emerging evidence suggests that diabetes-related subtle declines in sensory functions (somatosensory, visual and vestibular), metabolic muscle function and executive functions may also contribute to increased fall risk in older adults with type 2 diabetes. Knowledge of these type 2 diabetes-related sensorimotor and cognitive deficits may help to broaden approaches to falls prevention in older adults with type 2 diabetes. Therefore, the purpose of this mini review is to describe the impact of type 2 diabetes on sensorimotor and cognitive systems that may contribute to increased fall risk in older adults with type 2 diabetes. PMID:26778679
Full Text Available Galectin-3 is an important regulator of inflammation and acts as a receptor for advanced-glycation (AGE and lipoxidation end-products (ALE. Evidence indicates a significant upregulation in circulating levels and visceral adipose tissue production of Galectin-3 in obesity and type 2 diabetes. Recent studies demonstrate development of obesity and dysregulation of glucose metabolism in Galectin-3 “knockout” (KO mice, which also develop accelerated and more severe pathology in models of atherosclerosis and metabolically-induced kidney damage. Thus, evidence that Galectin-3 is an important player in metabolic disease is accumulating. This review discusses current evidence on the connection between Galectin-3 and metabolic disease, focusing on mechanisms by which this galectin modulates adiposity, glucose metabolism and obesity-associated inflammatory responses.
Andersen, Mette Korre; Pedersen, Casper-Emil Tingskov; Moltke, Ida; Hansen, Torben; Albrechtsen, Anders; Grarup, Niels
Type 2 diabetes (T2D) affects millions of people worldwide. Improving the understanding of the underlying mechanisms and ultimately improving the treatment strategies are, thus, of great interest. To achieve this, identification of genetic variation predisposing to T2D is important. A large number of variants have been identified in large outbred populations, mainly from Europe and Asia. However, to elucidate additional variation, isolated populations have a number of advantageous properties, including increased amounts of linkage disequilibrium, and increased probability for presence of high frequency disease-associated variants due to genetic drift. Collectively, this increases the statistical power to detect association signals in isolated populations compared to large outbred populations. In this review, we elaborate on why isolated populations are a powerful resource for the identification of complex disease variants and describe their contributions to the understanding of the genetics of T2D. PMID:27189761
Changqing Liu; Jake Hoekstra; Kangping Xiong; Jing Zhang
Various age-associated diseases are becoming more prominent as a greater percentage of the population reaches old age.Neurodegenerative disorders,e.g.Alzheimer's disease (AD)and Parkinson's disease (PD),and diabetes,in particular type 2 diabetes mellitus (T2DM),are the diseases that represent a large proportion of diagnoses amongst this group.These dis-eases have long been regarded as separate and each has distinct pathologies,symptoms,and treatments.Recent studies in epide-miology and pathology,however,have shown that T2DM may share a common mechanism of disease with AD and PD, which could allow for a therapeutic intervention capable of managing each disease.This review will discuss evidence implicating connections between these diseases,potential shared mechanisms,and possible treatments.
Full Text Available Type 2 diabetes is a major public health problem with high and increasing prevalence, morbidity and mortality. The association between diabetes and microvascular and macrovascular complications is well known besides, tight glycemic control is a necessity. HbA1C has clinically been used since 1980s as a gold standard for monitoring glycemic control and predicting of diabetic complications. The present review article was prepared by computerized sources of literature searches 2000 - 2009.The history of Hemoglobin A1C, its assay techniques, optimal A1C targets, its reliability in control of diabetic complications, limitations of test results and its importance in control of diabetes patients and their complications are discussed.
Siva Prasad Akula
Full Text Available Abstract Alzheimer's disease and type 2 diabetes mellitus tend to occur together. We sought to identify protein(s common to both conditions that could suggest a possible unifying pathogenic role. Using human neuronal butyrylcholinesterase (AAH08396.1 as the reference protein we used BLAST Tool for protein to protein comparison in humans. We found three groups of sequences among a series of 12, with an E-value between 0–12, common to both Alzheimer's disease and diabetes: butyrylcholinesterase precursor K allele (NP_000046.1, acetylcholinesterase isoform E4-E6 precursor (NP_000656.1, and apoptosis-related acetylcholinesterase (1B41|A. Butyrylcholinesterase and acetylcholinesterase related proteins were found common to both Alzheimer's disease and diabetes; they may play an etiological role via influencing insulin resistance and lipid metabolism.
Full Text Available A large proportion of heritability of type 2 diabetes (T2D has been attributed to inherent genetics. Recent genetic studies, especially genome-wide association studies (GWAS, have identified a multitude of variants associated with T2D. It is thus reasonable to question if these findings may be utilized in a clinical setting. Here we briefly review the identification of risk loci for T2D and discuss recent efforts and propose future work to utilize these loci in clinical setting—for the identification of individuals who are at particularly high risks of developing T2D and for the stratification of specific health-care approaches for those who would benefit most from such interventions.
Dorajoo, Rajkumar; Liu, Jianjun; Boehm, Bernhard O.
A large proportion of heritability of type 2 diabetes (T2D) has been attributed to inherent genetics. Recent genetic studies, especially genome-wide association studies (GWAS), have identified a multitude of variants associated with T2D. It is thus reasonable to question if these findings may be utilized in a clinical setting. Here we briefly review the identification of risk loci for T2D and discuss recent efforts and propose future work to utilize these loci in clinical setting—for the identification of individuals who are at particularly high risks of developing T2D and for the stratification of specific health-care approaches for those who would benefit most from such interventions. PMID:26110315
Hiroshi; Ogawa; Teerasak; Damrongrungruang; Sayaka; Hori; Kaname; Nouno; Kumiko; Minagawa; Misuzu; Sato; Hideo; Miyazaki
The association between adipokines and inflammatory periodontal diseases has been studied over the last two decades. This review was intended to explore the observation that periodontal therapy may lead to an improvement of adipokines in diabetic patients. In summary, substantial evidence suggests that diabetes is associated with increased prevalence, extent and severity of periodontitis. Numerous mechanisms have been elucidated to explain the impact of diabetes on the periodontium. However, current knowledge concerning the role of major adipokines indicates only some of their associations with the pathogenesis of periodontitis in type 2 diabetes. Conversely, treatment of periodontal disease and reduction of oral inflammation may have positive effects on the diabetic condition, although evidence for this remains somewhat equivocal.
patients suffered from LADA, 3.9% from secondary diabetes, 6.0% from steroid induced diabetes 5.9% had insulinopenic diabetes, whereas 56.7% presented the classic obesity-associated insulin-resistant phenotype. 24.6% was classified as normoinsulinopenic patients. Conclusion: We conclude that newly......Type 2 diabetes (T2D) can be considered a syndrome with several different pathophysiological mechanisms leading to hyperglycemia. Nonetheless, T2D is treated according to algorithms as if it was one disease entity. Methods: We investigated the prevalence of different pathophysiological phenotypes...... autoimmune diabetes (LADA) (GAD antibody titer >= 20 IE/ml and not T1D), secondary diabetes (recent history of pancreatitis, pancreatectomy or pancreas amylase > 65U/l, and GAD negativity), steroid-induced diabetes (oral glucocorticoid-treated subjects), insulinopenic (f-P-C-peptide < 333 pmol/l and not LADA...
Rasmussen, O. W.
Objectives: For patients with T2DM does telemedicine, compared with standard care, provide equivalent clinical outcomes? Methods: Forty patients with type 2 diabetes mellitus allocated from October 2011 until July 2012 randomized to either treatment at home by video conferences only or the standard...... treatments, given as changes in percent of telemedicine vs. standard, showed significant differences in HbA1c (-15 vs. -11 %), mean blood glucose (-18 vs. -13 %,.and in cholesterol (-7 vs. -6 %). No differences in LDL (-4 vs. -6 %), weight (-1 vs. 2 %), diastolic diurnal blood pressure (-1 vs. -7 %), and...... systolic diurnal blood pressure (0 vs. -1 %) were found. Nine consultations were missed in the standard outpatient group and none in the telemedicine group. Conclusions: The direct comparison of home video consultations versus standard outpatient treatment in T2DM, telemedicine was a safe and superior...
Full Text Available Diabetic peripheral neuropathy (DPN, a common and troublesome complication in patients with type 2 diabetes mellitus (T2DM, contributes to a higher risk of diabetic foot ulcer and lower limb amputation. These situations can negatively impact the quality of life of affected individuals. Despite its high prevalence and clinical importance, most diabetes mellitus patients not only do not recognize the presence of diabetic neuropathy, but also do not report their symptoms to physicians or other health care providers. Therefore, DPN is usually under diagnosed and undertreated. For early detection and appropriate intervention for DPN, a careful history, physical with neurologic examination, and prompt treatment are needed in T2DM patients.
Sang Youl Rhee
Full Text Available Peripheral arterial disease (PAD in patients with type 2 diabetes mellitus (T2DM exhibits broad clinical characteristics and various consequences and is known as one of the major macrovascular complications of T2DM. Atherosclerosis is recognized as the most direct and important cause of PAD, but acute or chronic limb ischemia may be the result of various risk factors. In light of the increasing number of patients who undergo peripheral vascular procedures, the number of subjects who are exposed to the risks for PAD and related complications is increasing. In this review, we will discuss the clinical and epidemiological characteristics of PAD, as well as the clinical significance of PAD in T2DM subjects.
Galling, Britta; Roldán, Alexandra; Nielsen, René E; Nielsen, Jimmi; Gerhard, Tobias; Carbon, Maren; Stubbs, Brendon; Vancampfort, Davy; De Hert, Marc; Olfson, Mark; Kahl, Kai G; Martin, Andres; Guo, Jeff J; Lane, Hsien-Yuan; Sung, Fung-Chang; Liao, Chun-Hui; Arango, Celso; Correll, Christoph U
Importance: Antipsychotics are used increasingly in youth for nonpsychotic and off-label indications, but cardiometabolic adverse effects and (especially) type 2 diabetes mellitus (T2DM) risk have raised additional concern. Objective: To assess T2DM risk associated with antipsychotic treatment in...... youth. Data Sources: Systematic literature search of PubMed and PsycINFO without language restrictions from database inception until May 4, 2015. Data analyses were performed in July 2015, and additional analyses were added in November 2015. Study Selection: Longitudinal studies reporting on T2DM...... incidence in youth 2 to 24 years old exposed to antipsychotics for at least 3 months. Data Extraction and Synthesis: Two independent investigators extracted study-level data for a random-effects meta-analysis and meta-regression of T2DM risk. Main Outcomes and Measures: The coprimary outcomes were study...
By influencing the standards of diabetes care and treatment guidelines throughout the world, the results of recent long-term risk factor interventions in Type 2 diabetes (T2D) have likely contributed to the improved health outcomes and induced a decline in mortality in people with T2D. Although we....... Current surveys show slow progress in achieving treatment goals and in the use of recommended drugs and adjustments of lifestyle for the prevention of vascular complications in diabetes. The resistance and barriers among medical professionals and patients likely have multiple causes. The present review...... have a need for even more evidence to support early, individualized, and intensive management of all known modifiable risk factors, we have now reached an era in T2D care where the critical challenges appear to be to translate the insights, knowledge and benefits to patients in the community setting...
Singh, Awadhesh Kumar
Incretin-based therapy has clearly emerged as one of the most sought out strategy in managing type 2 diabetes, primarily because they generally do not causes hypoglycemia and possess weight-neutral or weight losing properties. Efficacy-wise too, these agents, are more or less similar to commonly used drugs metformin and sulfonylureas. Interestingly, some studies recently suggested that glycemic response to these incretin-based therapies could also differ ethnicity-wise. Subsequently, meta-analysis from these studies also suggested that Asians may have better response to these incretin-based therapies. This review will be an attempt to critically analyze those studies available in literature and to address as to why East-Asians and South-Asians may have different incretin response compared to non-Asians. PMID:25593823
Awadhesh Kumar Singh
Full Text Available Incretin-based therapy has clearly emerged as one of the most sought out strategy in managing type 2 diabetes, primarily because they generally do not causes hypoglycemia and possess weight-neutral or weight losing properties. Efficacy-wise too, these agents, are more or less similar to commonly used drugs metformin and sulfonylureas. Interestingly, some studies recently suggested that glycemic response to these incretin-based therapies could also differ ethnicity-wise. Subsequently, meta-analysis from these studies also suggested that Asians may have better response to these incretin-based therapies. This review will be an attempt to critically analyze those studies available in literature and to address as to why East-Asians and South-Asians may have different incretin response compared to non-Asians.
Knop, Filip K; Vilsbøll, Tina; Holst, Jens Juul
This review article focuses on the therapeutic potential of the incretin hormones, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), in treating type 2 diabetes mellitus (T2DM). T2DM is characterized by insulin resistance, impaired glucose-induced insulin...... secretion and inappropriately regulated glucagon secretion which in combination eventually result in hyperglycemia and in the longer term microvascular and macrovascular diabetic complications. Traditional treatment modalities--even multidrug approaches--for T2DM are often unsatisfactory at getting patients...... to glycemic goals as the disease progresses due to a steady, relentless decline in pancreatic beta-cell function. Furthermore, current treatment modalities are often limited by inconvenient dosing regimens, safety and tolerability issues, the latter including hypoglycemia, body weight gain, edema and...
Sonne, David P; Rehfeld, Jens F; Holst, Jens Juul;
, gallbladder emptying and gastric emptying were examined. RESULTS: Gallbladder emptying increased with increasing meal fat content, but no intergroup differences were demonstrated. GIP and GLP1 responses were comparable among the groups with GIP levels being higher following high-fat meals, whereas GLP1......-induced GLP1 secretion combined with the findings of reduced postprandial gallbladder emptying in patients with type 2 diabetes (T2DM) led us to speculate whether reduced postprandial GLP1 responses in some patients with T2DM arise as a consequence of diabetic gallbladder dysmotility. DESIGN AND METHODS...... secretion was similar after both OGTT and meals. CONCLUSIONS: In conclusion, patients with T2DM exhibited normal gallbladder emptying to meals with a wide range of fat content. Incretin responses were similar to that in controls, and an association with postprandial gallbladder contraction could...
Oxidative stress is increased in metabolic syndromeand type 2 diabetes mellitus （T2DM） and this appearsto underlie the development of cardiovascular disease,T2DM and diabetic complications. Increased oxidativestress appears to be a deleterious factor leading to insulin resistance, dyslipidemia, β-cell dysfunction, impaired glucose tolerance and ultimately leading to T2DM. Chronic oxidative stress, hyperglycemia and dyslipidemia are particularly dangerous for β-cells from lowest levels of antioxidant, have high oxidative energy requirements, decrease the gene expression of key β-cell genes and induce cell death. If β-cell functioning is impaired, it results in an under production of insulin, impairs glucose stimulated insulin secretion, fasting hyperglycemia and eventually the development of T2DM.
Gonzalez-Franquesa, Alba; Burkart, Alison M; Isganaitis, Elvira; Patti, Mary-Elizabeth
Type 2 diabetes (T2D) is increasing worldwide, making identification of biomarkers for detection, staging, and effective prevention strategies an especially critical scientific and medical goal. Fortunately, advances in metabolomics techniques, together with improvements in bioinformatics and mathematical modeling approaches, have provided the scientific community with new tools to describe the T2D metabolome. The metabolomics signatures associated with T2D and obesity include increased levels of lactate, glycolytic intermediates, branched-chain and aromatic amino acids, and long-chain fatty acids. Conversely, tricarboxylic acid cycle intermediates, betaine, and other metabolites decrease. Future studies will be required to fully integrate these and other findings into our understanding of diabetes pathophysiology and to identify biomarkers of disease risk, stage, and responsiveness to specific treatments. PMID:27319324
Albers, Peter Hjorth; Pedersen, Andreas J T; Birk, Jesper Bratz; Kristensen, Dorte Enggaard; Vind, Birgitte F; Baba, Otto; Nøhr, Jane; Højlund, Kurt; Wojtaszewski, Jørgen
/or metabolic enzymes. Pools of type I and II fibers were prepared from biopsies of the vastus lateralis muscles from lean, obese and type 2 diabetic subjects before and after a hyperinsulinemic-euglycemic clamp. Type I fibers compared to type II fibers have higher protein levels of the insulin receptor, GLUT4...... insulin adjusted for protein level were not different between fiber types. Independently of fiber type, insulin signaling was similar (TBC1D1, GS and PDH-E1α) or decreased (Akt and TBC1D4) in muscle from patients with type 2 diabetes compared to lean and obese subjects. We conclude that human type I...
Xu Hui; Chen Yanbo; Li Yanxiang; Xia Fangzhen; Han Bing; Zhang Huixin; Zhai Hualing
Background Lymphocyte function and homeostasis is associated with immune defence to infection.Apoptosis of lymphocytes might be a considerably important component which has an impact on immunity to infections in people with hyperglycemia.The aim of this study was to explore the mitochondrial apoptosis pathway of lymphocyte in diabetic patients.Methods Sixty patients with type 2 diabetes mellitus and fifty healthy volunteers were included in this study.Annexin V and propidiumiodide (Pl) were joined in the isolated lymphocytes and the rate of lymphocyte apoptosis was calculated with flow cytometry.Observation of the lymphocytes was done using transmission electron microscopy; mitochondria had been extracted and then mitochondrial membrane potential (MMP) was detected to assess mitochondrial function; the mRNA level of Bcl-2,cytochrome c (Cyt-C),caspase-9 and caspase-3 were analyzed by real-time reverse transcriptionpolymerase chain reaction (RT-PCR).Results Apoptosis rate of lymphocyte was significantly higher in diabetic group than that in normal control group (P ＜0.05).Transmission electron microscopy showed lymphocyte shrinkage and breakage,chromatin condensation and less mitochondria; a fall in MMP levels was also evident; Bcl-2 concentration was reduced and the expressions of caspase-9,caspase-3 and Cyt-C were elevated (P ＜0.05) in diabetic patients.Conclusions The rate of lymphocyte apoptosis was significantly higher in type 2 diabetic patients than that in normal population.Mitochondrial apoptosis pathway may play a very important role in decreasing function of lymphocyte in diabetes.
Jacobsen, Lisbeth V; Flint, Anne; Olsen, Anette K; Ingwersen, Steen H
Liraglutide is an acylated glucagon-like peptide-1 analogue with 97 % amino acid homology with native glucagon-like peptide-1 and greatly protracted action. It is widely used for the treatment of type 2 diabetes mellitus, and administered by subcutaneous injection once daily. The pharmacokinetic properties of liraglutide enable 24-h exposure coverage, a requirement for 24-h glycaemic control with once-daily dosing. The mechanism of protraction relates to slowed release from the injection site, and a reduced elimination rate owing to metabolic stabilisation and reduced renal filtration. Drug exposure is largely independent of injection site, as well as age, race and ethnicity. Increasing body weight and male sex are associated with reduced concentrations, but there is substantial overlap between subgroups; therefore, dose escalation should be based on individual treatment outcome. Exposure is reduced with mild, moderate or severe renal or hepatic impairment. There are no clinically relevant changes in overall concentrations of various drugs (e.g. paracetamol, atorvastatin, griseofulvin, digoxin, lisinopril and oral combination contraceptives) when co-administered with liraglutide. Pharmacodynamic studies show multiple beneficial actions with liraglutide, including improved fasting and postprandial glycaemic control (mediated by increased insulin and reduced glucagon levels and minor delays in gastric emptying), reduced appetite and energy intake, and effects on postprandial lipid profiles. The counter-regulatory hormone response to hypoglycaemia is largely unaltered. The effects of liraglutide on insulin and glucagon secretion are glucose dependent, and hence the risk of hypoglycaemia is low. The pharmacokinetic and pharmacodynamic properties of liraglutide make it an important treatment option for many patients with type 2 diabetes. PMID:26597252
Kuo, Jane Z.; Guo, Xiuqing; Klein, Ronald; Klein, Barbara E.; Weinreb, Robert N.; Genter, Pauline; Hsiao, Fone-Ching; Goodarzi, Mark O.; Rotter, Jerome I.; Chen, Yii-Der Ida; Ipp, Eli
Objective Residual insulin secretion provides important protection against the development of diabetic retinopathy in type 1 diabetes. The data to support this in type 2 diabetes are unclear. We therefore tested in type 2 diabetes whether markers of residual beta-cell function are associated with the development of diabetic retinopathy, an important microvascular complication of diabetes. Design Prospective, cross-sectional, family-based study. Participants 585 Latino type 2 diabetic particip...
