Pub Date : 2023-02-17eCollection Date: 2023-04-01DOI: 10.1007/s13340-023-00620-6
Hiromitsu Sekizuka, Hitoshi Miyake
Objective: Nonrestorative sleep (NRS) is one of the symptoms of insomnia and is clearly more associated with objective indices, such as sleep stability, sleep fragmentation, and inflammatory responses, than other insomnia symptoms. However, the link between NRS and diabetes mellitus is poorly understood. Therefore, the prevalence of NRS in workers and the relationships between NRS and diabetes were investigated.
Methods: The results of a single year's medical examinations were investigated for 26,144 Japanese active office workers who were 30 to 59 years old. NRS was investigated using a personal computer in a medical interview. Furthermore, the relationships between NRS and diabetes comorbidity in addition to sleep duration were also analyzed.
Results: The mean age of the subjects was 47.9 ± 7.3 years old, and the proportion of subjects with NRS was 26%. The presence of NRS together with a sleep duration ≤ 5 h or a sleep duration of 6 h was an independent comorbid factor for diabetes compared with the absence of NRS together with a sleep duration of 7 h (odds ratio [OR] 1.34; 95% confidence interval [CI] 1.14-1.58; P < 0.001; and OR 1.25; 95% CI 1.04-1.48; P = 0.015).
Conclusion: NRS in active workers may contribute to the development of diabetes even if the workers have the same short sleep durations as other workers without NRS.
{"title":"Relationship between nonrestorative sleep with short sleep duration and diabetes mellitus comorbid among a Japanese occupational population.","authors":"Hiromitsu Sekizuka, Hitoshi Miyake","doi":"10.1007/s13340-023-00620-6","DOIUrl":"10.1007/s13340-023-00620-6","url":null,"abstract":"<p><strong>Objective: </strong>Nonrestorative sleep (NRS) is one of the symptoms of insomnia and is clearly more associated with objective indices, such as sleep stability, sleep fragmentation, and inflammatory responses, than other insomnia symptoms. However, the link between NRS and diabetes mellitus is poorly understood. Therefore, the prevalence of NRS in workers and the relationships between NRS and diabetes were investigated.</p><p><strong>Methods: </strong>The results of a single year's medical examinations were investigated for 26,144 Japanese active office workers who were 30 to 59 years old. NRS was investigated using a personal computer in a medical interview. Furthermore, the relationships between NRS and diabetes comorbidity in addition to sleep duration were also analyzed.</p><p><strong>Results: </strong>The mean age of the subjects was 47.9 ± 7.3 years old, and the proportion of subjects with NRS was 26%. The presence of NRS together with a sleep duration ≤ 5 h or a sleep duration of 6 h was an independent comorbid factor for diabetes compared with the absence of NRS together with a sleep duration of 7 h (odds ratio [OR] 1.34; 95% confidence interval [CI] 1.14-1.58; <i>P</i> < 0.001; and OR 1.25; 95% CI 1.04-1.48; <i>P</i> = 0.015).</p><p><strong>Conclusion: </strong>NRS in active workers may contribute to the development of diabetes even if the workers have the same short sleep durations as other workers without NRS.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 2","pages":"199-205"},"PeriodicalIF":2.2,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10113405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9387102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: Hemoglobin A1c (HbA1c) levels are widely employed to diagnose diabetes. However, estimates of the heritability of HbA1c and glucose levels are different. Therefore, we explored HbA1c- and blood glucose-associated loci in a non-diabetic Japanese population.
Methods: We conducted a two-stage genome-wide association study (GWAS) on variants associated with HbA1c and blood glucose levels in a Japanese population. In the initial stage, data of 4911 participants of the Japan Multi-Institutional Collaborative Cohort (J-MICC) were subjected to discovery analysis. In the second stage, two datasets from the Tohoku Medical Megabank project, with 8175 and 40,519 participants, were used for the replication study. Association of the imputed variants with HbA1c and blood glucose levels was determined via linear regression analyses adjusted for age, sex, body mass index (BMI), smoking, and genetic principal components (PC1-PC10). Moreover, we performed a BMI-stratified GWAS on HbA1c levels in the J-MICC. The discovery analysis and BMI-stratified GWAS results were validated with re-analyses of normalized HbA1c levels adjusted for site in addition to the above, and blood glucose adjusted for fasting time as an additional covariate.
Results: Genetic variants associated with HbA1c levels were identified in KCNQ1 and TMC6. None of the genetic variants associated with blood glucose levels in the discovery analysis were replicated. Association of rs2299620 in KCNQ1 with HbA1c levels showed heterogeneity between individuals with BMI ≥ 25 kg/m2 and BMI < 25 kg/m2.
Conclusions: The variant rs2299620 in KCNQ1 might affect HbA1c levels differentially based on BMI grouping in the Japanese population.
Supplementary information: The online version contains supplementary material available at 10.1007/s13340-023-00618-0.
{"title":"Comparison of the loci associated with HbA1c and blood glucose levels identified by a genome-wide association study in the Japanese population.","authors":"Takuya Sakashita, Yasuyuki Nakamura, Yoichi Sutoh, Atsushi Shimizu, Tsuyoshi Hachiya, Yayoi Otsuka-Yamasaki, Naoyuki Takashima, Aya Kadota, Katsuyuki Miura, Yoshikuni Kita, Hiroaki Ikezaki, Jun Otonari, Keitaro Tanaka, Chisato Shimanoe, Teruhide Koyama, Isao Watanabe, Sadao Suzuki, Hiroko Nakagawa-Senda, Asahi Hishida, Takashi Tamura, Yasufumi Kato, Rieko Okada, Kiyonori Kuriki, Sakurako Katsuura-Kamano, Takeshi Watanabe, Shiroh Tanoue, Chihaya Koriyama, Isao Oze, Yuriko N Koyanagi, Yohko Nakamura, Miho Kusakabe, Masahiro Nakatochi, Yukihide Momozawa, Kenji Wakai, Keitaro Matsuo","doi":"10.1007/s13340-023-00618-0","DOIUrl":"10.1007/s13340-023-00618-0","url":null,"abstract":"<p><strong>Aims: </strong>Hemoglobin A1c (HbA1c) levels are widely employed to diagnose diabetes. However, estimates of the heritability of HbA1c and glucose levels are different. Therefore, we explored HbA1c- and blood glucose-associated loci in a non-diabetic Japanese population.</p><p><strong>Methods: </strong>We conducted a two-stage genome-wide association study (GWAS) on variants associated with HbA1c and blood glucose levels in a Japanese population. In the initial stage, data of 4911 participants of the Japan Multi-Institutional Collaborative Cohort (J-MICC) were subjected to discovery analysis. In the second stage, two datasets from the Tohoku Medical Megabank project, with 8175 and 40,519 participants, were used for the replication study. Association of the imputed variants with HbA1c and blood glucose levels was determined via linear regression analyses adjusted for age, sex, body mass index (BMI), smoking, and genetic principal components (PC1-PC10). Moreover, we performed a BMI-stratified GWAS on HbA1c levels in the J-MICC. The discovery analysis and BMI-stratified GWAS results were validated with re-analyses of normalized HbA1c levels adjusted for site in addition to the above, and blood glucose adjusted for fasting time as an additional covariate.</p><p><strong>Results: </strong>Genetic variants associated with HbA1c levels were identified in <i>KCNQ1</i> and <i>TMC6</i>. None of the genetic variants associated with blood glucose levels in the discovery analysis were replicated. Association of rs2299620 in <i>KCNQ1</i> with HbA1c levels showed heterogeneity between individuals with BMI ≥ 25 kg/m<sup>2</sup> and BMI < 25 kg/m<sup>2</sup>.</p><p><strong>Conclusions: </strong>The variant rs2299620 in <i>KCNQ1</i> might affect HbA1c levels differentially based on BMI grouping in the Japanese population.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-023-00618-0.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 2","pages":"188-198"},"PeriodicalIF":2.2,"publicationDate":"2023-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10113415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9741110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-25eCollection Date: 2023-04-01DOI: 10.1007/s13340-023-00617-1
Mika Ito, Masataka Shikata, Masafumi Koga
We have reported cases of hemoglobin (Hb) A2-Niigata (δ1Val → Ala) with δ chain variant Hb and falsely high HbA1c levels. In subjects with Hb A2-Niigata, shoulder-shaped anomalous peak was detected immediately before the HbA1c peaks using high-performance liquid chromatography (HPLC; HLC-723 G9). The phenomenon where the valley between peaks of LA1c+ , a fraction containing labile HbA1c, and HbA1c fraction [fast valley (FV)] became shallow owing to the anomalous peak was observed. In this study, we attempted to quantify the height index of the FV. We assumed that the index FV height rate (FVHR) was useful for screening Hb A2-Niigata. Five subjects with Hb A2-Niigata were compared with the control group of 50 subjects without diabetes and 50 with diabetes. Various indices were measured using HPLC chromatograms, and FVHR was calculated based on these indices. FVHR in subjects with Hb A2-Niigata was significantly higher than that in subjects without and with diabetes (all P < 0.001). Furthermore, when the cutoff value of FVHR was set at 23-30%, Hb A2-Niigata could be diagnosed with high sensitivity and specificity (both 100%). Hb A2-Niigata can be screened using FVHR with high sensitivity and specificity. FVHR might be also useful for screening other variant hemoglobins with abnormal HPLC chromatograph.