Lauenborg, Jeannet; Grarup, Niels; Damm, Peter;
Objective: We aimed to examine the association between gestational diabetes (GDM) and eleven recently identified type 2 diabetes susceptibility loci. Research Design and Methods: Type 2 diabetes risk variants in TCF7L2, CDKAL1, SLC30A8, HHEX/IDE, CDKN2A/2B, IGF2BP2, FTO, TCF2, PPARG, KCNJ11 and WFS......1 loci were genotyped in a cohort of women with a history of GDM (n=283) and in glucose tolerant women of the population-based Inter99 cohort (n=2,446). Results: All the risk alleles in the 11 examined type 2 diabetes risk variants showed an odds ratio greater than 1 for the GDM group compared to...... previously proven type 2 diabetes risk alleles equals the findings from association studies on type 2 diabetes. This supports the hypothesis that GDM and type 2 diabetes are two of the same entity....
Lønnberg, Ann Sophie; Skov, Lone; Skytthe, Axel;
). Conclusions and Relevance: This study determines the contribution of genetic and environmental factors to the interaction between obesity, type 2 diabetes mellitus, and psoriasis. Psoriasis, type 2 diabetes mellitus, and obesity are also strongly associated in adults after taking key confounding factors, such......Importance: Psoriasis has been shown to be associated with overweight and type 2 diabetes mellitus. The genetic association is unclear. Objective: To examine the association among psoriasis, type 2 diabetes mellitus, and body mass index (BMI) (calculated as weight in kilograms divided by height in...... diagnoses of type 2 diabetes mellitus and self-reported BMI. Data were collected in the spring of 2002. Data were analyzed from January 1 to October 31, 2014. Main Outcomes and Measures: Crude and adjusted odds ratios (ORs) were calculated for psoriasis in relation to type 2 diabetes mellitus, increasing...
Full Text Available BackgroundThe purpose of this study was to evaluate maternal and neonatal outcomes in Korean women with type 1 diabetes and type 2 diabetes.MethodsWe performed a retrospective survey of 163 pregnancies in women with type 1 diabetes (n=13 and type 2 diabetes (n=150 treated from 2003 to 2010 at Cheil General Hospital & Women's Healthcare Center, Korea. We compared maternal characteristics as well as maternal and neonatal outcomes between groups.ResultsDifferences in glycosylated hemoglobin between type 1 and type 2 diabetes were not significant. Birth weight (3,501±689.6 g vs. 3,366±531.4 g and rate of major congenital malformations (7.7% vs. 5.6% were not significantly different. However, women with type 1 diabetes had higher rates of preeclampsia (38.5% vs. 8.2%, P=0.006, large for gestational age (LGA; 46.2% vs. 20.4%, P=0.004, macrosomia (38.5% vs. 13.4%, P=0.032, and admission for neonatal care (41.7% vs. 14.8%, P=0.03 than women with type 2 diabetes.ConclusionMaternal and neonatal outcomes for women with type 1 diabetes were poorer than for women with type 2 diabetes, especially preeclampsia, LGA, macrosomia and admission to the neonatal intensive care unit.
Gregory E Peterson
Full Text Available Gregory E PetersonDepartment of Internal Medicine, Des Moines University, USAObjective: To review insulin detemir for clinical use to better manage patients with type 1 and type 2 diabetes.Methods: A MEDLINE search, in English, from June 30, 2006 to December 1, 2008, using the terms “insulin analogs,” “insulin detemir” and “long-acting insulin analog.”Results: Insulin detemir improves glycemic control, based on HbA1C reduction and fasting glucose levels, without increasing the risk of hypoglycemia and weight gain. Insulin detemir has lower glycemic variability, with less intra-subject variability in blood glucose levels in patients with type 1 and type 2 diabetes, without increasing the risk of hypoglycemia. When added to oral anti-diabetes agents (OADs in type 2 diabetes, insulin detemir demonstrates superiority to other basal insulin options.Conclusion: Insulin detemir appears to provide better glycemic control with a lower risk of hypoglycemia and less weight gain in the treatment of patients with type 1 and type 2 diabetes.Keywords: type 1 diabetes, type 2 diabetes, insulin analogs, insulin detemir
Staiger, Harald; Machicao, Fausto; Kantartzis, Konstantinos; Schäfer, Silke A.; Kirchhoff, Kerstin; Guthoff, Martina; Silbernagel, Günther; Stefan, Norbert; Fritsche, Andreas; Häring, Hans-Ulrich
Background Genome-wide association (GWA) studies identified a series of novel type 2 diabetes risk loci. Most of them were subsequently demonstrated to affect insulin secretion of pancreatic β-cells. Very recently, a meta-analysis of GWA data revealed nine additional risk loci with still undefined roles in the pathogenesis of type 2 diabetes. Using our thoroughly phenotyped cohort of subjects at an increased risk for type 2 diabetes, we assessed the association of the nine latest genetic vari...
Narasimhan, Sumana; Weinstock, Ruth S.
Type 2 diabetes is increasingly diagnosed in obese children and adolescents. Evidence suggests that this disease commonly progresses more rapidly in youth compared to adults, and is associated with high rates of early microalbuminuria, hypertension and dyslipidemia. The Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study was the first multiethnic, multicenter randomized trial in the United States to compare three treatment approaches in new onset type 2 diabetes in ob...
Vineetha Kolar; Anand Sorikunte
OBJECTIVES Type 2 diabetes mellitus is associated with various rheumatological manifestations that are debilitating and affect the quality of life. The present study is about prevalence of rheumatological manifestations in type 2 diabetics. METHODS The current study is a cross sectional study with 100 patients of type 2 diabetics and 50 patients of age and sex matched non diabetics were examined for rheumatological manifestations during the period July 2008 to July 20...
Jalilian, Mohsen; Moeini, Babak; Hazavehei, Seyed Mohammad Mehdi.; Beigi, Abbas M.; Sharifirad, Gholamreza; Nodeh, Farhad Habibi
Background: Regular physical activity has an important role in reducing cardiovascular risk factors and improving metabolic control in patients with type 2 diabetes. This study aims to investigate the effect of physical activity stage-matched intervention on metabolic control in type 2 diabetes patients. Materials and Methods: An 8-week physical activity program conducted with 50 type 2 diabetes females who were physically inactive and in precontemplation, contemplation, and preparation stage...
Ming-Chun Kuo; Sheng-Hao Lin; Ching-Hsiung Lin; I-Chieh Mao; Shun-Jen Chang; Ming-Chia Hsieh
OBJECTIVE: Tuberculosis continues to be a major global health problem. We wanted to investigate whether Type 2 diabetes was a risk factor for tuberculosis in an Asian population. METHODS: From Taiwan's National Health Insurance Research Database, we collected data from 31,237 female patients with type 2 diabetes and 92,642 female controls and 32,493 male patients with type 2 diabetes and 96,977 male controls. Cox proportional hazard regression was performed to evaluate independent risk factor...
Zhao, Jianhua; Li, Mingyao; Bradfield, Jonathan P.; Wang, Kai; ZHANG, HAITAO; Sleiman, Patrick; Kim, Cecilia E.; Annaiah, Kiran; Glaberson, Wendy; Glessner, Joseph T.; Otieno, F. George; Thomas, Kelly A.; Garris, Maria; Hou, Cuiping; Frackelton, Edward C.
OBJECTIVE A number of studies have found that reduced birth weight is associated with type 2 diabetes later in life; however, the underlying mechanism for this correlation remains unresolved. Recently, association has been demonstrated between low birth weight and single nucleotide polymorphisms (SNPs) at the CDKAL1 and HHEX-IDE loci, regions that were previously implicated in the pathogenesis of type 2 diabetes. In order to investigate whether type 2 diabetes risk–conferring alleles associat...
Radhakrishnan Chandni; Kollengode Parameswaran Ramamoorthy
AIM: To estimate the level of serum lipoprotein (a) [Lp (a)] in type 2 diabetes mellitus patients and to determine the relationship between Lp(a) in type 2 diabetes mellitus patients and micro-vascular complications. METHODS: A cross sectional study was performed that enrolled 144 subjects with type 2 diabetes mellitus above the age of 25 years attending outpatient clinic of Government Medical College, Kozhikode. Lp(a) levels were measured quantitatively in venous samples using Turbidimetric ...
Singla, Seema; Kaur, Kiranjeet; Kaur, Gurdeep; Kaur, Habir; Kaur, Jasbinder; Jaswal, Shivani
BACKGROUND: Increased lipoprotein (a) [Lp (a)] concentrations are predictive of coronary artery disease (CAD). Type 2 diabetes mellitus also leads to dyslipidemia, like elevated triglyceride levels and low HDL levels, which are known risk factors for CAD. This study was designed to investigate the levels of Lp (a) in type 2 diabetic patients and their association with LDL: HDL ratio and glycemic control. MATERIALS AND METHODS: The study included 60 patients of type 2 diabetes and 50 age and s...
Singh, A.K.; Kumar, A.; D Karmakar; R K Jha
Context: Long-term metformin use has been hypothesized to cause B12 deficiency and neuropathy in Type 2 diabetes patients. However, there is a paucity of Indian data regarding the same. Aim: To compare the prevalence of B12 deficiency and peripheral neuropathy in patients with Type 2 diabetes mellitus treated with or without metformin. Materials and Methods: We recruited patients with Type 2 diabetes and divided them into metformin exposed and nonmetformin exposed groups. We measured baseline...
Larsen, Steen; Skaaby, Stinna; Helge, Jørn Wulff;
intensity training) improves insulin sensitivity in healthy humans and in patients with type 2 diabetes. Whether patients with type 2 diabetes have the same beneficial effects (same improvement) as control subjects, when it comes to regular physical activity in regard to mitochondrial function, is not...... established in the literature. This review will focus only on the effect of physical activity on skeletal muscle (mitochondrial function) in patients with type 2 diabetes....
Ghosh, Amrita; Sherpa, Mingma L.; Bhutia, Yazum; Pal, Ranabir; Dahal, Sanjay
Background: Serum nitric oxide (NO) has emerged as a fundamental signal associated with the endothelial dysfunction in type 2 diabetes. Aims: To compare serum nitric oxide level among type 2 diabetic patients along with other biochemical parameters and to compare it with that of normal population in Sikkim. Settings and Design: This prospective study was carried out in the Biochemistry Department in a tertiary care teaching hospital in Sikkim on 50 type 2 diabetics compared to 100 non-diabeti...
Grady, Katherine; Savas, Linda
Introduction Diabetes is one of the major health challenges of our time. Diabetes UK recently estimated 10% of the total NHS budget is spent on diabetes care. NICE guidance “Prevention of type 2 diabetes in adults” (2011) and “Prevention of type 2 diabetes in high-risk groups” (currently consultation phase) emphasises the importance of prevention. Impaired glucose tolerance (IGT) is a precursor for the development of type 2 diabetes and is additionally associated with increased cardiovascular...
F. Mohammadi; M Veissi; Haidari, F; Shahbazian, H.; M mohammad shahi
Introduction: Cardiovascular disease is more prevalent in patients with type 2 diabetes. Regarding the role of probiotics in control of inflammation and modulating the lipid profile, this study assess the effect of probiotic and conventional yogurt on inflammatory markers and lipid profile in type 2 diabetic patients. Methods: Forty- four subjects with type 2 diabetes were randomly assigned to two intervention and control groups. The intervention group consumed 300 g/d probiotic yogurt (e...
Anand Vijayakumar PR; Bhatt Jayesh Kumar; Varghese Jenny M; Das Sushanta Kr.
Oxidative stress has been suggested as a major contributing factor for initiation and progression of cognitive impairment along with various other complications in type 2 diabetes mellitus. The present study was, therefore, designed to assess the effect of vitamin E supplemention along with oral hypoglycaemic agents on cognitive functions and oxidative stress in patients with type 2 diabetes mellitus. A total of 74 type 2 diabetes mellitus patients were enrolled in this randomized open label ...
Jacob, Asha; Steinberg, Marissa L.; Yang, Juntao; Dong, Weifeng; Ji, Youxin; Wang, Ping
Hyperglycemia is common in critically ill patients and pronounced hyperglycemia may lead to complications which include severe infections, polyneuropathy, multiple organ failure and death in such patients. Sustained hyperglycemia is generally observed in patients with Type 2 diabetes. To explore sepsis-induced inflammation in Type 2 diabetes, polymicrobial sepsis was induced by cecal ligation and puncture (CLP) in the Goto-Kakizaki (GK) rat, a spontaneous animal model of Type 2 diabetes. The ...
Darabi, Hossein; Raeisi, Alireza; Kalantarhormozi, Mohammad Reza; Ostovar, Afshin; Assadi, Majid; Asadipooya, Kamyar; Vahdat, Katayoun; Dobaradaran, Sina; Nabipour, Iraj
Abstract Serum adiponectin levels have been suggested to be predictors of type 2 diabetes mellitus in diverse populations. However, the relationship between circulating adiponectin levels and the risk of development of type 2 diabetes in postmenopausal women has not been investigated. A total of 382 healthy postmenopausal women who participated in a prospective cohort study were followed for 5.8 years. Type 2 diabetes mellitus was defined according to the criteria set out by the American Diab...
Unjin Shim; Jee-Young Oh; Hye Jin Lee; Young Sun Hong; Yeon-Ah Sung
Background Long menstrual cycle is a risk factor for developing type 2 diabetes and cardiovascular disease in women. We aimed to evaluate the association between existing type 2 diabetes and oligomenorrhea before diagnosis of diabetes, and to observe the differences in this association among obese and non-obese Korean women. Methods Patients with type 2 diabetes (n=118) and without any clinical evidence of abnormal glucose regulation (n=258) who attended the outpatient clinic of a university ...
Even though obesity is a well-established risk factor of type 2 diabetes, there is emerging evidence that persistent organic pollutants (POPs), a variety of lipophilic chemicals accumulated in adipose tissue, may be critically involved in the pathogenesis of type 2 diabetes. Among various POPs, serum concentrations of organochlorine pesticides and polychlorinated biphenyls (PCBs) were the most strongly and consistently linked to type 2 diabetes in both cross-sectional and prospective studies....
Kitahara, Yoshihiro; Hattori, Noboru; Yokoyama, Akihito; Yamane, Kiminori; Sekikawa, Kiyokazu; Inamizu, Tsutomu; Kohno, Nobuoki
Patients with type 2 diabetes have impaired exercise capacity. While numerous factors are known to contribute to impaired exercise capacity, the role of lung function remains unclear. We conducted the present study to investigate the influence of lung function on exercise capacity in patients with type 2 diabetes. Cardiopulmonary exercise testing was carried out in 31 male patients with type 2 diabetes without diabetic complications or cardiopulmonary diseases. Patients with abnormal spir...
Hu, Huimei; Sawhney, Monika; Shi, Lizheng; Duan, Shengnan; Yu, Yunxian; Wu, Zhihong; Qiu, Guixing; Dong, Hengjin
Background Type 2 diabetes is associated with acute and chronic complications and poses a large economic, social, and medical burden on patients and their families as well as society. Objective This study aims to evaluate the direct economic burden of type 2 diabetes in China. Data source: systematic review on cost of illness, health care costs, direct service costs, drug costs, and health expenditures in relation to type 2 diabetes was conducted up to 2014 using databases such as Pubmed; EBS...
Saito, Eiko; Charvat, Hadrien; Goto, Atsushi; Matsuda, Tomohiro; Noda, Mitsuhiko; Sasazuki, Shizuka; Inoue, Manami
Diabetes mellitus constitutes a major disease burden globally, and the prevalence of diabetes continues to increase worldwide. We aimed to estimate the burden of cancer associated with type 2 diabetes mellitus in Japan between 2010 and 2030. In this study, we estimated the population attributable fraction of cancer risk associated with type 2 diabetes in 2010 and 2030 using the prevalence estimates of type 2 diabetes in Japan from 1990 to 2030, summary hazard ratios of diabetes and cancer ris...
Wood, Amanda G.; Jian Chen; Christopher Moran; Thanh Phan; Richard Beare; Kimberley Cooper; Stacey Litras; Velandai Srikanth
Type 2 diabetes mellitus increases the risk of dementia and neuronal dysfunction may occur years before perceptible cognitive decline. We aimed to study the impact of type 2 diabetes on brain activation during memory encoding in middle-aged people, controlling for age, sex, genes, and early-shared environment. Twenty-two twin pairs discordant for type 2 diabetes mellitus (mean age 60.9 years) without neurological disease were recruited from the Australian Twin Registry (ATR) and underwent fun...
Mehravar, Fatemeh; Mansournia, Mohammad Ali; Holakouie-Naieni, Kourosh; Nasli-Esfahani, Ensie; Mansournia, Nasrin; Almasi-Hashiani, Amir
OBJECTIVES: Diabetes is a major public health problem that is approaching epidemic proportions globally. Diabetes self-management can reduce complications and mortality in type 2 diabetic patients. The purpose of this study was to examine associations between diabetes self-management and microvascular complications in patients with type 2 diabetes. METHODS: In this cross-sectional study, 562 Iranian patients older than 30 years of age with type 2 diabetes who received treatment at the Diabete...
Aims. The purpose of the study was to investigate the differences of adenosine, adenine, inosine, xanthine, hypoxanthine, and uric acid concentrations in patients with type 2 diabetes mellitus and diabetic retinopathy and assess the relationship between purine metabolites and disease. Materials and Methods. The study group consisted of 114 subjects which were divided into three groups: control (n = 40), type 2 diabetes without retinopathy (n = 35), and type 2 diabetes with retinopathy (n = 39...
Condorelli, G.; Vigliotta, G; Iavarone, C; M. CARUSO; Tocchetti, C G; Andreozzi, F; Cafieri, A; Tecce, M F; Formisano, P; Beguinot, L; Beguinot, F.
We have used differential display to identify genes whose expression is altered in type 2 diabetes thus contributing to its pathogenesis. One mRNA is overexpressed in fibroblasts from type 2 diabetics compared with non-diabetic individuals, as well as in skeletal muscle and adipose tissues, two major sites of insulin resistance in type 2 diabetes. The levels of the protein encoded by this mRNA are also elevated in type 2 diabetic tissues; thus, we named it PED for phosphoprotein enriched in d...
Obesity and increases in body weight are among the most important risk factors for type 2 diabetes mellitus. Obesity contributes to the development of type 2 diabetes mellitus. Body mass index is also known as obesity index. Body mass index is a strong and independent risk factor for being diagnosed in cases of type 2 diabetes mellitus. There is a high risk of type 2 diabetes in those who have a higher body mass index. The present study has been done with the objective of finding correlation ...
Boushel, R; Gnaiger, E; Schjerling, P;
AIMS/HYPOTHESIS: Insulin resistance and type 2 diabetes are associated with mitochondrial dysfunction. The aim of the present study was to test the hypothesis that oxidative phosphorylation and electron transport capacity are diminished in the skeletal muscle of type 2 diabetic subjects, as a res......AIMS/HYPOTHESIS: Insulin resistance and type 2 diabetes are associated with mitochondrial dysfunction. The aim of the present study was to test the hypothesis that oxidative phosphorylation and electron transport capacity are diminished in the skeletal muscle of type 2 diabetic subjects...
CAI Xiao-ling; WANG Fang; JI Li-nong
Background Advances in treatment have greatly reduced the risk of blindness from this disease, but because diabetes is so common, diabetic retinopathy remains an important problem. The purpose of this study is to investigate the risk factors of diabetic retinopathy (DR) in Chinese type 2 diabetic patients.Methods Totally 746 type 2 diabetic patients were selected for biochemical and clinical characteristics test and examined by the retina-camera for diabetic retinopathy and the average age was 55.9 years old.Results A total of 526 patients was classified as non-DR, 159 patients as non-proliferative-DR and 61 patients as proliferative-DR. Duration of diabetes [(66.09±72.51) months vs (143.71 ±93.27) months vs (174.30±81.91)months, P=0.00], systolic blood pressure [(131.95±47.20) mmHg vs (138.71 ±21.36) mmHg vs (147.58±24.10)mmHg, P=0.01], urine albumin [(32.79± 122.29) mg/L vs (190.96±455.65) mg/L vs (362.00±552.51) mg/L,P=0.00], glycated hemoglobin (HbA1c) [(8.68 ± 2.26)% vs (9.42±1.84)% vs (9.42±1.96)%, P=0.04],C-reactive protein (CRP) [(3.19±7.37) mg/L vs (6.36± 23.59) mg/L vs (3.02±4.34) mg/L, P=0.03],high-density lipoprotein cholesterol (HDL-C) [(1.23±0.37) mmol/L vs (1.33±0.35) mmol/L vs (1.24±0.33)mmol/L, P=0.01], uric acid (UA) [(288.51 ±90.85) mmol/L vs (300.29±101.98) mmol/L vs (337.57±115.09)mmol/L, P=0.00], creatinine (CREA) [(84.22±16.31) μmol/L vs (89.35±27.45) μmol/L vs (103.28±48.64)μmol/L, P=0.00], blood urine nitrogen (BUN) [(5.62± 1.62) mmol/L vs (6.55±2.74) mmol/L vs (8.11±3.60)mmol/L, P=0.00] were statistically different among the three groups. Logistic regression analysis showed that diabetic duration and urine albumin were two independent risk factors of DR (the OR values were 1.010 and 1.003 respectively).Conclusions Diabetic duration and urine albumin are two independent risk factors of diabetic retinopathy in elderly type 2 diabetic patients.
Mario; Barbagallo; Ligia; J; Dominguez
Epidemiological and biological evidences support a link between type 2 diabetes mellitus(DM2) and Alzheimer’s disease(AD). Persons with diabetes have a higher incidence of cognitive decline and an increased risk of developing all types of dementia. Cognitive deficits in persons with diabetes mainly affect the areas of psychomotor efficiency, attention, learning and memory, mental flexibility and speed, and executive function. The strong epidemiological association has suggested the existence of a physiopathological link. The determinants of the accelerated cognitive decline in DM2, however, are less clear. Increased cortical and subcortical atrophy have been evidenced after controlling for diabetic vascular disease and inadequate cerebral circulation. Most recent studies have focused on the role of insulin and insulin resistance as possible links between diabetes and AD. Disturbances in brain insulin signaling mechanisms may contribute to the molecular, biochemical, and histopathological lesions in AD. Hyperglycemia itself is a risk factor for cognitive dysfunction and dementia. Hypoglycemia may also have deleterious effects on cognitive function. Recurrent symptomatic and asymptomatic hypoglycemic episodes have been suggested to cause sub-clinical brain damage, and permanent cognitive impairment. Futuretrials are required to clarify the mechanistic link, to address the question whether cognitive decline may be prevented by an adequate metabolic control, and to elucidate the role of drugs that may cause hypoglycemic episodes.
Full Text Available BACKGROUND: in type 2 diabetes, the maintenance of non-diabetic glycaemic levels has been shown to decrease the onset of long term complications and consequently their high management costs. In order to achieve and maintain normal blood glucose levels, lifestyle interventions are highly cost/effective, but require good compliance, strong motivation and efforts by the patients. For this reason, a majority of patients needs to start pharmacological therapy shortly after diagnosis. Rosiglitazone, an insulin-sensitising drug, is indicated for subjects with inadequate glycaemic control both as monotherapy, in those contraindicated to metformin, especially if overweight, and as combination therapy with metformin, sulphanilureas or both. OBJECTIVES: rosiglitazone offers clinical advantages over the alternatives, decreasing and/or postponing the need for insulin treatment. Its high acquisition cost may therefore be totally or partially offset by the reduction in future health care resources consumption, and by short-term practical advantages, such as the decrease in the need for blood glucose monitoring and of adverse events. Aim of this study was to investigate the impact of the use of rosiglitazone in eligible diabetic patients on the National Health System budget. METHODS: for this scope an analytic model was implemented, which pathway may be summarized as follows: a estimate of the number type 2 diabetes patients living in Italy, grouped according to current therapeutic classes; b estimate of the number of patients with inadequate glycaemic control for each subgroup; c identification of patients eligible to rosiglitazone treatment; d identification of the comparator strategy for each patient sub-group; e comparison of costs for each couple of alternative options; f calculation of budget impact. RESULTS: use of rosiglitazone monotherapy instead of sulphanilurea monotherapy induces a mild costs increase. Combination treatment with rosiglitazone added
Vimalkumar V K
Full Text Available Background: 31.7 million people in India are suffering from diabetes. Diabetic nephropathy (Kimmelstiel-Wilson syndrome is the leading cause of end-stage renal disease (ESRD worldwide and a leading cause of DM-related morbidity and mortality. It is estimated that 79.4 million diabetic patients will be in India by 2030. So a study was done on the prevalence rate of diabetic nephropathy (DN and its associated risk factors.Aims and Objectives: This study is a small cross sectional study conducted in a tertiary hospital (Dr. Ambedkar institute of diabetes, Kilpauk medical college hospital, Chennai.. The objective is to analyze the prevalence of DN and to determine the factors leading to DN in type 2 diabetic patients (mainly containing urban Asian Indian populationMaterials and Methods: 200 Type 2 diabetic patients were randomly selected. All the patients were interviewed with a questionnaire. A detailed history including risk factors like age ,sex , socio economic status, duration of diabetes , smoking , alcohol , family history of DM and kidney disease, Ischemic heart disease(IHD, Oral Hypoglycemic Drugs(OHA , Insulin was taken followed by measurement of blood pressure, BMI assessment, urine analysis for albuminuria and microalbuminuria using dipsticks, lipid profile, GFR estimation, retinopathy screening. Statistical analysis was done by SPSS software. Univariate analysis, Chi-square and Binary Logistic Regression Model was used.Results: In this study prevalence rate of overt nephropathy is 2.5% and microalbuminuria is 13%, Using Binary logistic regression analysis, Woman gender, Duration of diabetes, family history of kidney disease, Hypertension, BMI, GFR, retinopathy were found to be significantly associated with overt DN. There was no increased risk among IHD patients, smokers, alcoholics and no significant relationship with treatment history.Limitations: This is a hospital based cross sectional study. Population based Case control studies
Full Text Available Aml Mohamed Nada Department of Internal Medicine, Unit of Endocrinology, Diabetes and Metabolism, Faculty of Medicine, Mansoura University, Mansoura, Egypt Objective: To study the indices of some elements of the complete blood count, in type 2 diabetic patients, in comparison with nondiabetic healthy controls; and to find out the effects of glycemic control and different medications on these indices. To the best of our knowledge, this study is novel in our environment and will serve as a foundation for other researchers in this field. Methods: This retrospective study included 260 type 2 diabetic patients on treatment and 44 healthy control subjects. Sex, age, weight, height, blood pressure, complete blood count, fasting plasma glucose, hemoglobin A1c (HbA1c, and lipid profile data, were available for all of the study population. For diabetic patients, data on duration of diabetes and all medications were also available. Results: Red cell distribution width (RDW was significantly higher in diabetic patients than in control subjects (P=0.008. It was also higher in patients with uncontrolled glycemia (HbA1c >7% than those with good control (HbA1c ≤7%; P=0.035. Mean platelet volume (MPV was comparable in both diabetic patients and healthy controls (P=0.238. RDW and MPV did not significantly correlate with fasting plasma glucose, HbA1c, or duration of diabetes. Both aspirin and clopidogrel did not show a significant effect on MPV. Both insulin and oral hypoglycemic agents did not show a significant effect on RDW, mean corpuscular volume, MPV, platelet count, or white blood cell count. Diabetic patients treated with indapamide or the combined thiazides and angiotensin receptor blockers showed no significant difference in RDW when compared with the control subjects. Conclusion: RDW, which is recently considered as an inflammatory marker with a significant predictive value of mortality in diseased and healthy populations, is significantly higher in
Full Text Available With the increasing importance of early type 2 diabetes (DM2 and obesity detection, it is useful to reevaluate leptin role in these conditions. Our study aimed at investigating circulating leptin concentrations in a group of patients with DM2, and at assessing in detail whether leptin concentrations correlate with selected biochemical, clinical parameters and markers of systemic inflammation in patients with DM2 and in healthy volunteers. In our work, we analysed samples and data drawn from 71 patients aged 61.4 ± 11.7 years, who have been diagnosed with type 2 diabetes, as well as from a healthy control group (HC consisting of 51 healthy subjects with a mean age of 57.8 ± 13.7 years. Therein, the concentration of leptin in the DM2 patients was significantly higher than in the HC (p < 0.01, with median value of 16.59 (IQR 8.58-33.39 ng/ml in the DM2, vs median value of 6.66 (IQR 4.52-21.40 ng/ml in the HC. In the analysis of variance, higher leptin concentrations were revealed in the DM2 group as compared to the HC, and this figure remained significant after adjusting for gender and age (p < 0.001. Moreover, it was independent of HOMA-IR (p = 0.003. However, the differences in leptin levels between the groups disappeared when additional adjustments for anthropometric parameters (BMI, waist circumference were applied (p = 0.088. Beyond the aforementioned, significant positive correlations were found in the DM 2 group between leptin level and CRP (r=0.256; p < 0.05 and IL-6 (r = 0.345; p < 0.01. Among the selected variables, only gender and BMI were included in the predictive model explaining the variability of leptin, and, in total, were responsible for 72.6% of the original variation of the studied adipocytokine. The results of this study have led to conclusion that leptin may participate in the complex pathogenesis of DM2 and be a predictor of the development of this disease. As higher concentrations of leptin coexist with obesity, and this
Nyberg, Solja ,; Fransson, Eleonor ,; Heikkilä, Katriina; Ahola, Kirsi; Alfredsson, Lars; Bjorner, Jakob; Borritz, Marianne; Burr, Hermann; Dragano, Nico; Goldberg, Marcel; Hamer, Mark; Jokela, Markus; Knutsson, Anders; Koskenvuo, Markku; Koskinen, Aki
OBJECTIVE: The status of psychosocial stress at work as a risk factor for type 2 diabetes is unclear because existing evidence is based on small studies and is subject to confounding by lifestyle factors, such as obesity and physical inactivity. This collaborative study examined whether stress at work, defined as "job strain," is associated with incident type 2 diabetes independent of lifestyle factors. RESEARCH DESIGN AND METHODS: We extracted individual-level data for 124,808 diabetes-free ...
Althouse, Andrew D.; Abbott, J . Dawn; Forker, Alan D.; Bertolet, Marnie; Barinas-Mitchell, Emma; Thurston, Rebecca C.; Mulukutla, Suresh; Aboyans, Victor; Brooks, Maria Mori; ,
OBJECTIVE The aim of this article was to define risk factors for incidence of peripheral arterial disease (PAD) in a large cohort of patients with type 2 diabetes mellitus (T2DM), overall and within the context of differing glycemic control strategies. RESEARCH DESIGN AND METHODS The Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes (BARI 2D) randomized controlled trial assigned participants to insulin-sensitizing (IS) therapy versus insulin-providing (IP) therapy. A total...
Aims. To assess the effect of metformin and to compare it with insulin treatment in patients with type 2 diabetes in pregnancy in terms of perinatal outcome, maternal complications, additional insulin requirement, and treatment acceptability. Methods. In this randomized, open label study, 206 patients with type 2 diabetes in pregnancy who met the eligibility criteria were selected from the antenatal clinics. Insulin was added to metformin treatment when required, to maintain the target glycem...
Objective: To investigate the clinical application of urodilatin (URO) in tubular injury of DM2. Methods: 41 healthy controls, 33 type 2 diabetics without nephropathy, 37 patients with early stage of diabetic nephropathy and 26 patients with clinical diabetic nephropathy were enrolled in the study and categorized into four groups. Urodilatin was measured by radioimmunoassay (RIA). The changes of urodilatin levels among four groups were analyzed, and correlation analyses were performed between urodilatin and urinary micro-albumin/urine creatinine(mA/UCr). The efficiency index of URO were evaluated by receiver operation characteristic (ROC). Results: Compared with those in the controls,diabetics without nephropathy, early stage of diabetic nephropathy and clinical diabetic nephropathy, the urodilatin level decreased significantly in the course of diabetic nephropathy (P<0.001). The value of URO was significantly correlated with mA/UCr (r=-0.626, P<0.01). In early phase of DM2, The area under curve was 0.759. When the cut-off vaule of URO was ≤51.5 pg/ml, The sensitivity and specificity were 67.14% and 70.29%, respectively. Furthermore, Urodilatin had similar diagnosis efficiency with mA/UCr. Conclusion: The decrease of urodilatin level had clinical value in pristine tubular injury of DM2 and can serve as an evaluation parameter. (authors)
Ferit Kerim Kucukler
Full Text Available Many factors play a role in the etiology of acute pancreatitis and its pathogenesis is not fully understood. Dipeptidyl peptidase 4 (DPP-4 inhibitors are a new group of agents for the treatment of Diabetes Mellitus (DM. There are some controversies about specific adverse events such as pancreatitis and hypersensitivity reactions. A 50-year-old morbid obese woman presented with upper abdomen pain after the eating food, nausea and vomiting. She was diagnosed with type 2 diabetes mellitus 7 years ago. Vildagliptin had been added to her treatment six months ago. Abdominal examination revealed epigastric tenderness with guarding. Laboratory data revealed elevated pancreatic enzymes. Abdominal computed tomography (CT showed features of pancreatitis. Vildagliptin was stopped and patient's symptoms had diminished in parallel with normalization of pancreatic enzymes; and at the 5th day patient was discharged with healthy condition. She was free of symptoms and all laboratory data were normal at the 30th day after discharge. It is important to keep in mind that diabetic patients have an increased risk of pancreatitis which may be related to obesity, hyperlipidemia and/or drugs.
S V Kakorin
Full Text Available Cerebrovascular accident (CA is a nowadays widely spread, highly incapacitating and often lethal event that poses a prominent clini- cal problem. Cardiovascular disease (CVD and type 2 diabetes mellitus (T2DM – an “epidemic” of the century, – are known to be its primary risk factors. Hyperglycemia promotes CA risks by induction of protein glycosylation, elevation of blood plasma atherogenic potential, activation of coagulation system with higher risk for thrombosis and disturbance of microcirculation on tissue and organ lev- els. Influence of hyperglycemia on severity and extent of neurologic damage is still under evaluation. Development of macroangiopathy is thought to be associated with media calcification, distal polyneuropathy and renal disorders, all of which are cardiovascular risk factors. Application of so-called metabolic drugs resulted in certain disillusionment, as these agents failed to prove their efficacy during clinical trials. Incidence of pulmonary edema in patients with ischemic CA and T2DM is important as it dictates the necessity for use of loop diuretics. Incidence and severity of heart failure and its correlation with degree of glycemic disorders, incidence of pulmonary em- bolism, as well as tactics of management and prognosis in patients with ischemic CA and T2DM, remains a relevant research problem.
Singh, Shalini; Usman, Kauser; Banerjee, Monisha
Type 2 diabetes mellitus (T2DM) is a silent progressive polygenic metabolic disorder resulting from ineffective insulin cascading in the body. World-wide, about 415 million people are suffering from T2DM with a projected rise to 642 million in 2040. T2DM is treated with several classes of oral antidiabetic drugs (OADs) viz. biguanides, sulfonylureas, thiazolidinediones, meglitinides, etc. Treatment strategies for T2DM are to minimize long-term micro and macro vascular complications by achieving an optimized glycemic control. Genetic variations in the human genome not only disclose the risk of T2DM development but also predict the personalized response to drug therapy. Inter-individual variability in response to OADs is due to polymorphisms in genes encoding drug receptors, transporters, and metabolizing enzymes for example, genetic variants in solute carrier transporters (SLC22A1, SLC22A2, SLC22A3, SLC47A1 and SLC47A2) are actively involved in glycemic/HbA1c management of metformin. In addition, CYP gene encoding Cytochrome P450 enzymes also play a crucial role with respect to metabolism of drugs. Pharmacogenetic studies provide insights on the relationship between individual genetic variants and variable therapeutic outcomes of various OADs. Clinical utility of pharmacogenetic study is to predict the therapeutic dose of various OADs on individual basis. Pharmacogenetics therefore, is a step towards personalized medicine which will greatly improve the efficacy of diabetes treatment. PMID:27555891
Jiang, Xinli; Ma, Huijie; Wang, Yan; Liu, Yan
Type 2 diabetes mellitus (T2DM) is a multifactorial disease, and its aetiology involves a complex interplay between genetic, epigenetic, and environmental factors. In recent years, evidences from both human and animal experiments have correlated early life factors with programming diabetes risk in adult life. Fetal and neonatal period is crucial for organ development. Many maternal factors during pregnancy may increase the risk of diabetes of offsprings in later life, which include malnutrition, healthy (hyperglycemia and obesity), behavior (smoking, drinking, and junk food diet), hormone administration, and even stress. In neonates, catch-up growth, lactation, glucocorticoids administration, and stress have all been found to increase the risk of insulin resistance or T2DM. Unfavorable environments (socioeconomic situation and famine) or obesity also has long-term negative effects on children by causing increased susceptibility to T2DM in adults. We also address the potential mechanisms that may underlie the developmental programming of T2DM. Therefore, it might be possible to prevent or delay the risk for T2DM by improving pre- and/or postnatal factors. PMID:24455747
Najafi, Behzad; Farzadfar, Farshad; Ghaderi, Hossein; Hadian, Mohammad
Background: Although studies reported diabetes mellitus screening cost effective, the mass screening for type2 diabetes remains controversial. In this study we reviewed the recently evidence about the cost effectiveness of mass screening systematically. Methods: We reviewed the MEDLINE, Scopus, Web of Science (WOS), and Cochrane library databases by MeSH terms to identify relevant studies from 2000 to 2013. We had 4 inclusion and 6 exclusion criteria and used the Drummond’s checklist for appraising the quality of studies. Results: The initial search yielded 358 potentially related studies from selected databases. 6 studies met our inclusion and exclusion criteria and included in final review. 3 and 2 of them were conducted in Europe and America and only one of them in Asia. Quality-adjusted life year (QALY) was the main outcome to appraise the effectiveness in the studies. Incremental cost effectiveness ratio (ICER) was computed in range from $516.33 to $126,238 per QALY in the studies. Conclusion: A review of previous diabetes screening cost effectiveness analysis showed that the studies varied in some aspects but reached similar conclusions. They concluded that the screening may be cost effective, however further studies is required to support the diabetes mass screening. PMID:27390696
Naka Katerina K
Full Text Available Abstract Background Type 2 diabetes mellitus (T2DM is independently associated with an increased risk for cardiovascular diseases that is primarily due to the early development of advanced atherosclerotic vascular changes. The aim of our study was to investigate the predictors of vascular dysfunction in T2DM patients. Methods We studied 165 T2DM patients without known macrovascular or microvascular disease. Standard demographic (age, gender, cardiovascular risk factors, medications, clinical (body mass index, blood pressure and laboratory (glucose, glycated hemoglobin, lipids, renal function parameters were included in analyses. Brachial artery flow-mediated dilation (FMD, nitrate mediated dilation (NMD and Carotid-Femoral Pulse Wave Velocity (PWV were measured. Results Median age was 66 years and duration since T2DM diagnosis was 10 years, 70% were females and 79% hypertensives, while only 10% had a glycated hemoglobin Conclusions In T2DM patients, impairment of endothelium-dependent vasodilation was independently associated only with longer diabetes duration while no association with other established risk factors was found. Vascular smooth muscle dysfunction and increased arterial stiffness were more prominent in older T2DM patients with hypertension. Worse glycemic control was associated with impaired vascular smooth muscle function.
Elizabeth R. Gilbert
Full Text Available Insulin resistance and loss of β-cell mass cause Type 2 diabetes (T2D. The objective of this study was to generate a nongenetic mouse model of T2D. Ninety-six 6-month-old C57BL/6N males were assigned to 1 of 12 groups including (1 low-fat diet (LFD; low-fat control; LFC, (2 LFD with 1 i.p. 40 mg/kg BW streptozotocin (STZ injection, (3, (4, (5, (6 LFD with 2, 3, 4, or 5 STZ injections on consecutive days, respectively, (7 high-fat diet (HFD, (8 HFD with 1 STZ injection, (9, (10, (11, (12 HFD with 2, 3, 4, or 5 STZ injections on consecutive days, respectively. After 4 weeks, serum insulin levels were reduced in HFD mice administered at least 2 STZ injections as compared with HFC. Glucose tolerance was impaired in mice that consumed HFD and received 2, 3, or 4 injections of STZ. Insulin sensitivity in HFD mice was lower than that of LFD mice, regardless of STZ treatment. Islet mass was not affected by diet but was reduced by 50% in mice that received 3 STZ injections. The combination of HFD and three 40 mg/kg STZ injections induced a model with metabolic characteristics of T2D, including peripheral insulin resistance and reduced β-cell mass.