{"title":"Usefulness of measuring fast valley height rate using high-performance liquid chromatography for variant hemoglobin, Hb A2-Niigata.","authors":"Mika Ito, Masataka Shikata, Masafumi Koga","doi":"10.1007/s13340-023-00617-1","DOIUrl":"10.1007/s13340-023-00617-1","url":null,"abstract":"<p><p>We have reported cases of hemoglobin (Hb) A2-Niigata (δ1Val → Ala) with δ chain variant Hb and falsely high HbA1c levels. In subjects with Hb A2-Niigata, shoulder-shaped anomalous peak was detected immediately before the HbA1c peaks using high-performance liquid chromatography (HPLC; HLC-723 G9). The phenomenon where the valley between peaks of LA1c+ , a fraction containing labile HbA1c, and HbA1c fraction [fast valley (FV)] became shallow owing to the anomalous peak was observed. In this study, we attempted to quantify the height index of the FV. We assumed that the index FV height rate (FVHR) was useful for screening Hb A2-Niigata. Five subjects with Hb A2-Niigata were compared with the control group of 50 subjects without diabetes and 50 with diabetes. Various indices were measured using HPLC chromatograms, and FVHR was calculated based on these indices. FVHR in subjects with Hb A2-Niigata was significantly higher than that in subjects without and with diabetes (<i>all P</i> < <i>0.001</i>). Furthermore, when the cutoff value of FVHR was set at 23-30%, Hb A2-Niigata could be diagnosed with high sensitivity and specificity (both 100%). Hb A2-Niigata can be screened using FVHR with high sensitivity and specificity. FVHR might be also useful for screening other variant hemoglobins with abnormal HPLC chromatograph.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 2","pages":"183-187"},"PeriodicalIF":2.2,"publicationDate":"2023-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10113408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9756144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: CAPTURE was a cross-sectional, non-interventional study (NCT03786406, NCT03811288) investigating the prevalence and characteristics of cardiovascular disease (CVD) in adults with type 2 diabetes (T2D) across 13 countries worldwide. Here we present the findings for Japan.
Materials and methods: Data were collected from adults aged ≥ 20 years (aged ≥ 18 years in countries outside Japan) with T2D who were managed in clinics or hospitals in 2019. Standardized methodology was used for all countries. The prevalence of CVD and its subtypes was estimated, weighted by care setting (clinics versus hospitals).
Results: Among participants from Japan (total: 800; clinics: 440; hospitals: 360), mean (standard deviation) age was 65.6 (11.2) years and glycated hemoglobin 7.2% (0.9). Sixty-seven percent of participants were male, 57.8% had diabetes duration > 10 years, 49.8% had body mass index ≥ 25 kg/m2 and 63.1% had hypertension. The weighted prevalences (95% confidence interval [CI]) of CVD and atherosclerotic CVD were 37.3% (34.2;40.3) and 33.5% (30.6;36.4), respectively. The prevalence (95% CI) of the most common subtypes of CVD was: carotid artery disease 20.5% (18.2;22.8), coronary heart disease 11.9% (9.7;14.1) and cerebrovascular disease 10.4% (8.3;12.5).
Conclusions: These contemporary data from the CAPTURE study on CVD prevalence in adults with T2D in Japan show that approximately one in three adults with T2D had established CVD, which is comparable to the prevalence in the global study cohort.
Supplementary information: The online version contains supplementary material available at 10.1007/s13340-022-00612-y.
{"title":"Cardiovascular disease prevalence in adults with type 2 diabetes in Japan: results from the Japanese centers in the CAPTURE study.","authors":"Hiroaki Seino, Yukiko Onishi, Kosei Eguchi, Keiji Nishijima, Toshihiro Sato, Shinichiro Shirabe","doi":"10.1007/s13340-022-00612-y","DOIUrl":"10.1007/s13340-022-00612-y","url":null,"abstract":"<p><strong>Introduction: </strong>CAPTURE was a cross-sectional, non-interventional study (NCT03786406, NCT03811288) investigating the prevalence and characteristics of cardiovascular disease (CVD) in adults with type 2 diabetes (T2D) across 13 countries worldwide. Here we present the findings for Japan.</p><p><strong>Materials and methods: </strong>Data were collected from adults aged ≥ 20 years (aged ≥ 18 years in countries outside Japan) with T2D who were managed in clinics or hospitals in 2019. Standardized methodology was used for all countries. The prevalence of CVD and its subtypes was estimated, weighted by care setting (clinics versus hospitals).</p><p><strong>Results: </strong>Among participants from Japan (total: 800; clinics: 440; hospitals: 360), mean (standard deviation) age was 65.6 (11.2) years and glycated hemoglobin 7.2% (0.9). Sixty-seven percent of participants were male, 57.8% had diabetes duration > 10 years, 49.8% had body mass index ≥ 25 kg/m<sup>2</sup> and 63.1% had hypertension. The weighted prevalences (95% confidence interval [CI]) of CVD and atherosclerotic CVD were 37.3% (34.2;40.3) and 33.5% (30.6;36.4), respectively. The prevalence (95% CI) of the most common subtypes of CVD was: carotid artery disease 20.5% (18.2;22.8), coronary heart disease 11.9% (9.7;14.1) and cerebrovascular disease 10.4% (8.3;12.5).</p><p><strong>Conclusions: </strong>These contemporary data from the CAPTURE study on CVD prevalence in adults with T2D in Japan show that approximately one in three adults with T2D had established CVD, which is comparable to the prevalence in the global study cohort.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-022-00612-y.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 2","pages":"172-182"},"PeriodicalIF":2.2,"publicationDate":"2023-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10113416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9756146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to determine the association between diabetic complications and the nutritional index at the first hospital visit in untreated patients with diabetes. Two hundred and four patients with untreated type 2 diabetes were enrolled in the present study. Nutrition-related risks were assessed using the Geriatric Nutritional Risk Index (GNRI). The patients were divided into the following three subgroups: major/moderate risk, low risk, and no risk. Intergroup comparisons of clinical characteristics were carried out. The risk of complications related to diabetes was associated with the GNRI. The major/moderate-risk group (GNRI < 92) had a high risk for diabetic retinopathy, diabetic nephropathy, and diabetic foot, while the low-risk group (GNRI of 92 to ≤ 98) had a high risk for diabetic nephropathy only. The odds ratio of diabetic retinopathy for a major/moderate risk was 17.6. The odds ratio of diabetic nephropathy for a major/moderate risk was 16.7. Nutritional assessment at the first hospital visit using the GNRI could be a simple and useful tool for predicting the risk of diabetic complications in untreated patients with diabetes.