Thaning, Pia; Bune, Laurids T.; Hellsten, Ylva;
. 143+/-26 ml/mu;mol ATP x kg; by 494+/-80 vs. 234+/-39 ml/mumol UTP x kg; and by 14.9+/-2.7 vs. 7.5+/-0.6 ml/mumol ADO x kg in control and diabetic subjects, respectively, thus making the vasodilator potency: UTP-controls (100) > ATP-controls (55) > UTP-DM (47) > ATP-DM (29) > ADO-controls (3) > ADO......Objective: Extra cellular nucleotides and nucleosides are involved in regulation of skeletal muscle blood flow. Diabetes induces cardiovascular dysregulation but the extent to which the vasodilatatory capacity of nucleotides and nucleosides are affected in type 2 diabetes is unknown. The present...... study investigated: 1) the vasodilatatory effect of ATP, UTP, and adenosine (ADO) and 2) the expression and distribution of P2Y(2) and P2X(1) receptors in skeletal muscles of diabetic subjects. Research Design and Methods: In 10 diabetic patients and 10 age-matched controls, leg blood flow (LBF) was...
Full Text Available Type 2 diabetes mellitus (T2DM is a multifactorial disease, and its aetiology involves a complex interplay between genetic, epigenetic, and environmental factors. In recent years, evidences from both human and animal experiments have correlated early life factors with programming diabetes risk in adult life. Fetal and neonatal period is crucial for organ development. Many maternal factors during pregnancy may increase the risk of diabetes of offsprings in later life, which include malnutrition, healthy (hyperglycemia and obesity, behavior (smoking, drinking, and junk food diet, hormone administration, and even stress. In neonates, catch-up growth, lactation, glucocorticoids administration, and stress have all been found to increase the risk of insulin resistance or T2DM. Unfavorable environments (socioeconomic situation and famine or obesity also has long-term negative effects on children by causing increased susceptibility to T2DM in adults. We also address the potential mechanisms that may underlie the developmental programming of T2DM. Therefore, it might be possible to prevent or delay the risk for T2DM by improving pre- and/or postnatal factors.
Full Text Available Disease risk factors identified in epidemiological studies serve as important public health tools, helping clinicians identify individuals who may benefit from more aggressive screening or risk-modification procedures, allowing policymakers to prioritize intervention programs, and encouraging at-risk individuals to modify behavior and improve their health. These factors have been based primarily on evidence from cross-sectional and prospective studies, as most do not lend themselves to randomized trials. While some risk factors are not modifiable, eating habits are subject to change through both individual action and broader policy initiatives. Meat consumption has been frequently investigated as a variable associated with diabetes risk, but it has not yet been described as a diabetes risk factor. In this article, we evaluate the evidence supporting the use of meat consumption as a clinically useful risk factor for type 2 diabetes, based on studies evaluating the risks associated with meat consumption as a categorical dietary characteristic (i.e., meat consumption versus no meat consumption, as a scalar variable (i.e., gradations of meat consumption, or as part of a broader dietary pattern.
Ngwa, Elvis Ndonwi; Kengne, Andre-Pascal; Tiedeu-Atogho, Barbara; Mofo-Mato, Edith-Pascale; Sobngwi, Eugene
Type 2 diabetes mellitus (T2DM) is a major and fast growing public health problem. Although obesity is considered to be the main driver of the pandemic of T2DM, a possible contribution of some environmental contaminants, of which persistent organic pollutants (POPs) form a particular class, has been suggested. POPs are organic compounds that are resistant to environmental degradation through chemical, biological, and photolytic processes which enable them to persist in the environment, to be capable of long-range transport, bio accumulate in human and animal tissue, bio accumulate in food chains, and to have potential significant impacts on human health and the environment. Several epidemiological studies have reported an association between persistent organic pollutants and diabetes risk. These findings have been replicated in experimental studies both in human (in-vitro) and animals (in-vivo and in-vitro), and patho-physiological derangements through which these pollutants exercise their harmful effect on diabetes risk postulated. This review summarizes available studies, emphasises on limitations so as to enable subsequent studies to be centralized on possible pathways and bring out clearly the role of POPs on diabetes risk. PMID:25987904
Full Text Available BACKGROUND: Type 2 diabetes (T2D is a metabolic disorder characterized by disturbances of carbohydrate, fat and protein metabolism and insulin resistance. The majority of T2D patients are obese and obesity by itself may be a cause of insulin resistance. Our aim was to evaluate whether the recently identified T2D risk alleles are associated with human measures of fatness as characterized with Dual Energy X-ray Absorptiometry (DEXA. METHODOLOGY/PRINCIPAL FINDINGS: Genotypes and phenotypes of approximately 3,000 participants from cross-sectional ERF study were analyzed. Nine single nucleotide polymorphisms (SNPs in CDKN2AB, CDKAL1, FTO, HHEX, IGF2BP2, KCNJ11, PPARG, SLC30A8 and TCF7L2 were genotyped. We used linear regression to study association between individual SNPs and the combined allelic risk score with body mass index (BMI, fat mass index (FMI, fat percentage (FAT, waist circumference (WC and waist to hip ratio (WHR. Significant association was observed between rs8050136 (FTO and BMI (p = 0.003, FMI (p = 0.007 and WC (p = 0.03; fat percentage was borderline significant (p = 0.053. No other SNPs alone or combined in a risk score demonstrated significant association to the measures of fatness. CONCLUSIONS/SIGNIFICANCE: From the recently identified T2D risk variants only the risk variant of the FTO gene (rs8050136 showed statistically significant association with BMI, FMI, and WC.
Full Text Available Background: The high prevalence of type 2 diabetes mellitus (T2DM in individuals over 65 years old and cognitive deficits caused by T2DM have attracted broad attention. The pathophysiological mechanism of T2DM induced cognitive impairments, however, remains poorly understood. Previous studies have suggested that the cognitive impairments can be attributed not merely to local functional and structural abnormalities but also to specific brain networks. Thus, we aimed to investigate the changes of global networks selectively affected by T2DM. Methods: A resting state functional network analysis was conducted to investigate the intrinsic functional connectivity in 37 patients with diabetes and 40 healthy controls which were recruited from local communities in Beijing, China. Results: We found that patients with T2DM exhibited cognitive function declines and functional connectivity disruptions within the default mode network, left frontal parietal network, and sensorimotor network. More importantly, the fasting glucose level was correlated with abnormal functional connectivity.Conclusions: These findings could help to understand the neural mechanisms of cognitive impairments in T2DM and provide potential neuroimaging biomarkers that may be used for early diagnosis and intervention in cognitive decline.
Singh, Shalini; Usman, Kauser; Banerjee, Monisha
Type 2 diabetes mellitus (T2DM) is a silent progressive polygenic metabolic disorder resulting from ineffective insulin cascading in the body. World-wide, about 415 million people are suffering from T2DM with a projected rise to 642 million in 2040. T2DM is treated with several classes of oral antidiabetic drugs (OADs) viz. biguanides, sulfonylureas, thiazolidinediones, meglitinides, etc. Treatment strategies for T2DM are to minimize long-term micro and macro vascular complications by achieving an optimized glycemic control. Genetic variations in the human genome not only disclose the risk of T2DM development but also predict the personalized response to drug therapy. Inter-individual variability in response to OADs is due to polymorphisms in genes encoding drug receptors, transporters, and metabolizing enzymes for example, genetic variants in solute carrier transporters (SLC22A1, SLC22A2, SLC22A3, SLC47A1 and SLC47A2) are actively involved in glycemic/HbA1c management of metformin. In addition, CYP gene encoding Cytochrome P450 enzymes also play a crucial role with respect to metabolism of drugs. Pharmacogenetic studies provide insights on the relationship between individual genetic variants and variable therapeutic outcomes of various OADs. Clinical utility of pharmacogenetic study is to predict the therapeutic dose of various OADs on individual basis. Pharmacogenetics therefore, is a step towards personalized medicine which will greatly improve the efficacy of diabetes treatment.
It was previously understood that body weight gainand obesity observed in type 2 diabetes mellitus （T2DM）could be beneficial since body weight increase elevatedbone mineral density and thus helped maintain theskeletal framework. However, a number of recentfindings in humans and rodents have revealed thatT2DM is not only associated with trabecular defectsbut also increases cortical porosity, and compromisedbone cell function and bone mechanical properties.Hyperglycemia and insulin resistance in T2DM mayfurther induce osteoblast apoptosis and uncouplingbone turnover. Prolonged accumulation of advancedglycation end products and diminished activity of lysyloxidase, an essential enzyme for collagen cross-link,can lead to structural abnormalities of bone collagenfibrils, brittle matrix, and fragility fractures. Our studiesin T2DM rats showed that dyslipidemia, which oftenoccurs in T2DM, could obscure the T2DM-associatedchanges in bone microstructure and osteopenia. Longitudinalbone growth regulated by the growth platechondrocytes is also impaired by T2DM since differentiationof growth plate chondrocytes is arrested andretained in the resting state while only a small numberof cells undergo hypertrophic differentiation. Such adelayed chondrocyte differentiation may have alsoresulted from premature apoptosis of the growth platechondrocytes. Nevertheless, the underlying cellularand molecular mechanisms of insulin resistance inosteoblasts, osteoclasts, osteocytes, and growth platechondrocytes remain to be investigated.
Reeves, Helen L; Zaki, Marco Y W; Day, Christopher P
Hepatocellular carcinoma (HCC) is the second commonest cause of cancer death worldwide. Rather than falling as a result of prevention and treatments for viral hepatitis, an increase is evident in developed nations consequent to the rising prevalence of obesity and type 2 diabetes mellitus (T2DM)-the two major risk factors for nonalcoholic fatty liver disease (NAFLD). The majority of patients with HCC complicating these conditions present with advanced disease as the tools for surveillance are inadequate, and the "at-risk" population is not well characterized. This review will summarize the epidemiological evidence linking obesity, T2DM, and NAFLD with HCC, what is known about the pathogenic mechanisms involved, as well as their relevance for clinicians managing patients at risk. There will also be an overview of the "unmet needs" surrounding this topic, with suggestions for the direction translational research should take in order to prevent progression of NAFLD to HCC, to improve early detection of HCC in those with NAFLD, as well as to improve outcomes for those affected. PMID:26921078
Dulaglutide is a novel glucagon-like peptide 1 (GLP-1) receptor agonist with a unique structure that supports once-weekly dosing in patients with type 2 diabetes (T2DM), most of whom have a big pill burden. It appears to be efficacious in reducing hemoglobin A1c (HbA1c) up to 1.59% and promotes modest weight loss up to 3 kg with a low incidence of hypoglycemia and mild to moderate gastrointestinal adverse events. Convenient weekly dosing could improve compliance and help attain sustained glycemic goals. Addressing obesity is an integral part of T2DM management and weight loss may contribute to better glycemic and cardiovascular benefits. Results of ongoing clinical trials on cardiovascular safety are important to determine the risk-to-benefit ratio. As with any drug, patient selection and ongoing monitoring will be important. If approved, dulaglutide will be one of the first weekly GLP-1 receptor agonist to be available in a ready-to-use pen device with an automatic injector. PMID:24918645
Full Text Available Background: Diabetes mellitus represents a syndrome complex in which multiple organ systems, including the central nervous system, are affected. Aim: The study was conducted to determine the changes in the brainstem auditory evoked potentials in type 2 diabetes mellitus. Materials and Methods: A cross sectional study was conducted on 126 diabetic males, aged 35-50 years, and 106 age-matched, healthy male volunteers. Brainstem auditory evoked potentials were recorded and the results were analyzed statistically using student′s unpaired t-test. The data consisted of wave latencies I, II, III, IV, V and interpeak latencies I-III, III-V and I-V, separately for both ears. Results: The latency of wave IV was significantly delayed only in the right ear, while the latency of waves III, V and interpeak latencies III-V, I-V showed a significant delay bilaterally in diabetic males. However, no significant difference was found between diabetic and control subjects as regards to the latency of wave IV unilaterally in the left ear and the latencies of waves I, II and interpeak latency I-III bilaterally. Conclusion: Diabetes patients have an early involvement of central auditory pathway, which can be detected with fair accuracy with auditory evoked potential studies.
Mohammed Ejas Hussain
Full Text Available Exercise, along with medical nutrition therapy and pharmacological interventions, is an important component in the clinical management of type 2 diabetes mellitus (T2D. Current clinical guidelines on type 2 diabetes provide no detailed information on the modalities of effective exercise intervention in the treatment of type 2 diabetes. Both endurance and resistance types of exercise seem to be equally effective in improving metabolic control in patients with type 2 diabetes. Determining the best method of providing exercise is clinically relevant to this population. This paper reviews the epidemiology of diabetes and problems of physical function associated with type 2 diabetes and discuss the benefits of exercise therapy on the parameters of glycemic control and function in type 2 diabetes patients, with special reference to Asian Indians. Based on the currently available literature, it is concluded that type 2 diabetes patients should be encouraged to participate in specifically designed exercise intervention programs. Attention should be paid to the avoidance of cardiovascular and musculoskeletal deconditioning. More clinical research is warranted to establish the efficacy of different dosages of exercise intervention in a holistic approach for type 2 diabetes subpopulations within different stages of the disease and various levels of co-morbidity.
Gaster, M; Staehr, P; Beck-Nielsen, H;
morphometry, GLUT4 density was found to be significantly higher in slow compared with fast fibers in biopsy specimens from lean and obese subjects. In contrast, in type 2 diabetic subjects, GLUT4 density was significantly lower in slow compared with fast fibers. GLUT4 density in slow fibers from diabetic...
To determine the level of thyroid auto immunity among clinically euthyroid patients of type 1 and type 2 diabetics and to correlate the levels with pattern of diabetes. Blood samples were collected from 163 subjects (51 of type 1, 61 of type 2 diabetics and 51 non- diabetic controls) and sera were separated. They were all clinically euthyroid and selected conveniently. Thyroid profile (FT4, TSH and anti- TPO) was assessed in the three groups and compared. It was observed that at a cut off value of less than 100 units of anti-TPO level was normal, raised anti-TPO antibodies were found in 12% of normal control group, 61% in type 1 and 42.3% in type 2 diabetics. In type 1 diabetics, the TSH was higher in the younger age patients with progressive rise in anti-TPO antibodies level by age. The TSH, anti-TPO antibodies and BSF were significantly higher in type 1 diabetics than in the controls. In type 2 diabetics, TSH was moderately low but anti-TPO antibodies and BSF were higher than in the controls (author)
Joosten, M.M.; Grobbee, D.E.; Verschuren, W.M.M.; Hendriks, H.F.J.; Beulens, J.W.J.
Background: It has been suggested that the inverse association between alcohol and type 2 diabetes could be explained by moderate drinkers' healthier lifestyles. Objective: We studied whether moderate alcohol consumption is associated with a lower risk of type 2 diabetes in adults with combined low-
Reinhard, H; Jacobsen, P Karl; Lajer, Marianne;
Endothelial progenitor cells (EPC) augment vascular repair and neovascularisation. Patients with type 2 diabetes have reduced EPC and increased risk of cardiovascular disease (CVD), which is reduced by multifactorial intervention. Our aim, therefore, was to evaluate in type 2 diabetic patients...... whether the numbers of EPC derived from peripheral blood mononuclear cells is influenced by a multifactorial treatment strategy....
Objective To investigate the characteristics of the dysfunction of isletβ-cell in newly diagnosed type 2 diabetic patients. Methods Intravenous glucose tolerance test (IVGTT) was carried out on 352 newly diagnosed type 2 diabetic patients and 48 subjects with normal glucose tolerance (NGT) and then blood samples were collected 1, 2, 4, 6, and 10 minutes later to measure the
Zinman, Bernard; Philis-Tsimikas, Athena; Cariou, Bertrand;
To compare ultra-long-acting insulin degludec with glargine for efficacy and safety in insulin-naive patients with type 2 diabetes inadequately controlled with oral antidiabetic drugs (OADs).......To compare ultra-long-acting insulin degludec with glargine for efficacy and safety in insulin-naive patients with type 2 diabetes inadequately controlled with oral antidiabetic drugs (OADs)....
Stefansdottir, G.; Zoungas, S.; Chalmers, J.; Kengne, A. P.; Knol, M. J.; Leufkens, H. G. M.; Patel, A.; Woodward, M.; Grobbee, D. E.; De Bruin, M. L.
Type 2 diabetes has been associated with an increased risk of cancer. This study examines the effect of more vs less intensive glucose control on the risk of cancer in patients with type 2 diabetes. All 11,140 participants from the Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR C
Bay leaves (Laurus nobilis) have been shown to improve insulin function in vitro but the effects on people have not been determined. The objective of this study was to determine if bay leaves may be important in the prevention and/or alleviation of type 2 diabetes. Forty people with type 2 diabet...
Patel, A.; MacMahon, S.; Chalmers, J.; Neal, B.; Billot, L.; Woodward, M.; Marre, M.; Cooper, M.; Glasziou, P.; Grobbee, D.; Hamet, P.; Harrap, S.; Heller, S.; Liu, L.; Mancia, G.; Mogensen, C.E.; Pan, C.; Poulter, N.; Rodgers, A.; Williams, B.; Bompoint, S.; Galan, B.E. de; Joshi, R.; Travert, F.
BACKGROUND: In patients with type 2 diabetes, the effects of intensive glucose control on vascular outcomes remain uncertain. METHODS: We randomly assigned 11,140 patients with type 2 diabetes to undergo either standard glucose control or intensive glucose control, defined as the use of gliclazide (
Minet, A D; Gaster, M
Increased oxidative stress and mitochondrial dysfunction have been implicated in the development of insulin resistance in type 2 diabetes. To date, it is unknown whether increased mitochondrial reactive oxygen species (ROS) production in skeletal muscle from patients with type 2 diabetes is prima...
de Mol, Pieter; Fokkert, Marion J.; de Vries, Suzanna T.; de Koning, Eelco J. P.; Dikkeschei, Bert D.; Gans, Rijnold O. B.; Tack, Cees J.; Bilo, Henk J. G.
OBJECTIVE-Limited information is available regarding the metabolic effects of high altitude trekking in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS-Thirteen individuals with type 2 diabetes took part, in a 12-day expedition to the summit of Mount Toubkal (altitude, 4,167 m), Morocco,
Beck-Nielsen, Henning; Solomon, Thomas Pj; Lauridsen, Jørgen Trankjær; Karstoft, Kristian; Pedersen, Bente Klarlund; Johnsen, Søren P; Nielsen, Jens Steen; Kryger, Tine Bjerregaard; Sortsø, Camilla; Vaag, Allan
The overall aim of the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) is to near-normalize metabolic control in newly diagnosed patients with type 2 diabetes (T2D) using an individualized treatment approach. We hypothesize that this will not only prevent complications and improve...
Kim, Yu-Sok; Immink, Rogier V.; Stok, Wim J.; Karemaker, John M.; Secher, Niels H; van Lieshout, Johannes J.
Abstract Type 2 diabetes is associated with an increased risk of endothelial dysfunction and microvascular complications with impaired autoregulation of tissue perfusion. Both microvascular disease and cardiovascular autonomic neuropathy may affect cerebral autoregulation. We tested the hypothesis that in absence of cardiovascular autonomic neuropathy, cerebral autoregulation is impaired in subjects with type 2 diabetes with microvascular complications but intact in subjects withou...
Stanford, Kristin I.; Goodyear, Laurie J.