{"title":"Relationship between diabetic complications and the nutritional index in untreated diabetes.","authors":"Shuji Horinouchi, Mihoko Harada, Sakiko Ikeda, Remi Horinouchi, Misako Kubo, Yuma Tashiro, Ayako Ijuin, Miki Mukai, Yoshihiko Nishio","doi":"10.1007/s13340-022-00595-w","DOIUrl":"https://doi.org/10.1007/s13340-022-00595-w","url":null,"abstract":"<p><p>This study aimed to determine the association between diabetic complications and the nutritional index at the first hospital visit in untreated patients with diabetes. Two hundred and four patients with untreated type 2 diabetes were enrolled in the present study. Nutrition-related risks were assessed using the Geriatric Nutritional Risk Index (GNRI). The patients were divided into the following three subgroups: major/moderate risk, low risk, and no risk. Intergroup comparisons of clinical characteristics were carried out. The risk of complications related to diabetes was associated with the GNRI. The major/moderate-risk group (GNRI < 92) had a high risk for diabetic retinopathy, diabetic nephropathy, and diabetic foot, while the low-risk group (GNRI of 92 to ≤ 98) had a high risk for diabetic nephropathy only. The odds ratio of diabetic retinopathy for a major/moderate risk was 17.6. The odds ratio of diabetic nephropathy for a major/moderate risk was 16.7. Nutritional assessment at the first hospital visit using the GNRI could be a simple and useful tool for predicting the risk of diabetic complications in untreated patients with diabetes.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 1","pages":"58-64"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9829937/pdf/13340_2022_Article_595.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9777755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1007/s13340-022-00598-7
Hala Mohamed El-Radad, Hazem A Sayed Ahmed, Nahed Amen Eldahshan
Objective: Egyptian studies in assessing the relationship between diabetes self-care, social support, and glycemic control in primary healthcare (PHC) are limited. Therefore, this study aimed to assess this relationship, and to evaluate the associated factors of diabetes self-care, social support, and glycemic control in Egyptian PHC patients with type 2 diabetes (T2DM).
Methods: A cross-sectional study was conducted on 320 T2DM patients at four PHC settings in Port Said city, affiliated with the General Authority of Healthcare. A semi-structured questionnaire was used to collect data, including demographic characteristics, socioeconomic status scale, disease profile, the Arabic versions of the Summary of Diabetes Self-Care Activities, and the received social support scales. Data were collected from January 2020 to June 2020.
Results: Diabetes self-care activities, and self-monitoring of blood glucose had a very weak negative correlations with glycated hemoglobin (HbA1c) levels (rho = - 0.125, p = 0.025, rho = - 0.112, p = 0.044, respectively). Receiving social support on following a meal correlated positively and very weakly with HbA1c levels (rho = 0.145, p = 0.010). Hardly positive correlation was found between receiving emotional support on feelings about diabetes, and following a specific diet (rho = 0.169, p = 0.002). Diabetes self-care activities were positively associated with higher education levels, and elevated BMI. Received social support was negatively associated with having coronary artery disease, and marital status e.g. divorced and widow. Increased age, and female gender were the predictors of good glycemic control.
Conclusion: Diabetes self-care activities were linked with reduced HBA1c levels. Further studies are needed to evaluate the buffering effect of social support on glycemic outcomes in PHC patients with T2DM.
目的:埃及在初级保健(PHC)中评估糖尿病自我保健、社会支持和血糖控制之间关系的研究是有限的。因此,本研究旨在评估这种关系,并评估埃及PHC合并2型糖尿病(T2DM)患者糖尿病自我护理、社会支持和血糖控制的相关因素。方法:对塞得港市隶属于卫生保健总局的四家初级保健机构的320例T2DM患者进行横断面研究。采用半结构化问卷收集数据,包括人口统计学特征、社会经济地位量表、疾病概况、阿拉伯语版《糖尿病自我护理活动摘要》和获得的社会支持量表。数据收集时间为2020年1月至2020年6月。结果:糖尿病自我护理活动、自我血糖监测与糖化血红蛋白(HbA1c)水平呈极弱负相关(rho = - 0.125, p = 0.025, rho = - 0.112, p = 0.044)。餐后获得社会支持与HbA1c水平呈极弱正相关(rho = 0.145, p = 0.010)。在糖尿病感受方面接受情感支持与遵循特定饮食之间几乎没有正相关(rho = 0.169, p = 0.002)。糖尿病自我保健活动与高等教育水平和高BMI呈正相关。接受社会支持与患冠状动脉疾病和婚姻状况(如离婚和寡妇)呈负相关。年龄增加和女性是血糖控制良好的预测因素。结论:糖尿病自我护理活动与降低HBA1c水平有关。需要进一步的研究来评估社会支持对PHC合并T2DM患者血糖结局的缓冲作用。