Exercise is a well-established tool to prevent and combat type 2 diabetes. Exercise improves whole body metabolic health in people with type 2 diabetes, and adaptations to skeletal muscle are essential for this improvement. An acute bout of exercise increases skeletal muscle glucose uptake, while chronic exercise training improves mitochondrial…
Joosten, M.M.; Grobbee, D.E.; A, van der D.L.; Verschuren, W.M.; Hendriks, H.F.J.; Beulens, J.W.J.
ackground: It has been suggested that the inverse association between alcohol and type 2 diabetes could be explained by moderate drinkers’ healthier lifestyles. Objective: We studied whether moderate alcohol consumption is associated with a lower risk of type 2 diabetes in adults with combined low-r
... news/fullstory_158338.html Widely Used Type 2 Diabetes Drug May Reduce Cancer Death Risk Older women taking metformin saw a ... study found that for women with type 2 diabetes and cancer, the odds of dying from cancer appeared to ...
Tobin, L. W. L.; Kiens, Bente; Galbo, Henrik
To elucidate if postprandial exercise can reduce the exaggerated lipidemia seen in type 2 diabetic patients after a high-fat meal. Two mornings eight type 2 diabetic patients (males) (58 +/- 1.2 years, BMI 28.0 +/- 0.9 kg m(-2)) and seven non-diabetic controls ate a high-fat breakfast (680 kcal m...
Goudswaard, AN; Stolk, RP; Zuithoff, P; de Valk, HW; Rutten, GE
Objective To evaluate the effects of insulin 30/70 twice daily or bedtime isophane (NPH) insulin plus continued sulfonylurea and metformin in patients with type 2 diabetes in primary care. Study Design Open-label, randomized trial. Population Persons younger than 76 years with type 2 diabetes whose
Full Text Available Abstract Background Reduced lung function is associated with incident insulin resistance and diabetes. The aim of this study was to assess the relationship between lung function and incident type 2 diabetes in Korean men. Methods This study included 9,220 men (mean age: 41.4 years without type 2 diabetes at baseline who were followed for five years. Subjects were divided into four groups according to baseline forced vital capacity (FVC (% predicted and forced expiratory volume in one second (FEV1 (% predicted quartiles. The incidence of type 2 diabetes at follow-up was compared according to FVC and FEV1 quartiles. Results The overall incidence of type 2 diabetes was 2.2%. Reduced lung function was significantly associated with the incidence of type 2 diabetes after adjusting for age, BMI, education, smoking, exercise, alcohol, and HOMA-IR. Both FVC and FEV1 were negatively associated with type 2 diabetes (P 1 had a significantly higher odds ratio for type 2 diabetes compared with the highest quartile after adjusting for age and BMI (2.15 [95% CI 1.02-4.57] and 2.19 [95% CI 1.09-4.42]. Conclusions Reduced lung function is independently associated with the incidence of type 2 diabetes in Korean men.
Wolffenbuttel, B H; Sels, J P; Rondas-Colbers, G J; Menheere, P P
OBJECTIVE: To assess which factors influence or predict the efficacy of insulin therapy in subjects with type 2 diabetes, who were poorly controlled despite maximal doses of oral glucose lowering agents. RESEARCH DESIGN AND METHODS: Seventy-five patients with type 2 diabetes participated (mean age (
Hemmingsen, Bianca; Christensen, Louise Lundby; Wetterslev, Jørn;
To compare the benefits and harms of metformin and insulin versus insulin alone as reported in randomised clinical trials of patients with type 2 diabetes.......To compare the benefits and harms of metformin and insulin versus insulin alone as reported in randomised clinical trials of patients with type 2 diabetes....
Lin, Shu-Ping; Wang, Ming-Jye
Background: Long-term behaviour change in type 2 diabetic patients may provide effective glycemic control. Purpose: To investigate the key factors that promote behaviour change in diabetic subjects using the transtheoretical model. Methods: Subjects were selected by purposive sampling from type 2 diabetes outpatients. Self-administered…
Munch, I C; Larsen, M; Borch-Johnsen, Knut; Glümer, C; Lund-Andersen, H; Kessel, L
The aim of this study was to assess the association between lifelong cumulative glycaemia estimated by lens fluorometry and the presence of retinopathy in individuals with type 2 diabetes.......The aim of this study was to assess the association between lifelong cumulative glycaemia estimated by lens fluorometry and the presence of retinopathy in individuals with type 2 diabetes....
Wijk, J.P.H. van
The focus of this thesis is on two aspects of metabolic dysregulation, type 2 diabetes mellitus and HIV-lipodystrophy, and the effects of insulin-sensitizing agents. Thiazolidinediones (TZDs) have received increasing attenttion for the treatment of hyperglycemia in type 2 diabetes. Currently, ther
To determine the frequency of sensory motor neuropathy in type 2 diabetics at the time of presentation to the hospital. The study was conducted at Medical Unit-1, Jinnah Postgraduate Medical Center, Karachi, from November 2005 to April 2006. Patients of different ages and either gender with history of confirmed diabetes for ten years and above, on regular follow up were included. Those with non-diabetic causes of hyperglycemia or neuropathy were excluded. Relevant features like age, gender, treatment, symptoms , signs, nerve conduction study (NCS) results, duration of Diabetes mellitus (DM), fasting blood sugar (FBS) and serum values of glycosylated hemoglobin (HB1Ac) were recorded. Out of a total of 300 patients, there were 111 female and 189 male patients. Mean age was 58 +- 11.23 years. Mean duration of diabetes was 13.6+-5.48 years. One hundred and twenty three patients had symptoms of neuropathy. Clinical examination revealed mixed sensory and motor signs in 135 (45%) patients. Nerve conduction studies revealed abnormalities in 159 (53%) patients. Among patients having an abnormal NCS, the fasting blood glucose (FBS) was 120mg/dl in 147 (91%) patients. The glycosylated hemoglobin ranged from 4-15% with mean of 8.1% and standard deviation of 2.5%. This showed significant association (p <0.001) of peripheral neuropathy with abnormal FBS, HB1Ac and duration of diabetes. NCS diagnosed the neuropathy in more than half of the total number of patients, including both symptomatic and asymptomatic patients. Majority of the patients revealed symmetrical and a mixed type (motor and sensory) polyneuropathy. This shows that nerve conduction may not be concordant with the clinical signs and symptoms. NCS detects neuropathy much earlier, before it becomes evident clinically. The neuropathy is associated with abonromal fasting blood sugar, HBIAC and duration of diabetes. (author)
Type 2 diabetes mellitus and Alzheimer＇s disease areboth associated with increasing age, and each increasesthe risk of development of the other. Epidemiological,clinical, biochemical and imaging studies have shownthat elevated glucose levels and diabetes are associatedwith cognitive dysfunction, the most prevalent causeof which is Alzheimer＇s disease. Cross sectional studieshave clearly shown such an association, whereaslongitudinal studies are equivocal, reflecting the manycomplex ways in which the two interact. Despitethe dichotomy, common risk and etiological factors（obesity, dyslipidemia, insulin resistance, and sedentaryhabits） are recognized; correction of these by lifestylechanges and pharmacological agents can be expectedto prevent or retard the progression of both diseases.Common pathogenic factors in both conditions span abroad sweep including chronic hyperglycemia per se ,hyperinsulinemia, insulin resistance, acute hypoglycemicepisodes, especially in the elderly, microvascular disease,fibrillar deposits （in brain in Alzheimer＇s disease and inpancreas in type 2 diabetes）, altered insulin processing,inflammation, obesity, dyslipidemia, altered levels ofinsulin like growth factor and occurrence of variant formsof the protein butyrylcholinesterase. Of interest not onlydo lifestyle measures have a protective effect against thedevelopment of cognitive impairment due to Alzheimer＇sdisease, but so do some of the pharmacological agentsused in the treatment of diabetes such as insulin（especially when delivered intranasally）, metformin,peroxisome proliferator-activated receptors γ agonists,glucagon-like peptide-1 receptor agonists and dipeptidylpeptidase-4 inhibitors. Diabetes must be recognized asa risk for development of Alzheimer＇s disease; cliniciansmust ensure preventive care be given to control andpostpone both conditions, and to identify cognitiveimpairment early to manage it appropriately.
Berbudi, Afiat; Ajendra, Jesuthas; Wardani, Ajeng P F; Hoerauf, Achim; Hübner, Marc P
It is estimated that by the year 2035 almost 600 million people will suffer from diabetes. In the case of type 2 diabetes, the strongest increase of diabetes incidence occurs in developing and newly industrialized countries. This increase correlates not only with a progressing sedentary lifestyle and nutritional changes, but also environmental changes. Similarly, the increase of type 1 diabetes incidence in industrialized countries over the past decades cannot be explained by genetic factors alone, suggesting that environmental changes are also involved. One such environmental change is a reduced exposure to pathogens because of improved hygiene. Parasitic helminths modulate the immune system of their hosts and induce type 2 as well as regulatory immune responses. As pro-inflammatory immune responses are crucial for the onset of both type 1 and type 2 diabetes, helminth-induced immunomodulation may prevent diabetes onset and ameliorate insulin sensitivity. Several epidemiological studies in human and experimental animal models support such a protective effect of helminths for autoimmune diabetes. Recent studies further suggest that helminths may also provide such a beneficial effect for type 2 diabetes. In this review we summarize studies that investigated parasitic helminths and helminth-derived products and their impact on both type 1 and type 2 diabetes highlighting potential protective mechanisms. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26119261
Both type 1 and type 2 diabetes mellitus are associated with altered brain function, a complication referred to as diabetic encephalopathy. The issues surrounding the cognitive and emotional status in chronic, older diabetic patients remain complex. The literature shows contrasting findings and espe
Full Text Available The goal of this retrospective study was to establish differences in clinical picture, biochemical parametres and precipitating factors in patiens with diabetic ketoacidosis in type 1 and type 2 diabetes. A total number of 25 patients was hospitalised in the Intensive Case Unit of the Department for Internal Diseases of the Cantonal Hospital in Zenica in the period of 14 months. Most patients had type 1 diabetes whose ketoacidosis showed symptoms of vomiting, stomachache and it was most often caused by a discontinued application of insulin or an infection. In patients with type 2 diabetes an inadequate regulation of glycemia had been noticed before hospitalisation and diabetic ketoacidosis was manifested by polyuria, polyphagia, polydipsia and weight loss. Precipitating factor in most patients with type 2 diabetes was an infection. In addition, a significant number of patients were newly discovered diabetics whose precipitating factor in most cases could not be found and the symptoms of the disease correspond to insulin dependent patients. The observed biochemical parameters did not show statistically significant differences between the groups of patients suffering from different types of diabetes. This study has shown that diabetic ketoacidosis can occur in type 2 diabetes. DKA can be prevented by education of patients, improvement of health care as well as improved communication between patients and doctors of family medicine.
Full Text Available Aims : Previous studies have shown that diabetes mellitus (DM increases the risk of cardiovascular diseases in females to a greater extent than in males. In this cross-sectional study, we evaluated the lipid profiles of type 2 diabetic males and females. Materials and Methods : The study included 107 type 2 diabetic patients (41 males and 66 females, and 122 hypertensive type 2 diabetic patients (39 males and 83 females, aged 15 years and older. Total cholesterol (TC, triglycerides (TG, low density lipoprotein-cholesterol (LDL-C, very low density lipoprotein-cholesterol (VLDL-C and high density lipoprotein-cholesterol (HDL-C concentrations were assayed for each group using standard biochemical methods. Results : The mean TC, TG, VLDL-C, HDL-C and LDL-C concentrations, TG/HDL and LDL/HDL ratios were higher in type 2 diabetic and hypertensive type 2 diabetic patients compared with non-diabetic, and hypertensive non-diabetic control subjects, although these were not significant (P > 0.05. Hypertensive type 2 diabetic females had significantly higher serum TC (7.42 ± 1.63 mmol/L than hypertensive non-diabetic males (5.76±1.57 mmol/L; P 0.05. Conclusion : This study demonstrated that dyslipidemia exists in our type 2 diabetic population with greater TC in hypertensive type 2 diabetic females compared with hypertensive type 2 diabetic males. This suggests that hypertensive type 2 diabetic females are exposed more profoundly to risk factors including atherogenic dyslipidemia compared with males.
Full Text Available Abstract Background The incidence of type 2 diabetes mellitus (T2DM has been increasing in recent years. Sleep loss and circadian rhythm abnormalities are thought to be one of the underlying causes of adverse metabolic health. However, little is known about sleep-wake cycle irregularities in T2DM. The present study compared the bedtime, waking time, and estimated sleep duration between T2DM and non-T2DM subjects. Methods The study subjects were 106 consecutive outpatients with lifestyle-related diseases (males/females = 56/50, who answered a questionnaire on sleep status. Subjects were divided into two groups; non-T2DM (n = 32 and T2DM (n = 74 subjects. Results T2DM subjects retired to bed on weekdays and holidays significantly later than non-T2DM subjects (23:43 versus 22:52, p = 0.0032; 23:45 versus 22:53, p = 0.0038, respectively, and woke up significantly later on weekdays and holidays, compared with non-T2DM subjects (06:39 versus 06:08, p = 0.0325; 06:58 versus 06:24, p = 0.0450, respectively. There was no significant difference in the estimated sleep duration between the two groups. Daytime sleepiness was reported significantly more commonly by T2DM subjects than non-T2DM subjects (p = 0.0195. Conclusions Sleep-wake cycle irregularities are more common in T2DM subjects than non-T2DM. Confirmation that such irregularity plays a role in the metabolic abnormalities of T2DM requires further investigation in the future. Trial registration UMIN 000002998
Ofstad, Anne Pernille
Type 2 diabetes mellitus (T2DM) is strongly associated with increased risk of myocardial dysfunction and cardiovascular disease (CVD), two separate conditions which often co-exist and influence each other's course. The prevalence of myocardial dysfunction may be as high as 75% in T2DM populations but is often overlooked due to the initial asymptomatic nature of the disease, complicating co-morbidities such as coronary artery disease (CAD) and obesity, and the lack of consensus on diagnostic criteria. More sensitive echocardiographic applications are furthermore needed to improve detection of early subclinical changes in myocardial function which do not affect conventional echocardiographic parameters. The pathophysiology of the diabetic myocardial dysfunction is not fully elucidated, but involves hyperglycemia and high levels of free fatty acids. It evolves over several years and increases the risk of developing overt HF, and is suggested to at least in part account for the worse outcome seen in T2DM individuals after cardiac events. CAD and stroke are the most frequent CV manifestations among T2DM patients and relate to a large degree to the accelerated atherosclerosis driven by inflammation. Diagnosing CAD is challenging due to the lower sensitivity inherent in the diagnostic tests and there is thus a need for new biomarkers to improve prediction and detection of CAD. It seems that a multi-factorial approach (i.e. targeting several CV risk factors simultaneously) is superior to a strict glucose lowering strategy in reducing risk for macrovascular events, and recent research may even support an effect also on HF outcomes. PMID:27071642
Cipolla, Maurizio; Merante, Valentina; Medaglia, Valeria; Irace, Concetta; Gnasso, Agostino
Background Type 2 diabetes mellitus T2DM has a huge and growing burden on public health, whereas new care models are not implemented into clinical practice; in fact the purpose of this study was to test the effectiveness of a program of integrated care for T2DM, compared with ordinary diligence. Methods "Progetto Diabete Calabria" is a new organizational model for the management of patients with diabetes mellitus, based on General Practitioners (GPs) empowerment and the use of a web-based electronic health record, shared in remote consultations among GPs and Hospital Consultants. One-year change in glucose and main cardiovascular risk factors control in 104 patients (Cases) following this integrated care program has been evaluated and compared with that of 208 control patients (Controls) matched for age, gender, and cardiometabolic profile, and followed in an ordinary outpatient medical management by the Consultants only. Both patient groups had Day Hospitals before and after the study period. Results The mean number of accesses to the Consultants during the study was 0.6±0.9 for Cases, and 1.3±1.5 for Controls (p<0.0001). At follow-up, glycated hemoglobin (HbA1c) significantly decreased from 58±6 to 54±8 mmol/mol in Cases only (p=0.01); LDL cholesterol decreased in both groups; body mass index decreased in Cases only, from 31.0±4.8 to 30.5±4.6 kg/m2 (p=0.03). Conclusions The present study demonstrates that a health care program based on GPs empowerment and taking care plus remote consultation with Consultants is at least as effective as standard outpatient management, in order to improve the control of T2DM. PMID:25974092
Charmaine Shuyu Ng
Full Text Available Due to the chronic nature of diabetes along with their complications, they have been recognised as a major health issue, which results in significant economic burden. This study aims to estimate the direct medical cost associated with type 2 diabetes mellitus (T2DM in Singapore in 2010 and to examine both the relationship between demographic and clinical state variables with the total estimated expenditure. The National Healthcare Group (NHG Chronic Disease Management System (CDMS database was used to identify patients with T2DM in the year 2010. DM-attributable costs estimated included hospitalisations, accident and emergency (A&E room visits, outpatient physician visits, medications, laboratory tests and allied health services. All charges and unit costs were provided by the NHG. A total of 500 patients with DM were identified for the analyses. The mean annual direct medical cost was found to be $2,034, of which 61% was accounted for by inpatient services, 35% by outpatient services, and 4% by A&E services. Independent determinants of total costs were DM treatments such as the use of insulin only (p<0.001 and the combination of both oral medications and insulin (p=0.047 as well as having complications such as cerebrovascular disease (p<0.001, cardiovascular disease (p=0.002, peripheral vascular disease (p=0.001, and nephropathy (p=0.041. In this study, the cost of DM treatments and DM-related complications were found to be strong determinants of costs. This finding suggests an imperative need to address the economic burden associated with diabetes with urgency and to reorganise resources required to improve healthcare costs.
Full Text Available Objectives: Diabetes mellitus has been one of the most crippling diseases that man has seen, and its prevalence has risen dramatically over the past two decades. Currently, there are over 150 million diabetics worldwide and this number is likely to increase to 300 million or more by the year 2025. Diabetes mellitus increases the risk of many disorders including cardiovascular diseases. Understanding the molecular properties of diabetic progression is a big challenge in the system biology era. The aim of this study is to determine association in albumin modifications between Chernobyl clean-up workers with and without type 2 diabetes mellitus. Methods: ABM (3-aminobenzanthrone derivative developed in Daugavpils University, Latvia has been previously shown as a potential biomarker for determination of the immune state of patients with different pathologies. In this study several aspects of plasma albumin alterations in the group of Chernobyl clean-up workers with diabetes mellitus in relation to the group of workers without diabetes mellitus and people having no professional contact with radioactivity were determined. The following parameters were examined: (1 spectral characteristics of ABM in blood plasma; (2 effective and total albumin concentration in blood plasma; and (3 quantitative parameters of albumin auto-fluorescence. Results: Screening of individuals with diabetes mellitus 25-26 years after their work in Chernobyl revealed two groups of patients differing in structural and functional properties of membrane. The revealed structural modifications of membrane are dependent on radiation-induced factors. Concomitant diseases (diabetes mellitus, cardiovascular diseases reinforce radiation-induced effects. Conclusion: ABM is a sensitive probe of albumin alterations; it can be used to elucidate the changes in protein systems. Significant differences in albumin dynamics exist between the control group (donors and that of diabetics and non
Full Text Available Type 2 diabetes mellitus T2DM has a huge and growing burden on public health, whereas new care models are not implemented into clinical practice; in fact the purpose of this study was to test the effectiveness of a program of integrated care for T2DM, compared with ordinary diligence."Progetto Diabete Calabria" is a new organizational model for the management of patients with diabetes mellitus, based on General Practitioners (GPs empowerment and the use of a web-based electronic health record, shared in remote consultations among GPs and Hospital Consultants. One-year change in glucose and main cardiovascular risk factors control in 104 patients (Cases following this integrated care program has been evaluated and compared with that of 208 control patients (Controls matched for age, gender, and cardiometabolic profile, and followed in an ordinary outpatient medical management by the Consultants only. Both patient groups had Day Hospitals before and after the study period.The mean number of accesses to the Consultants during the study was 0.6 ± 0.9 for Cases, and 1.3 ± 1.5 for Controls (p<0.0001. At follow-up, glycated hemoglobin (HbA1c significantly decreased from 58 ± 6 to 54 ± 8 mmol/mol in Cases only (p=0.01; LDL cholesterol decreased in both groups; body mass index decreased in Cases only, from 31.0 ± 4.8 to 30.5 ± 4.6 kg/m(2 (p=0.03.The present study demonstrates that a health care program based on GPs empowerment and taking care plus remote consultation with Consultants is at least as effective as standard outpatient management, in order to improve the control of T2DM.