{"title":"The relationship between self-care activities, social support, and glycemic control in primary healthcare patients with type 2 diabetes.","authors":"Hala Mohamed El-Radad, Hazem A Sayed Ahmed, Nahed Amen Eldahshan","doi":"10.1007/s13340-022-00598-7","DOIUrl":"https://doi.org/10.1007/s13340-022-00598-7","url":null,"abstract":"<p><strong>Objective: </strong>Egyptian studies in assessing the relationship between diabetes self-care, social support, and glycemic control in primary healthcare (PHC) are limited. Therefore, this study aimed to assess this relationship, and to evaluate the associated factors of diabetes self-care, social support, and glycemic control in Egyptian PHC patients with type 2 diabetes (T2DM).</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 320 T2DM patients at four PHC settings in Port Said city, affiliated with the General Authority of Healthcare. A semi-structured questionnaire was used to collect data, including demographic characteristics, socioeconomic status scale, disease profile, the Arabic versions of the Summary of Diabetes Self-Care Activities, and the received social support scales. Data were collected from January 2020 to June 2020.</p><p><strong>Results: </strong>Diabetes self-care activities, and self-monitoring of blood glucose had a very weak negative correlations with glycated hemoglobin (HbA1c) levels (rho = - 0.125, <i>p</i> = 0.025, rho = - 0.112, <i>p</i> = 0.044, respectively). Receiving social support on following a meal correlated positively and very weakly with HbA1c levels (rho = 0.145, <i>p</i> = 0.010). Hardly positive correlation was found between receiving emotional support on feelings about diabetes, and following a specific diet (rho = 0.169, <i>p</i> = 0.002). Diabetes self-care activities were positively associated with higher education levels, and elevated BMI. Received social support was negatively associated with having coronary artery disease, and marital status e.g. divorced and widow. Increased age, and female gender were the predictors of good glycemic control.</p><p><strong>Conclusion: </strong>Diabetes self-care activities were linked with reduced HBA1c levels. Further studies are needed to evaluate the buffering effect of social support on glycemic outcomes in PHC patients with T2DM.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 1","pages":"65-75"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9362383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10516629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: To determine the associations between combined urinary protein (UP) and a reduced estimated glomerular filtration rate (eGFR) and the risk of starting dialysis with or without diabetes mellitus (DM).
Methods: A nationwide database with claims data on 335,778 people with and without DM aged 19-72 years in Japan was used to elucidate the impact of the severities of UP and eGFR on starting dialysis. Initiation of dialysis was determined from claims using ICD-10 codes and medical procedures. Using multivariate Cox modeling, we investigated the severities of UP and eGFR to predict the initiation of dialysis with and without DM.
Results: Both eGFR < 60 and UP(+) were independent predictors for starting dialysis with and without DM, and their values exhibited a synergistic risk of dialysis. eGFR < 60 presented a nearly twofold risk for starting dialysis compared to UP(+) regardless of DM. Risk of starting dialysis was increased with UP(+) and eGFR ≥ 60 accompanied by DM although this association was not observed without DM. Those who had UP(-) and eGFR < 60 had a high risk of starting dialysis regardless of DM. Compared with DM(-)UP(-)eGFR ≥ 60, HRs for starting dialysis for DM(+)UP(+)eGFR ≥ 60, DM(+)UP(-)eGFR < 60 and DM(+)UP(+)eGFR < 60 significantly increased 17.7 (10.6-29.7), 25.5 (13.8-47.1) and 358.1 (239.1-536.5) times, respectively.
Conclusions: eGFR < 60 and UP(+) together presented an extremely high risk of dialysis especially with DM. UP( +) increased the risk of starting dialysis regardless of the eGFR with DM. Both patient education and a treatment strategy by physicians might be helpful to avoid the progression of renal failure.