Full Text Available The epidemic rise of patients with type 2 diabetes mellitus (T2DM worldwide continues, despite all efforts taken by the international medical community to curb it. It seems that the advent of new drugs does not contribute to a better control of the disease, the tightening up of diagnostic criteria causes an abrupt increase in the number of patients, while a revision of the main goals of treatment (a reduction of targets for glycemic control often becomes an argument in favor of an overly aggressive approach to drug therapy in diabetes. The main therapeutic goal of existing algorithms for the management of T2DM patients is to achieve and maintain long-term indicators of glycemic control, as close to normal values as possible. However, almost none of these algorithms address the factors associated with the pathogenesis of development and progression of the underlying disease, such as lack of exercise and excessive adiposity. For the sake of achieving glycemic target values, patients often receive treatment that is known to be conducive to weight gain, insulin resistance and increased progression of relative insulin deficiency, eventually leading to the prescription of exogenous insulin. At the same time, an active modification of the pathogenetic factors of T2DM – excess body weight and physical inactivity – may lead to restoration of glucose tolerance, reducing the need of pharmacotherapy until its complete withdrawal, as has been shown in many major studies . The "gravicentric concept" of treatment of T2DM is designed to redefine the basic therapeutic targets and change the emphasis in the of patients' management scheme. Its mission is to create a clear idea for both doctors and patients about the possibility of de-intensification of pharmacotherapy under certain conditions, and to focus maximum effort to address the factors of progression of the disease with the hope of a cure or remission
Full Text Available Type 2 diabetes mellitus (T2D is a metabolic disease with inflammation as an important pathogenic background. However, the pattern of immune cell subsets and the cytokine profile associated with development of T2D are unclear. The objective of this study was to evaluate different components of the immune system in T2D patients' peripheral blood by quantifying the frequency of lymphocyte subsets and intracellular pro- and anti-inflammatory cytokine production by T cells. Clinical data and blood samples were collected from 22 men (51.6±6.3 years old with T2D and 20 nonsmoking men (49.4±7.6 years old who were matched for age and sex as control subjects. Glycated hemoglobin, high-sensitivity C-reactive protein concentrations, and the lipid profile were measured by a commercially available automated system. Frequencies of lymphocyte subsets in peripheral blood and intracellular production of interleukin (IL-4, IL-10, IL-17, tumor necrosis factor-α, and interferon-γ cytokines by CD3+ T cells were assessed by flow cytometry. No differences were observed in the frequency of CD19+ B cells, CD3+CD8+ and CD3+CD4+ T cells, CD16+56+ NK cells, and CD4+CD25+Foxp3+ T regulatory cells in patients with T2D compared with controls. The numbers of IL-10- and IL-17-producing CD3+ T cells were significantly higher in patients with T2D than in controls (P<0.05. The frequency of interferon-γ-producing CD3+ T cells was positively correlated with body mass index (r=0.59; P=0.01. In conclusion, this study shows increased numbers of circulating IL-10- and IL-17-producing CD3+ T cells in patients with T2D, suggesting that these cytokines are involved in the immune pathology of this disease.
Sharma, Surendra Kumar; Panneerselvam, A; Singh, K P; Parmar, Girish; Gadge, Pradeep; Swami, Onkar C
Teneligliptin is a recently developed oral dipeptidyl peptidase 4 inhibitor indicated for the management of type 2 diabetes mellitus (T2DM) in adults along with diet and exercise. Teneligliptin has been recently available in Japan (Teneria(®)), Argentina (Teneglucon(®)), and India (Tenepure; Teneza) at relatively affordable price. This is a positive step toward the management of T2DM in developing countries, where the cost of medicine is out-of-pocket expenditure and is a limiting factor for health care. This review evaluates the efficacy and safety of teneligliptin in the management of T2DM. Teneligliptin has been systematically evaluated in T2DM as monotherapy with diet and exercise and in combination with metformin, glimepiride, pioglitazone, and insulin in short-term (12 weeks) and long-term (52 weeks) studies. These studies have reported a reduction in HbA1c of 0.8%-0.9% within 12 weeks of therapy. Two 52-week studies reported sustained improvement in glycemic control with teneligliptin. Teneligliptin has been found to be well tolerated, and the safety profile is similar to other dipeptidyl peptidase 4 inhibitors. Hypoglycemia and constipation are the main adverse events. Teneligliptin can be administered safely to patients with mild, moderate, or severe renal impairment or end-stage renal disease without dose adjustment. Similarly, it can be used in patients with mild-to-moderate hepatic impairment. Teneligliptin is effective and well tolerated and may have an important role in the management of T2DM. PMID:27574456
Sharma, Surendra Kumar; Panneerselvam, A; Singh, KP; Parmar, Girish; Gadge, Pradeep; Swami, Onkar C
Teneligliptin is a recently developed oral dipeptidyl peptidase 4 inhibitor indicated for the management of type 2 diabetes mellitus (T2DM) in adults along with diet and exercise. Teneligliptin has been recently available in Japan (Teneria®), Argentina (Teneglucon®), and India (Tenepure; Teneza) at relatively affordable price. This is a positive step toward the management of T2DM in developing countries, where the cost of medicine is out-of-pocket expenditure and is a limiting factor for health care. This review evaluates the efficacy and safety of teneligliptin in the management of T2DM. Teneligliptin has been systematically evaluated in T2DM as monotherapy with diet and exercise and in combination with metformin, glimepiride, pioglitazone, and insulin in short-term (12 weeks) and long-term (52 weeks) studies. These studies have reported a reduction in HbA1c of 0.8%–0.9% within 12 weeks of therapy. Two 52-week studies reported sustained improvement in glycemic control with teneligliptin. Teneligliptin has been found to be well tolerated, and the safety profile is similar to other dipeptidyl peptidase 4 inhibitors. Hypoglycemia and constipation are the main adverse events. Teneligliptin can be administered safely to patients with mild, moderate, or severe renal impairment or end-stage renal disease without dose adjustment. Similarly, it can be used in patients with mild-to-moderate hepatic impairment. Teneligliptin is effective and well tolerated and may have an important role in the management of T2DM. PMID:27574456
Bailey, Clifford J; Tahrani, Abd A; Barnett, Anthony H
The multivariable and progressive natural history of type 2 diabetes limits the effectiveness of available glucose-lowering drugs. Constraints imposed by comorbidities (notably cardiovascular disease and renal impairment) and the need to avoid hypoglycaemia, weight gain, and drug interactions further complicate the treatment process. These challenges have prompted the development of new formulations and delivery methods for existing drugs alongside research into novel pharmacological entities. Advances in incretin-based therapies include a miniature implantable osmotic pump to give continuous delivery of a glucagon-like peptide-1 receptor agonist for 6-12 months and once-weekly tablets of dipeptidyl peptidase-4 inhibitors. Hybrid molecules that combine the properties of selected incretins and other peptides are at early stages of development, and proof of concept has been shown for small non-peptide molecules to activate glucagon-like peptide-1 receptors. Additional sodium-glucose co-transporter inhibitors are progressing in development as well as possible new insulin-releasing biological agents and small-molecule inhibitors of glucagon action. Adiponectin receptor agonists, selective peroxisome proliferator-activated receptor modulators, cellular glucocorticoid inhibitors, and analogues of fibroblast growth factor 21 are being considered as potential new approaches to glucose lowering. Compounds that can enhance insulin receptor and post-receptor signalling cascades or directly promote selected pathways of glucose metabolism have suggested opportunities for future treatments. However, pharmacological interventions that are able to restore normal β-cell function and β-cell mass, normalise insulin action, and fully correct glucose homoeostasis are a distant vision. PMID:26809680
Garber, A J
An estimated 72.5 million American adults are obese, and the growing US obesity epidemic is responsible for substantial increase in morbidity and mortality, as well as increased health care costs. Obesity results from a combination of personal and societal factors, but is often viewed as a character flaw rather than a medical condition. This leads to stigma and discrimination towards obese individuals and decreases the likelihood of effective intervention. Conditions related to obesity are increasingly common, such as metabolic syndrome, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), all of which indicate high risk for type 2 diabetes (T2DM). This paper reviews the progression from obesity to diabetes, identifying physiological changes that occur along this path as well as opportunities for patient identification and disease prevention. Patients with prediabetes (defined as having IFG, IGT or both) and/or metabolic syndrome require interventions designed to preserve insulin sensitivity and β-cell function, both of which start to deteriorate prior to T2DM diagnosis. Lifestyle modification, including both healthy eating choices and increased physical activity, is essential for weight management and diabetes prevention. Although sustained weight loss is often considered by patients and physicians as being impossible to achieve, effective interventions do exist. Specifically, the Diabetes Prevention Program (DPP) and programs modelled along its parameters have shown repeated successes, even with long-term maintenance. Recent setbacks in the development of medications for weight loss further stress the importance of lifestyle management. By viewing obesity as a metabolic disorder rather than a personal weakness, we can work with patients to address this increasingly prevalent condition and improve long-term health outcomes. PMID:22074144
The prevalence of diabetes among children and adolescents has been steadily increasing, making it even more important that diabetes be adequately managed in this patient population. A basic distinction between type 1 and type 2 diabetes has long been understood. Type 1 diabetes results from a primary loss of pancreatic insulin production, usually as a consequence of autoimmune destruction of pancreatic cells; in type 2 diabetes, insulin production continues and may even be exaggerated, but is insufficient to adequately compensate for resistance to insulin action, leading to the loss of glycemic control. Regardless of the type of diabetes, the treatment goal is to control hyperglycemia. However, the optimal treatment strategy depends on the underlying cause of hyperglycemia. It is therefore important to accurately diagnose whether a patient has type 1 or type 2 diabetes. Historically, this has been thought possible based on the different clinical presentations and age of onset of the conditions. More recently, with the increasing prevalence of type 2 diabetes among adolescents and the trend toward a more obese society, the distinction has become less clear. This has led to the need for the differential diagnosis of diabetes to be confirmed using biochemical and immunological testing. In addition, because the prevalence of type 2 diabetes in the pediatric population is a relatively new phenomenon, available treatments for type 2 diabetes have been studied predominantly in adult populations. With type 2 diabetes becoming increasingly common in pediatric centers, there is a need to evaluate the optimal treatments for children and adolescents. PMID:20463418
... them at a higher risk for type 2 diabetes and obesity." SOURCE: Cell Reports , news release, March 24, 2016 HealthDay Copyright (c) 2016 HealthDay . All rights ... Diabetes Type 2 Fetal Health and Development Hormones Recent ...
Bartels, E D; Bang, C A; Nielsen, L B
median lesion area was 8.0 times higher than in fat-fed wild-type mice (P = 0.001). Intracellular adhesion molecule-1 staining of the aortic endothelium was most pronounced in the fat-fed apoB transgenic mice. CONCLUSIONS: Our findings suggest that diet-induced type 2 diabetes causes early......BACKGROUND: Obesity and type 2 diabetes increase the risk of atherosclerosis. It is unknown to what extent this reflects direct effects on the arterial wall or secondary effects of hyperlipidaemia. MATERIALS AND METHODS: The effect of obesity and type 2 diabetes on the development of...
Full Text Available Amy Fleischman, Erinn T RhodesDivision of Endocrinology, Children’s Hospital Boston, Boston, MA, United StatesAbstract: Childhood obesity has become a national and international epidemic. The prevalence and incidence of type 2 diabetes in youth have been increasing, and type 2 diabetes is one of the most challenging complications of obesity in childhood. Comprehensive lifestyle interventions that include attention to dietary change, increased physical activity and behavior change appear to be required for the successful treatment of pediatric obesity. In particular, aspects of behavioral interventions that have been identified as contributing to effectiveness have included intensity, parent/family participation, addressing healthy dietary change, promoting physical activity, and involving behavioral management principles such as goal setting. A multidisciplinary team approach is required for successful management of type 2 diabetes in youth as well. As with many therapies in pediatrics, clinical trials and support for treatments of obesity and type 2 diabetes in youth lag behind adult data. Pediatric recommendations may be extrapolated from adult data and are often based on consensus guidelines. Type 2 diabetes in children is most commonly managed with lifestyle modification and medications, metformin and/or insulin, the only medications currently approved for use in children. However, many opportunities exist for ongoing research to clarify optimal management for obesity and type 2 diabetes in youth.Keywords: children, obesity, type 2 diabetes, metformin, insulin, bariatric surgery
Wu, Yanling; Ding, Yanping; Tanaka, Yoshimasa; Zhang, Wen
Type 2 diabetes is a serious and common chronic disease resulting from a complex inheritance-environment interaction along with other risk factors such as obesity and sedentary lifestyle. Type 2 diabetes and its complications constitute a major worldwide public health problem, affecting almost all populations in both developed and developing countries with high rates of diabetes-related morbidity and mortality. The prevalence of type 2 diabetes has been increasing exponentially, and a high prevalence rate has been observed in developing countries and in populations undergoing "westernization" or modernization. Multiple risk factors of diabetes, delayed diagnosis until micro- and macro-vascular complications arise, life-threatening complications, failure of the current therapies, and financial costs for the treatment of this disease, make it necessary to develop new efficient therapy strategies and appropriate prevention measures for the control of type 2 diabetes. Herein, we summarize our current understanding about the epidemiology of type 2 diabetes, the roles of genes, lifestyle and other factors contributing to rapid increase in the incidence of type 2 diabetes. The core aims are to bring forward the new therapy strategies and cost-effective intervention trials of type 2 diabetes. PMID:25249787
Full Text Available Syed Khalid ImamLiaquat National Hospital and Medical College, Karachi, Pakistan; Al-Mouwasat Hospital, Jubail Industrial City, Kingdom of Saudi ArabiaAbstract: Diabetes mellitus (DM is a disorder of abnormal glucose metabolism resulting primarily from insulin resistance and relative insulin deficiency and characterized by hyperglycemia causing significant short- and long-term complications. Type 2 diabetes mellitus (T2DM contributes to more than 90% of cases of diabetes. Obesity, sedentary lifestyles, and consumption of very high-caloric meals are thought to be the primary triggering factors causing T2DM in genetically predisposed individuals. Although treatment of hyperglycemia plays a key role in the management, therapies directed at other comorbid conditions, such as dyslipidemia, hypertension, hypercoagulability, obesity, and insulin resistance, have also been a major focus of research and therapy. DM is rising to an epidemic proportion globally, and it is, indeed, one of the most challenging public health problems in the 21st century. According to 2011 statistics, there were approximately 366 million diabetes cases worldwide, and this figure would probably increase to 552 million by 2030. Long-term complications from high blood sugar include coronary artery disease, cerebrovascular events, peripheral arterial diseases leading to amputation, retinopathy, nephropathy leading to end-stage renal disease requiring hemodialysis and transplantation, and neuropathy. The acute complication of T2DM includes drug-induced hypoglycemia, hyperosmolar hyperglycemic state, and although uncommon, ketoacidosis. Diabetes care requires a comprehensive and multidisciplinary approach to delay the progression to acute as well as chronic and debilitating long-term complications. This approach requires the thorough understanding of the pathophysiology of hyperglycemia and impact of various risk factors and comorbidities, careful selection of antihyperglycemic
Full Text Available Marek Rosiak,1,2 Susanna Grzeszczak,2 Dariusz A Kosior,2,3 Marek Postuła1,2 1Department of Cardiology and Hypertension, Central Clinical Hospital, the Ministry of the Interior, Warsaw, Poland; 2Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Poland; 3Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland Abstract: Type 2 diabetes mellitus (T2DM is a prevalent metabolic disorder, which affects more than 300 million people globally. The common effect of uncontrolled diabetes is the state of hyperglycemia, which results from beta-cell dysfunction as well as insulin resistance, which is accompanied with microvascular and macrovascular complications. As hyperglycemia defines diabetes, glycemic control is fundamental to the management of diabetes. Sodium glucose co-transporter 2 inhibitors (SGLT2 are a new group of oral antidiabetic medications that act by blocking the reabsorption of glucose, causing it to be excreted in the urine. Canagliflozin was the first SGLT2 inhibitor to be approved in the US by the Food and Drug Administration for the treatment and control of T2DM and on September 19, 2013, the Committee for Medicinal Products for Human Use of the European Medicines Agency adopted a positive opinion, recommending the granting of a marketing authorization for the medicinal product Invokana®. Canagliflozin is a SGLT2 inhibitor, which acts upon the proximal tubules of the kidneys and reduces the renal threshold for glucose. It is highly selective, binding 250 times more potently to SGLT2 than sodium glucose co-transporter 1 inhibitor. This action allows a higher amount of glucose to be excreted within the urine, causing the patient's plasma glucose level to be decreased and indirectly causing weight loss. Among the most common adverse events are hypoglycemia, headache, nausea, female genital and urinary tract infections, nasopharyngitis, and transient postural dizziness. Given its
Huda Kaatabi; Bamosa, Abdullah O.; Lebda, Fatma M.; Al Elq, Abdulmohsen H.; Al-Sultan, Ali I.
Background and Aim: The atherogenic pattern of dyslipidemia associated with type 2 diabetes mellitus (DM) has been increasingly discussed. We have recently reported a hypoglycemic effect of Nigella sativa (NS) seeds in patients with type 2 DM. In this study we sought to assess the impact of NS seeds on lipid profile in type 2 diabetic patients. Patients and Method: A total of 94 patients with type 2 DM were recruited and divided into 3 dose groups. Capsules containing NS were administered ora...
Tonstad, Serena; Butler, Terry; Yan, Ru; Fraser, Gary E.
OBJECTIVE We assessed the prevalence of type 2 diabetes in people following different types of vegetarian diets compared with that in nonvegetarians. RESEARCH DESIGN AND METHODS The study population comprised 22,434 men and 38,469 women who participated in the Adventist Health Study-2 conducted in 2002–2006. We collected self-reported demographic, anthropometric, medical history, and lifestyle data from Seventh-Day Adventist church members across North America. The type of vegetarian diet was...
Objective: To investigate the characteristic rCBF abnormalities and the relationship between rCBF and cognitive disorders in type 2 diabetes mellitus patients. Methods: The study subjects were 11 middle aged, glycemic controlled type 2 diabetes mellitus patients. Age range of type 2 diabetes mellitus patients was 46 - 59 years. Eleven age-, sex-, education- and occupation- matched normal controls (age range 41 - 58 years) were studied under identical conditions. Cognitive functions were evaluated by Wechsler Memory Scale (WMS), Trail Marking Test A and Wisconsin Card Sorting Test (WCST), respectively. 99Tcm-ECD (ethyl-cysteine ate dimer) SPECT imaging was performed on all patients and normal controls. Results: 1) Cognitive test scores of type 2 diabetes mellitus patients were lower than that of normal controls. Diabetic patients were scored lower in memory test than controls (accumulation adding, visual recognition, learning and total memory quotient of WMS, P < 0.05). Type 2 diabetes mellitus patients needed much more time to complete the trail marking test (74.2 s vs. 48.7 s). WCST scores were significantly different between two groups. 2) The rCBF values of frontal, temporal and parietal lobe were decreased significantly in type 2 diabetes mellitus patients. 3) For type 2 diabetes mellitus patients, there was a correlation between rCBF values of right frontal lobe and adding, understanding scores of WMS (positively correlated), preservative errors(%) of WCST (negatively correlated). The rCBF values of right temporal lobe were positively correlated with inverted counting. Conclusions: 1) Impairments of central nervous system are existed in glycemic controlled (lack of repeated hypoglycemia) type 2 diabetes mellitus patients. Abnormalities in CNS can express as cognitive dysfunction, such as decrement of memory, attention, thinking and conceptual reasoning abilities. 2) Hypo-perfusions of frontal, temporal and parietal cortex can be identified in patients of
Hill, James O; Stuht, Jennifer; Wyatt, Holly R; Regensteiner, Judith G
Obesity and type-2 diabetes can be considered diseases of physical inactivity. Physically activity protects against type-2 diabetes through its positive effects on weight management and on the metabolic pathways involved in glycemic control that are not weight-dependent. Increasing physical activity is one of the most effective strategies both for preventing type-2 diabetes and for managing it once it is present. However, we still face an enormous challenge in getting people to achieve sustainable increases in physical activity. A promising strategy is to get people walking more, starting small and increasing gradually over time. PMID:16820740
Lykke, Jacob A; Langhoff-Roos, Jens; Sibai, Baha M; Funai, Edmund F; Triche, Elizabeth W; Paidas, Michael J
Minimal data exist concerning the relationship between hypertensive pregnancy disorders and various subsequent cardiovascular events and the effect of type 2 diabetes mellitus on these. In a registry-based cohort study, we identified women delivering in Denmark from 1978 to 2007 with a first...... pregnancy disorders are strongly associated with subsequent type 2 diabetes mellitus and hypertension, the latter independent of subsequent type 2 diabetes mellitus. The severity, parity, and recurrence of these hypertensive pregnancy disorders increase the risk of subsequent cardiovascular events....
Laubner, Katharina; Seufert, Jochen
SGLT2 inhibitors represent a novel therapeutic approach for the tretment of type 2 diabetes mellitus. Beyond glucose control, these drugs also induce weight loss and blod pressure reduction. In a specific cardiovascular outcome trial (EMPA-REG-OUTCOME), the SGLT 2 inhibitor empagliflozin has for the first time demonstrated to reduce cardiovascular and overall mortality as well as hospitalization for heart failure in patients with type 2 diabetes and high cardiovascular risk. These results will drastically affect future recommendations for the treatment of type 2 diabetes mellitus.). PMID:27176455
Kuo, Ming-Chun; Lin, Sheng-Hao; Lin, Ching-Hsiung; Mao, I-Chieh; Chang, Shun-Jen; Hsieh, Ming-Chia
Objective Tuberculosis continues to be a major global health problem. We wanted to investigate whether Type 2 diabetes was a risk factor for tuberculosis in an Asian population. Methods From Taiwan’s National Health Insurance Research Database, we collected data from 31,237 female patients with type 2 diabetes and 92,642 female controls and 32,493 male patients with type 2 diabetes and 96,977 male controls. Cox proportional hazard regression was performed to evaluate independent risk factors ...
Harita, Nobuko; Hayashi, Tomoshige; Sato, Kyoko Kogawa; Nakamura, Yoshiko; Yoneda, Takeshi; Endo, Ginji; Kambe, Hiroshi
OBJECTIVE—Because skeletal muscle is one of the target tissues for insulin, skeletal muscle mass might be associated with type 2 diabetes. Serum creatinine is a possible surrogate marker of skeletal muscle mass. The purpose of this study was to determine whether serum creatinine level is associated with type 2 diabetes. RESEARCH DESIGN AND METHODS—The study participants were nondiabetic Japanese men (n = 8,570) aged 40–55 years at entry. Type 2 diabetes was diagnosed if fasting plasma glucose...
Butler, A. E.; Galasso, R; Matveyenko, A.; R.A. Rizza; Dry, S.; Butler, P. C.
Aims/hypothesis In a high-fat-fed rat model of type 2 diabetes we noted increased exocrine duct replication. This is a predisposing factor for pancreatitis and pancreatic cancer, both of which are more common in type 2 diabetes. The aim of the study reported here was to establish if obesity and/or type 2 diabetes are associated with increased pancreatic ductal replication in humans. Methods We obtained pancreas at autopsy from 45 humans, divided into four groups: lean (BMI 27 kg/m2); non-diab...
Mera, Jun-ichiro; Okada, Eiko; Okuda, Masumi; Ota, Tatsuru; Sibata, Shigeru; Uchida, Shunya
Background There are few studies evaluating long-term glycemic control using a dipeptidyl peptidase-4 inhibitor in type 2 diabetes patients with end-stage renal disease (ESRD). The aim of this study was to evaluate the safety and efficacy of vildagliptin therapy over 2 years in type 2 diabetes with ESRD. Methods Patients with ESRD resulting from type 2 diabetes requiring dialysis who had ≥20 % glycated albumin (GA) were enrolled. Vildagliptin 50 mg once daily was administered for 2 years. Cha...
de Bresser, Jeroen; Tiehuis, Audrey M.; van den Berg, Esther; Reijmer, Yael D.; Jongen, Cynthia; Kappelle, L Jaap; Mali, Willem P.; Viergever, Max A.; Biessels, Geert Jan; ,
OBJECTIVE Type 2 diabetes is associated with a moderate degree of cerebral atrophy and a higher white matter hyperintensity (WMH) volume. How these brain-imaging abnormalities evolve over time is unknown. The present study aims to quantify cerebral atrophy and WMH progression over 4 years in type 2 diabetes. RESEARCH DESIGN AND METHODS A total of 55 patients with type 2 diabetes and 28 age-, sex-, and IQ-matched control participants had two 1.5T magnetic resonance imaging scans with a 4-year ...
Klein Woolthuis, E.P.; Grauw, W.J.C. de; Cardol, M.; Weel, C. van; Metsemakers, J.F.M.; Biermans, M.C.J.
Background. In type 2 diabetes, educational interventions that target differences between patients’ and partners’ illness perceptions have been advocated. Objective. To investigate how the route to diagnosis of type 2 diabetes (through screening versus clinical symptoms) affects illness perceptions
Schiøtz, Michaela Louise; Bøgelund, Mette; Almdal, Thomas;
To determine preferences among patients with type 2 diabetes for content and format of patient education.......To determine preferences among patients with type 2 diabetes for content and format of patient education....
Hey-Mogensen, Martin; Sahlin, Kent; Fernström, Maria;
We tested the hypothesis of a lower respiratory capacity per mitochondrion in skeletal muscle of type 2 diabetic patients compared with obese subjects. Muscle biopsies obtained from 10 obese type 2 diabetic and 8 obese nondiabetic male subjects were used for assessment of 3-hydroxy......-Acyl-CoA-dehydrogenase (HAD) and citrate synthase activity, uncoupling protein (UCP)3 content, oxidative stress measured as 4-hydroxy-2-nonenal (HNE), fiber type distribution, and respiration in isolated mitochondria. Respiration was normalized to citrate synthase activity (mitochondrial content) in isolated mitochondria....... Maximal ADP-stimulated respiration (state 3) with pyruvate plus malate and respiration through the electron transport chain (ETC) were reduced in type 2 diabetic patients, and the proportion of type 2X fibers were higher in type 2 diabetic patients compared with obese subjects (all P < 0.05). There were...
Skladany, Matthew J.; Miller, Michaela; Guthermann, Joshua S.; Ludwig, Christopher R.
The recent development of novel “patch”-type insulin infusion pump (IIP) technologies has created an opportunity to improve the quality of life for a broader type 2 diabetes patient demographic. At first glance, type 2 diabetes patients represent a large percentage of the total diabetes patient population; however, adoption of traditional IIP products and multiple daily injection (MDI) therapy has remained limited amongst this patient segment. With an insulin reservoir, delivery system, and c...
Guo-Chao Xu; Yun Luo; Qian Li; Meng-Fan Wu; Zi-Jun Zhou
Background: In recent years, the prevalence of type 2 diabetes among Chinese population has been increasing by years, directly leading to an average annual growth rate of 19.90% of medical expenditure. Therefore, it is urgent to work on strategies to control the growth of medical expenditure on type 2 diabetes on the basis of the reality of China. Therefore, in this study, we explored the feasibility of implementing bundled payment in China through analyzing bundled payment standards of type ...
Rosenfalck, A M; Thorsby, P; Kjems, L;
The effect on postprandial blood glucose control of an immediately pre-meal injection of the rapid acting insulin analogue Aspart (IAsp) was compared with that of human insulin Actrapid injected immediately or 30 minutes before a test meal in insulin-treated type 2 diabetic patients with residual...... that the improved glucose control previously demonstrated with insulin Aspart compared to human insulin in healthy subjects and type 1 diabetic patients also applies to insulin-treated type 2 diabetic patients....
Freathy, Rachel M; Bennett, Amanda J.; Ring, Susan M; Shields, Beverley; Groves, Christopher J; Timpson, Nicholas J.; Weedon, Michael N.; Zeggini, Eleftheria; Lindgren, Cecilia M.; Lango, Hana; John R. B. Perry; Pouta, Anneli; Ruokonen, Aimo; Hyppönen, Elina; Power, Chris
OBJECTIVE Low birth weight is associated with an increased risk of type 2 diabetes. The mechanisms underlying this association are unknown and may represent intrauterine programming or two phenotypes of one genotype. The fetal insulin hypothesis proposes that common genetic variants that reduce insulin secretion or action may predispose to type 2 diabetes and also reduce birth weight, since insulin is a key fetal growth factor. We tested whether common genetic variants that predispose to type...
Popa Simona Georgiana; Popa Adina; Moţa Maria
Type 2 diabetes is a progressive disease and, despite recent progress in the treatment of diabetes, the glycemic control usually deteriorates gradually and insulin therapy is needed. When insulin therapy should be started and which are the appropriate insulin therapy strategies, still represent subjects of debates. Insulin represents a therapeutic option in type 2 diabetes due to the existence of early β-cell dysfunction and significant reduction of β-cell mass in natural history of type 2 di...
Miyawaki, Yoshiko; Iwahashi, Hiromi; Okauchi, Yukiyoshi; Sudo, Yoshiko; Fujiwara, Yuko; Omote, Yayoko; Imagawa, Akihisa; Shimomura, Iichiro
Objective The purpose of this study was to determine the differences in emotional distress among three groups of inpatients with type 1, obese type 2, and non-obese type 2 diabetes during hospitalization. Methods The 42 participating inpatients were divided into three groups: type 1 diabetes (n=11), obese type 2 diabetes [body mass index (BMI) ≥25 kg/m(2); n=24], and non-obese type 2 diabetes (BMI emotional distress in the patients with diabetes, was performed at admission and discharge. Results The total PAID score was similar and tended to improve during hospitalization in all three groups, although there were differences among the groups in the scores of particular questions. At admission, the score of the question "worrying about low blood sugar reactions?" was significantly different among the three groups and highest in the patients with type 1 diabetes. At discharge, the score of "not accepting diabetes?" was significantly different among the three groups and highest in the patients with non-obese type 2 diabetes, while that of "feeling unsatisfied with your diabetes physician?" was significantly different among the three groups and highest in the patients with obese type 2 diabetes. The score of "feelings of deprivation regarding food and meals?" significantly worsened in the patients with obese type 2 diabetes during hospitalization compared with the patients in with non-obese type 2 diabetes. Conclusion The characteristics of emotional distress during hospitalization varied among the patients with the three types of diabetes, thus emphasizing the importance of tailoring support according to the type of diabetes. PMID:26466689
Full Text Available Objective: Our aim was to assess the prevalence of binge eating disorder (BED in individuals with type 2 diabetes and to investigate whether a comorbidity with BED would affect glycemic control in these patients. Materials and Methods: Eighty-two type 2 diabetic patients were enrolled. The participants were assessed for eating disorders by a psychiatrist. Blood samples were drawn and HbA1c and other biochemical parameters were measured. Results: Of the 82 subjects, 27 (34.1% met the criteria for BED. No other types of eating disorders were detected. HbA1c was significantly higher in individuals with BED (p<0.05. Conclusion: Our findings reveal that BED is highly prevalent among type 2 diabetic patients and it impairs glycemic control. Thus, patients with type 2 diabetes should be assessed carefully for eating disorders. Turk Jem 2011; 15: 26-7
Ng, Maggie C Y; Saxena, Richa; Li, Jiang; Palmer, Nicholette D; Dimitrov, Latchezar; Xu, Jianzhao; Rasmussen-Torvik, Laura J; Zmuda, Joseph M; Siscovick, David S; Patel, Sanjay R; Crook, Errol D; Sims, Mario; Chen, Yii-Der I; Bertoni, Alain G; Li, Mingyao; Grant, Struan F A; Dupuis, Josée; Meigs, James B; Psaty, Bruce M; Pankow, James S; Langefeld, Carl D; Freedman, Barry I; Rotter, Jerome I; Wilson, James G; Bowden, Donald W
Type 2 diabetes (T2D) disproportionally affects African Americans (AfA) but, to date, genetic variants identified from genome-wide association studies (GWAS) are primarily from European and Asian populations. We examined the single nucleotide polymorphism (SNP) and locus transferability of 40 reported T2D loci in six AfA GWAS consisting of 2,806 T2D case subjects with or without end-stage renal disease and 4,265 control subjects from the Candidate Gene Association Resource Plus Study. Our results revealed that seven index SNPs at the TCF7L2, KLF14, KCNQ1, ADCY5, CDKAL1, JAZF1, and GCKR loci were significantly associated with T2D (P KLF14, and HMGA2 loci as well as suggestive signals in KCNQ1 after correction for the effective number of SNPs at each locus. Of these loci, the regional best SNPs were in differential linkage disequilibrium (LD) with the index and adjacent SNPs. Our findings suggest that some loci discovered in prior reports affect T2D susceptibility in AfA with similar effect sizes. The reduced and differential LD pattern in AfA compared with European and Asian populations may facilitate fine mapping of causal variants at loci shared across populations. PMID:23193183
Both type 1 and type 2 diabetes mellitus are associated with altered brain function, a complication referred to as diabetic encephalopathy. The issues surrounding the cognitive and emotional status in chronic, older diabetic patients remain complex. The literature shows contrasting findings and especially the role of recurrent hypoglycemic episodes remains controversial. The research of this thesis was designed to further unravel the clinical and cognitive characteristics of altered central n...
Boris Il'ich Kuznik; Yuriy Antonovich Vitkovskiy; Marina Yur'evna Zakharova; Natal'ya Nikolaevna Klyuchereva; Ol'ga Sergeevna Rodnina; Aleksey Vladimirovich Solpov
Aims. To assess differences in blood formed elements aggregation activity in patients with type 1 (T1) and type 2 (T2) diabetes mellitus (DM). Materials and methods. We studied blood samples from 88 patients with T1 and T2 DM. Platelet aggregation activity was assessed by means of «Biola» aggregometer; we also determined platelet-lymphocyte and leucocyte-erythrocyte adhesion intensity. Results. We show that spontaneous platelet aggregation is markedly increased in patients with T1...
Aleksandr Sergeevich Ametov
Full Text Available AimsThe aim of the present study was to investigate the role of chronic low-grade inflammation in the development of the diabetic neuropathy and the possibility of its medical treatment with fenofibrate (145 mg/day.Materials and MethodsThis trial included 60 patients with type 2 diabetes mellitus. The serum levels of several factors were measured: tumour necrosis factor-α (TNF-α, interleukin-1β (IL-1β, interleukin-6 (IL-6, C-reactive protein (CRP, markers of oxidative stress (malondialdehyde levels, haemostasis, uric acid, glycaemic and lipid profile and the peripheral status (electromyography, total symptom score [TSS] and neuropathy impairment score in the lower limbs [NIS-LL]. Follow-up was at 24 weeks.ResultsA significant negative correlation was found between the excitation rate of the sural nerve and levels of TNF, IL-6 and CRP (p <0.05. A number of changes were observed in the group of patients treated with fenofibrate (145 mg, daily for 24 weeks: Levels of TNF decreased from 9.6±3.68 to 8.1±3.02 pg/ml (p <0.05, IL-6 decreased from 3.3±1.69 to 2.7±1.28 pg/ml (p <0.05, CRP decreased from 5.6±3.63 to 3.1±2.34 mg/l (p <0.05, thiobarbituric acid (TBARS decreased from 3.1±089 to 2.6±1.21 mmol/l (p >0.05, uric acid decreased from 364±69.85 to 296.8±87.3 mmol/l (p <0.05 and fibrinogen decreased from 4.1±0.59 to 3.4±0.71 g/l (p <0.05. Improved levels of total cholesterol, triglycerides, HDL, VLDL and atherogenic index (p <0.05 were observed. Significantly increased M-wave in extensor digitorum brevis muscle was observed, from 5.25±2.31 to 6.3±3.14 mV (p <0.05. In addition, TSS changed from 9.55±1.53 to 7.28±1.26 (p <0.005 and NIS-LL changed from 10.12±2.05 to 8.24±1.68 (p <0.05.ConclusionA correlation was found between EMG parameters and serum levels of inflammatory markers. Fenofibrate significantly reduced levels of inflammatory cytokines and improved lipid and purine metabolism as well as the function of the peripheral
Tarnow, L; Gall, M-A; Hansen, B V; Hovind, Peter; Parving, H-H
AIMS/HYPOTHESIS: Raised N-terminal pro-B-type natriuretic peptide (NT-proBNP) is associated with a poor cardiac outcome in non-diabetic populations. Elevated NT-proBNP predicts excess morbidity and mortality in diabetic patients with an elevated urinary albumin excretion rate. This study...... investigated the prognostic value of NT-proBNP in a cohort of type 2 diabetic patients. SUBJECTS, MATERIALS AND METHODS: In a prospective observational follow-up study, 315 type 2 diabetic patients with normoalbuminuria (n=188), microalbuminuria (n=80) and macroalbuminuria (n=47) at baseline were followed for...... 1.37 [0.79-2.37] and 2.26 [1.27-4.02], p=0.01). When patients with normo-, micro- and macroalbuminuria were analysed separately, NT-proBNP levels above the median (62 ng/l) were consistently associated with increased overall and cardiovascular mortality in all three groups (p<0.001). CONCLUSIONS...
Jørgensen, Gitte Maria; Vind, Birgitte; Nybo, Mads; Rasmussen, Lars Melholt; Højlund, Kurt
the acute effects of insulin on plasma OPG concentrations in individuals with type 2 diabetes and obese individuals compared with lean controls. DESIGN: The study population consisted of ten type 2 diabetic, ten obese subjects, and ten lean subjects with no family history of diabetes. METHODS: All....... Insulin infusion decreased plasma OPG concentrations in all groups (P<0.01); however, the fall in OPG was 50% less in obese and type 2 diabetic individuals (P=0.007). Baseline OPG correlated with fasting insulin, baseline lactate, and low density lipoprotein cholesterol in the diabetic group, and with...... baseline FFA in the lean group. The relative change of OPG in response to insulin correlated inversely with HbA1c and baseline FFA in the lean group. CONCLUSIONS: Acute hyperinsulinemia decreases plasma OPG, but with diminished effect in individuals with type 2 diabetes and obesity. Increased levels of OPG...
Kirana, H; Agrawal, S S; Srinivasan, B P
One of the major etiologies in pathogenesis of type 2 diabetes especially complications is oxidative stress. Aqueous extract of Ficus religiosa at a dose of 100 and 200 mg/kg orally decreased the fasting blood glucose in streptozotocin induced type 2 diabetic rats. The drug had enzyme induction effect with respect to catalase (CAT) and glutathione peroxidase (GSH-Px) activity, however decreased the exaggerated activity of superoxide dismutase (SOD) in type 2 diabetic rats. F. religiosa modulated the enzymes of antioxidant defence system to combat oxidative stress. As a result, glutathione (GSH-reduced form) was restored and inhibited the formation of malondialdehyde. Drug at higher dose (200 mg/kg) had more pronounced effect. F. religiosa, a rasayana group of plant drug having anti-diabetic activity along with antioxidant potential was beneficial in treatment of type 2 diabetes. PMID:20112810
Wimmelmann, Cathrine L; Smith, Evelyn; Lund, Michael T;
BACKGROUND: Some bariatric patients are referred for surgery with a diagnosis of type 2 diabetes while others are referred without co-morbid diabetes, but psychological differences between patients with and without type 2 diabetes undergoing bariatric surgery have not yet been investigated. The...... objective of this study was to present the baseline results of the longitudinal GASMITO-PSYC study, and to evaluate the psychological differences between bariatric patients with and without type 2 diabetes. METHODS: A total of 129 Roux-en- Y gastric bypass patients were recruited from the bariatric clinic...... sex and age. The total study sample differed significantly from Danish test norms reporting higher neuroticism (P = .000), more mental symptoms (P = .000), lower HRQOL (P = .000), and less positive weight-related body image (P = .000). CONCLUSION: Patients with type 2 diabetes had better physical...