{"title":"Association of the estimated glomerular filtration rate (eGFR) and/or proteinuria to predict the risk of initiation of dialysis in people with and without diabetes.","authors":"Taeko Osawa, Kazuya Fujihara, Mayuko Harada Yamada, Yuta Yaguchi, Takaaki Sato, Masaru Kitazawa, Yasuhiro Matsubayashi, Takaho Yamada, Satoru Kodama, Hirohito Sone","doi":"10.1007/s13340-022-00603-z","DOIUrl":"https://doi.org/10.1007/s13340-022-00603-z","url":null,"abstract":"<p><strong>Aims: </strong>To determine the associations between combined urinary protein (UP) and a reduced estimated glomerular filtration rate (eGFR) and the risk of starting dialysis with or without diabetes mellitus (DM).</p><p><strong>Methods: </strong>A nationwide database with claims data on 335,778 people with and without DM aged 19-72 years in Japan was used to elucidate the impact of the severities of UP and eGFR on starting dialysis. Initiation of dialysis was determined from claims using ICD-10 codes and medical procedures. Using multivariate Cox modeling, we investigated the severities of UP and eGFR to predict the initiation of dialysis with and without DM.</p><p><strong>Results: </strong>Both eGFR < 60 and UP(+) were independent predictors for starting dialysis with and without DM, and their values exhibited a synergistic risk of dialysis. eGFR < 60 presented a nearly twofold risk for starting dialysis compared to UP(+) regardless of DM. Risk of starting dialysis was increased with UP(+) and eGFR ≥ 60 accompanied by DM although this association was not observed without DM. Those who had UP(-) and eGFR < 60 had a high risk of starting dialysis regardless of DM. Compared with DM(-)UP(-)eGFR ≥ 60, HRs for starting dialysis for DM(+)UP(+)eGFR ≥ 60, DM(+)UP(-)eGFR < 60 and DM(+)UP(+)eGFR < 60 significantly increased 17.7 (10.6-29.7), 25.5 (13.8-47.1) and 358.1 (239.1-536.5) times, respectively.</p><p><strong>Conclusions: </strong>eGFR < 60 and UP(+) together presented an extremely high risk of dialysis especially with DM. UP( +) increased the risk of starting dialysis regardless of the eGFR with DM. Both patient education and a treatment strategy by physicians might be helpful to avoid the progression of renal failure.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 1","pages":"86-93"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9829938/pdf/13340_2022_Article_603.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10574614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Unprovoked A-β+ ketosis-prone type 2 diabetes (KPD) is characterized by the sudden onset of diabetic ketosis/ketoacidosis (DK/DKA) without precipitating factors, negative anti-islet autoantibodies ("A- "), and preservation of β-cell function ("β+ ") after recovery from DKA using insulin therapy. However, there have been few reports on glucose tolerance after recovery. We present a case of KPD with nearly normalized glucose tolerance after recovery from severe DKA. A 41-year-old obese woman first presented with unprovoked severe DKA, i.e., ketonuria, plasma glucose 570 mg/dL, pH 7.18, and HCO3- 5.2 mmol/L, without anti-islet autoantibodies. She achieved insulin-free glycemic remission after recovery from DKA, leading to the diagnosis of KPD. Thereafter, 75 g oral glucose tolerance test showed impaired fasting glucose and time-in-range using intermittently scanned continuous glucose monitoring was 97% without medication. These findings suggest that, despite the initial severe DKA, some patients with KPD might achieve normalized glucose tolerance after recovery. The similar onset patterns of DKA necessitates appropriately distinguishing KPD from acute-onset type 1B (idiopathic) diabetes.
Supplementary information: The online version contains supplementary material available at 10.1007/s13340-022-00599-6.