L.N. Broekhuizen; B.A. Lemkes; H.L. Mooij; M.C. Meuwese; H. Verberne; F. Holleman; R.O. Schlingemann; M. Nieuwdorp; E.S.G. Stroes; H. Vink
Endothelial glycocalyx perturbation contributes to increased vascular permeability. In the present study we set out to evaluate whether: (1) glycocalyx is perturbed in individuals with type 2 diabetes mellitus, and (2) oral glycocalyx precursor treatment improves glycocalyx properties. Male particip
Adriana Florinela CĂTOI
Full Text Available Obesity per se carries the features of chronic inflammation and oxidative stress that interrelate in a complex network and exert an important role in the onset of several complications such as type 2 diabetes, atherosclerosis and cardiovascular events. On the other hand, it seems that hyperglycemia per se as well as insulin resistance (independent of hyperglycemia, both induce increased oxidative stress. The aim of our study was to analyze proinflammatory and oxidative stress markers in obese patients with and without type 2 diabetes and to verify the hypothesis that type 2 diabetes associated with obesity would promote a higher chronic inflammation and oxidative stress state as compared to obesity alone. We found no differences between the two groups of patients regarding chronic inflammation and oxidative stress markers. Therefore we may conclude that there is no influence of type 2 diabetes on chronic inflammation and oxidative stress in obese patients.
Full Text Available Macro elements are the minerals of which the body needs more amounts and are more important than any other elements. Trace elements constitute a minute part of the living tissues and have various metabolic characteristics and functions. Trace elements participate in tissue and cellular and subcellular functions; these include immune regulation by humoral and cellular mechanisms, nerve conduction, muscle contractions, membrane potential regulations, and mitochondrial activity and enzyme reactions. The status of micronutrients such as iron and vanadium is higher in type 2 diabetes. The calcium, magnesium, sodium, chromium, cobalt, iodine, iron, selenium, manganese, and zinc seem to be low in type 2 diabetes while elements such as potassium and copper have no effect. In this review, we emphasized the status of macro and trace elements in type 2 diabetes and its advantages or disadvantages; this helps to understand the mechanism, progression, and prevention of type 2 diabetes due to the lack and deficiency of different macro and trace elements.
Practice implications: The findings of this study set the stage to develop teaching strategies that will improve DSM and subsequently improve diabetes management in patient with type-2 diabetes in Oman.
Mularoni, Loris; Miguel-Escalada, Irene; Akerman, İldem; Tena, Juan J.; Morán, Ignasi; Gómez-Marín, Carlos; van de Bunt, Martijn; Ponsa-Cobas, Joan; Castro, Natalia; Nammo, Takao; Cebola, Inês; García-Hurtado, Javier; Maestro, Miguel Angel; Pattou, François; Piemonti, Lorenzo; Berney, Thierry; Gloyn, Anna L.; Ravassard, Philippe; Skarmeta, José Luis Gómez; Müller, Ferenc; McCarthy, Mark I.; Ferrer, Jorge
Type 2 diabetes affects over 300 million people, causing severe complications and premature death, yet the underlying molecular mechanisms are largely unknown. Pancreatic islet dysfunction is central for type 2 diabetes pathogenesis, and therefore understanding islet genome regulation could provide valuable mechanistic insights. We have now mapped and examined the function of human islet cis-regulatory networks. We identify genomic sequences that are targeted by islet transcription factors to drive islet-specific gene activity, and show that most such sequences reside in clusters of enhancers that form physical 3D chromatin domains. We find that sequence variants associated with type 2 diabetes and fasting glycemia are enriched in these clustered islet enhancers, and identify trait-associated variants that disrupt DNA-binding and islet enhancer activity. Our studies illustrate how islet transcription factors interact functionally with the epigenome, and provide systematic evidence that dysregulation of islet enhancers is relevant to the mechanisms underlying type 2 diabetes. PMID:24413736
Pasquali, Lorenzo; Gaulton, Kyle J; Rodríguez-Seguí, Santiago A; Mularoni, Loris; Miguel-Escalada, Irene; Akerman, Ildem; Tena, Juan J; Morán, Ignasi; Gómez-Marín, Carlos; van de Bunt, Martijn; Ponsa-Cobas, Joan; Castro, Natalia; Nammo, Takao; Cebola, Inês; García-Hurtado, Javier; Maestro, Miguel Angel; Pattou, François; Piemonti, Lorenzo; Berney, Thierry; Gloyn, Anna L; Ravassard, Philippe; Gómez-Skarmeta, José Luis; Müller, Ferenc; McCarthy, Mark I; Ferrer, Jorge
Type 2 diabetes affects over 300 million people, causing severe complications and premature death, yet the underlying molecular mechanisms are largely unknown. Pancreatic islet dysfunction is central in type 2 diabetes pathogenesis, and understanding islet genome regulation could therefore provide valuable mechanistic insights. We have now mapped and examined the function of human islet cis-regulatory networks. We identify genomic sequences that are targeted by islet transcription factors to drive islet-specific gene activity and show that most such sequences reside in clusters of enhancers that form physical three-dimensional chromatin domains. We find that sequence variants associated with type 2 diabetes and fasting glycemia are enriched in these clustered islet enhancers and identify trait-associated variants that disrupt DNA binding and islet enhancer activity. Our studies illustrate how islet transcription factors interact functionally with the epigenome and provide systematic evidence that the dysregulation of islet enhancers is relevant to the mechanisms underlying type 2 diabetes. PMID:24413736
LUO Sen-lin; GAO Juan; JIA Hong-bo; WANG Heng; ZHANG Tie-mei; HAN Yi-wen
Taking the advantage of the nearly 14000 items of multi-source, multi-dimension practical dataset of type 2 diabetes, and a series of data mining experiments are designed to seek for important type 2 diabetes risk factors and their relationships with blood glucose. The valuable pathological knowledge includes, the decision tree is almost identical with the list of clinical diabetic risk factors; 9 items important risk factors of type 2 diabetes were found, and the relationship between the main risk factors and the blood glucose, and the feature of critical value of the risk factors were given too in this paper. These valuable results are good to the cure and macro-control type 2 diabetes.
Parellada, C B; Asbjörnsdóttir, Björg; Ringholm, Lene;
AIMS: To evaluate fetal growth in relation to gestational weight gain in women with Type 2 diabetes. METHODS: A retrospective cohort study of 142 consecutive pregnancies in 28 women of normal weight, 39 overweight women and 75 obese women with Type 2 diabetes (pre-pregnancy BMI < 25, 25-29.9, ≥ 30...... was almost 0.5 kg higher in women with Type 2 diabetes and excessive gestational weight gain than in women with Type 2 diabetes and non-excessive weight gain....... kg/m2, respectively). Gestational weight gain was categorized as excessive (exceeding the US Institute of Medicine recommendations) or as non-excessive (within or below the Institute of Medicine recommendations). RESULTS: Excessive and non-excessive gestational weight gain were seen in 61 (43%) and...
Steven, S; Woodcock, S; Small, P K; Taylor, R
Women with pre-existing abnormal glucose regulation are certain to develop gestational diabetes in pregnancy and pre-gestational type 2 diabetes will become more difficult to control. However, an increasing number of women with type 2 diabetes have had bariatric surgery. In this group, the effect of pregnancy on glucose metabolism is unknown. We report two women with type 2 diabetes who underwent laparoscopic gastric bypass surgery with normalization of plasma glucose levels. During subsequent pregnancy, maternal blood glucose levels remained completely normal throughout. This is remarkable given the predisposition to abnormal glucose tolerance and the ongoing obesity, in the face of the insulin resistance of pregnancy. Women with prior type 2 diabetes reversed by gastric bypass surgery are not at high risk for gestational diabetes.
Nagwa F. Ahmed
As angiogenin is one of most powerful angiogenic factors, we recommend further studies to evaluate the diagnostic, prognostic, and therapeutic value of angiogenin in various microangiopathic and cardiovascular complications of type 2 diabetes.
... Disease Organizations (PDF, 293 KB). Alternate Language URL I Can Lower My Risk for Type 2 Diabetes: ... a blood test at the clinic." [ Top ] Should I be tested for diabetes? Anyone 45 years of ...
Hempler, Nana Folmann; Ekholm, Ola; Willaing, Ingrid
Aims: Poor social support and lack of social network are well-established risk factors for morbidity and mortality in general populations. Good social relations, such as social support and network contacts, are associated with better self-management and fewer psychosocial problems in persons with...... type 2 diabetes. The aim of this study was to investigate whether persons with type 2 diabetes have poorer social relations than the general population. Methods: We conducted a cross-sectional survey in three settings: a specialist diabetes clinic (SDC) (n = 1084), a web panel (WP) consisting of...... persons with type 2 diabetes (n = 1491) and a sample from the 2010 Danish Health and Morbidity Survey, representative of the general population (n = 15,165). We compared social relations using multivariate logistic regression. Results: Compared to the general population, persons with type 2 diabetes more...
Conclusion: Further studies are needed to develop more specific suggestions regarding fructose intake and to better understand the relationship between fructose intakes, body composition and biochemical parameters in individuals with type 2 diabetes.
... https://medlineplus.gov/news/fullstory_159225.html Intensive Blood Sugar Control May Be Too Much for Some With ... June 6, 2016 (HealthDay News) -- Intensive treatment of blood sugar levels in some people with type 2 diabetes ...
Muscelli, Elza; Casolaro, Arturo; Gastaldelli, Amalia; Mari, Andrea; Seghieri, Giuseppe; Astiarraga, Brenno; Chen, Yu; Alba, Maria; Holst, Jens Juul; Ferrannini, Ele
Dipeptidyl peptidase IV (DPP-4) inhibitors improve glycemic control in patients with type 2 diabetes. The underlying mechanisms (incretin effect, β-cell function, endogenous glucose production) are not well known....
Nordestgaard, Ask Tybjærg; Thomsen, Mette; Nordestgaard, Børge Grønne
BACKGROUND: Coffee is one of the most widely consumed beverages. We tested the hypothesis that genetically high coffee intake is associated with low risk of obesity, metabolic syndrome and type 2 diabetes, and with related components thereof. METHODS: We included 93,179 individuals from two large...... general population cohorts in a Mendelian randomization study. We tested first whether high coffee intake is associated with low risk of obesity, metabolic syndrome and type 2 diabetes, and with related components thereof, in observational analyses; second, whether five genetic variants near the CYP1A1......, CYP1A2 and AHR genes are associated with coffee intake; and third, whether the genetic variants are associated with obesity, metabolic syndrome and type 2 diabetes, and with related components thereof. Finally, we tested the genetic association with type 2 diabetes in a meta-analysis including up...
Færch, Kristine; Carstensen, Bendix; Almdal, Thomas Peter;
CONTEXT: It is unclear to what extent recent advances in diabetes care have reduced the excess mortality in patients with complicated type 2 diabetes. OBJECTIVE: The aim of this study was to estimate time trends in mortality among patients with complicated type 2 diabetes at the Steno Diabetes.......0%]). The decline in overall mortality was explained by a decline in cardiovascular mortality for both men and women. CONCLUSION: Overall and cardiovascular mortality have decreased during the last decade among Danish patients with complicated type 2 diabetes, and for men, the decline in mortality was more...... Center relative to the general Danish background population. DESIGN, SETTING, AND STUDY PARTICIPANTS: We performed a longitudinal follow-up study from 2002 to 2010 of 5844 patients with type 2 diabetes at the Steno Diabetes Center, Denmark. All-cause and cause-specific mortality was identified from the...
Faul, John L.; Wilson, Sandra R.; Chu, James W.; Canfield, James; Kuschner, Ware G.
Objective: To determine the effect of inhaled corticosteroid (ICS) therapy on glucose control in adults with type 2 diabetes mellitus and coexisting asthma or chronic obstructive pulmonary disease (COPD).
Dhamdhere, Kavita P.; Schneck, Marilyn E.; Bearse, Marcus A.; Lam, Wendy; Barez, Shirin; Adams, Anthony J.
We assess vision function at reduced contrast and luminance in adult patients with type 2 diabetes mellitus using the SKILL Card. The SKILL Card discriminated patients having diabetes with or without retinopathy from the controls with high overall accuracy.
Krishnan, Supriya; Coogan, Patricia F; Boggs, Deborah A.; Rosenberg, Lynn; Palmer, Julie R.
Background: Type 2 diabetes is a major problem in Western nations. Profound secular changes in the food environment and eating habits may play a role. In particular, consumption of foods prepared outside the home has greatly increased.
Conclusions: There were no significant differences in food security levels of diabetic and non-diabetic groups. However, some risk factors of type 2 diabetes including sex, marital status, educational level, and obesity were associated with food insecurity.
Holst, Jens Juul; McGill, Maria A
Type 2 diabetes mellitus is associated with a progressive decline in insulin-producing pancreatic ß-cells, an increase in hepatic glucose production, and a decrease in insulin sensitivity. The incretin hormones glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1......) stimulate glucose-induced insulin secretion; however, in patients with type 2 diabetes, the incretin system is impaired by loss of the insulinotropic effects of GIP as well as a possible reduction in secretion of GLP-1. Agents that modify GLP-1 secretion may have a role in the management of type 2 diabetes....... The currently available incretin-based therapies, GLP-1 receptor agonists (incretin mimetics) and dipeptidyl peptidase-4 (DPP-4) inhibitors (CD26 antigen inhibitors) [incretin enhancers], are safe and effective in the treatment of type 2 diabetes. However, they may be unable to halt the progression of...
BACKGROUND: Diabetes confers an increased risk for cardiovascular effects of airborne particles. OBJECTIVE: We hypothesized that inhalation of elemental carbon ultrafine particles (UFP) would activate blood platelets and vascular endothelium in people with type 2 diabetes. ...
Park, Jeong Rang; Jung, Tae Sik; Jung, Jung Hwa; Lee, Gyeong-Won; Kim, Me Ae; Park, Ki-Jong; Kim, Deok Ryong; Chang, Se-Ho; Chung, Soon Il; Hahm, Jong Ryeal
Primary hypothyroidism and type 2 diabetes are both typically associated with the increased level of triglycerides. To date, there have been only a few case reports of type 2 diabetes patients with both type V hyperlipoproteinemia and eruptive xanthomas, but there have been no reports of hypothyroidism patients associated with eruptive xanthomas. We report here on a case of a 48-yr old female patient who was diagnosed with type 2 diabetes and primary hypothyroidism associated with both type V hyperlipoproteinemia and eruptive xanthomas. We found rouleaux formation of RBCs in peripheral blood smear, elevated TSH, and low free T4 level, and dyslipidemia (total cholesterol 18.1 mM/L, triglyceride 61.64 mM/L, HDL 3.0 mM/L, and LDL 2.54 mM/L). She has taken fenofibrate, levothyroxine, and oral hypoglycemic agent for 4 months. After treatment, both TSH level and lipid concentration returned to normal range, and her yellowish skin nodules have also disappeared. PMID:15953878
Background: Diabetic retinopathy is one of the most common and serious complications of type 2 diabetes mellitus and a leading cause of blindness not only in Pakistan but also worldwide. So we conducted this study to record the frequency of diabetic retinopathy in known diabetic patients ten years after diagnosis of type 2 diabetes mellitus. Methods: The study was conducted at Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan for a period of 1 year from January 2008 to January 2010. The study group comprised of 200 patients of type 2 diabetes mellitus attending the medical clinic. All patients who were diagnosed as type 2 diabetes mellitus since ten years duration were included in the study. Retinopathy was graded into background, pre proliferative and proliferative retinopathy. Type 2 diabetes was diagnosed using the WHO criteria. Statistical analysis was carried out using the SPSS-11. Results: Diabetic retinopathy was found in 25.5% of the total Type 2 patients after ten years of diagnosis, and of these 4% of patients had proliferative retinopathy. Conclusion: Type 2 diabetic patients should be screened as early as possible to prevent permanent visual loss by timely management of diabetic retinopathy because diabetes is one of most common preventable cause of blindness in the world. (author)
Amy Fleischman, Erinn T RhodesDivision of Endocrinology, Children’s Hospital Boston, Boston, MA, United StatesAbstract: Childhood obesity has become a national and international epidemic. The prevalence and incidence of type 2 diabetes in youth have been increasing, and type 2 diabetes is one of the most challenging complications of obesity in childhood. Comprehensive lifestyle interventions that include attention to dietary change, increased physical activity and behavior change ap...
Eckel, Robert H; Kahn, Steven E.; Ferrannini, Ele; Schwartz, Michael W.; Steven R Smith; Goldfine, Allison Braunwald; Nathan, David Matthew; Smith, Robert J.
Objective: This report examines what is known about the relationship between obesity and type 2 diabetes and how future research in these areas might be directed to benefit prevention, interventions, and overall patient care. Research Design and Methods: An international working group of 32 experts in the pathophysiology, genetics, clinical trials, and clinical care of obesity and/or type 2 diabetes participated in a conference held on 6–7 January 2011 and cosponsored by The Endocrine Society...
Nuryati Kuman; Bangunawati Rahajeng
Some health system in various countries in the world is highly fragmented and is unable to resolve health problems. With collaborative care system, it is expected that DM patients can be managed well. We conducted a study to determine the effect of collaborative care system on blood glucose levels of patients with type 2 diabetes mellitus. This study uses a quasi-experimental design. Data was obtained by measuring random blood glucose levels in patients with type 2 diabetes mellitus. The samp...
Aim: This study was conducted to examine the effects of aerobic exercise training on psychosocial aspects (mental health, the aspects of physical symptoms, anxiety and insomnia, social functioning, and depression) in patients with type 2 diabetes mellitus. Methods: 53 men who had type 2 diabetes mellitus for a mean duration of the disease for 3±5 years were selected purposely and classified randomly into experimental (27 patients) and a control group (26 patients). Patients in the experimenta...
There are no available data about the factors associated with diabetic nephropathy (DN) in Kuwaiti individuals with type 2 diabetes. This study was conducted on 154 consecutive Kuwaiti adults with type 2 diabetes who attended the diabetic out-patient clinic at Al-Sabah Hospital to determine the factors associated with albuminuria among them. Albuminuria was considered to be present if the urinary albumin:creatinine ratio test or 24-h collection was positive on two occasions. There were 102 (6...
Morrison, Steven; Colberg, Sheri R.; Mariano, Mira; Henri K. Parson; Vinik, Arthur I.
OBJECTIVE This study assessed the effects of balance/strength training on falls risk and posture in older individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS Sixteen individuals with type 2 diabetes and 21 age-matched control subjects (aged 50–75 years) participated. Postural stability and falls risk was assessed before and after a 6-week exercise program. RESULTS Diabetic individuals had significantly higher falls risk score compared with control subjects. The diabetic group also e...
Objective To study the changes of resistin and the relationship between resistin and other indexes in patients with type 2 diabetes mellitus.Methods Seventy patients with type 2 diabetics were chosen and divided into three groups according to weight index and 15 healthy persons were chosen as controls.ELISA was adopted to determine resistin concentration.Oxydase method was adopted to measure blood sugar.Radio immunoassay was used to measure insulin level.Results Resistin concentration of patient groups [(23...
Meysamie Alipasha; Hamidi Sepehr; Aghamohammadzadeh Naser; Esfahanian Fatemeh; Esteghamati Alireza; Nakhjavani Manouchehr; Abbasi Mehrshad
Abstract Objective To study the prevalence and correlates of increased urinary albumin excretion (UAE) in an Iranian type 2 diabetic population. Methods Over a one year period since October 2002, 400 consecutive type 2 diabetic patients referred to an outpatient diabetes clinic, were enrolled in a cross sectional study. Subjects had no history of renal impairment or overt proteinuria. Data concerning demographic characteristics and cardiovascular risk factors were recorded and height, weight ...
Bauer, Leah K.; Wulsin, Lawson R.; Guadagno, Gina
Although psychosis increases the risk for developing type 2 diabetes, the temporal relationship between the onset of psychosis and the onset of diabetes has not been studied. We present 6 cases of acute psychosis, which led to the new diagnosis of type 2 diabetes during inpatient psychiatric admission within days to weeks of the psychotic episode. The implications of these findings and the efficacy of current diabetes screening guidelines are discussed.
Moudi Albargawi; Julia Snethen; Abdulaziz A.L. Gannass; Sheryl Kelber
Purpose: To explore how perceptions of self-efficacy, health locus of control and outcome expectancy impact the adherence of adults with type 2 diabetes mellitus in Saudi Arabiato self-care activities. Methods: A descriptive correlation design was used to analyse self-report questionnaires completed by a convenience sample of Arabic-speaking individuals (n = 30) with type 2 diabetes mellitus from King Abdulaziz Medical City in Riyadh. Results: More than half (53%) of participants report...