{"title":"A patient with ketosis-prone type 2 diabetes showing nearly normalized glucose tolerance after recovery from severe diabetic ketoacidosis.","authors":"Atsushi Satomura, Yoichi Oikawa, Haruhiko Sato, Sotaro Takagi, Takuto Yamashita, Akira Shimada","doi":"10.1007/s13340-022-00599-6","DOIUrl":"https://doi.org/10.1007/s13340-022-00599-6","url":null,"abstract":"<p><p>Unprovoked A-β+ ketosis-prone type 2 diabetes (KPD) is characterized by the sudden onset of diabetic ketosis/ketoacidosis (DK/DKA) without precipitating factors, negative anti-islet autoantibodies (\"A- \"), and preservation of β-cell function (\"β+ \") after recovery from DKA using insulin therapy. However, there have been few reports on glucose tolerance after recovery. We present a case of KPD with nearly normalized glucose tolerance after recovery from severe DKA. A 41-year-old obese woman first presented with unprovoked severe DKA, i.e., ketonuria, plasma glucose 570 mg/dL, pH 7.18, and HCO<sub>3</sub> <sup>-</sup> 5.2 mmol/L, without anti-islet autoantibodies. She achieved insulin-free glycemic remission after recovery from DKA, leading to the diagnosis of KPD. Thereafter, 75 g oral glucose tolerance test showed impaired fasting glucose and time-in-range using intermittently scanned continuous glucose monitoring was 97% without medication. These findings suggest that, despite the initial severe DKA, some patients with KPD might achieve normalized glucose tolerance after recovery. The similar onset patterns of DKA necessitates appropriately distinguishing KPD from acute-onset type 1B (idiopathic) diabetes.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-022-00599-6.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 1","pages":"109-113"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9829925/pdf/13340_2022_Article_599.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9939283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Periodontal disease often develops in patients with diabetes, and further exacerbated with diabetic complications. It would be clinically important to clarify the relationship between diabetic microvascular diseases and periodontal disease. This study aimed to evaluate the association between periodontal disease and diabetic complications in patients with type 2 diabetes with poor glycemic control. A total of 447 patients with type 2 diabetes hospitalized at Rakuwakai Otowa Hospital, Japan, were initially recruited in this study. After excluding 134 patients who lacked clinical data or were edentulous, 312 were included in our study. The severity of periodontal disease was evaluated based on the average bone resorption rate. Patients with diabetic nephropathy developed severe periodontal disease (multivariate-adjusted odds ratio, 3.00 [95% CI 1.41-5.19]). Diabetic neuropathy was positively associated with the severity of periodontal disease; the multivariate-adjusted odds ratio (95% CI) was 1.62 (0.87‒2.99) for moderate and 4.26 (2.21‒8.20) for severe periodontal disease. In contrast, diabetic retinopathy was linked with moderate periodontal disease (multivariate-adjusted odds ratio 2.23 [95% CI 1.10-4.10]), but not with severe conditions (multivariate-adjusted odds ratio 0.92 [95% CI 0.67-3.07]). In conclusion, periodontal disease, evaluated by average bone resorption rate, was associated with diabetic nephropathy and neuropathy.
Supplementary information: The online version contains supplementary material available at 10.1007/s13340-022-00591-0.
牙周病常发生于糖尿病患者,并因糖尿病并发症而进一步加重。阐明糖尿病微血管病变与牙周病的关系具有重要的临床意义。本研究旨在评估血糖控制不良的2型糖尿病患者牙周病与糖尿病并发症之间的关系。在日本Rakuwakai Otowa医院住院的447例2型糖尿病患者最初被招募参加这项研究。在排除了134名缺乏临床资料或缺牙的患者后,我们的研究纳入了312名患者。根据平均骨吸收率评估牙周病的严重程度。糖尿病肾病患者发生严重的牙周病(多变量校正优势比为3.00 [95% CI 1.41-5.19])。糖尿病神经病变与牙周病严重程度呈正相关;中度牙周病多变量校正优势比(95% CI)为1.62(0.87-2.99),重度牙周病为4.26(2.21-8.20)。相比之下,糖尿病视网膜病变与中度牙周病相关(多变量校正优势比2.23 [95% CI 1.10-4.10]),但与重度牙周病无关(多变量校正优势比0.92 [95% CI 0.67-3.07])。总之,以平均骨吸收率评估的牙周病与糖尿病肾病和神经病变有关。补充信息:在线版本包含补充资料,提供地址为10.1007/s13340-022-00591-0。
{"title":"Periodontal diseases assessed by average bone resorption are associated with microvascular complications in patients with type 2 diabetes.","authors":"Noriko Sugi, Eri Eguchi, Ayaka Tsuboi, Kazu Hatanaka, Shogo Takashiba, Yuri Kira, Masako Miura, Keiki Ogino, Keita Hirano, Takahiko Nakagawa, Kentaro Doi","doi":"10.1007/s13340-022-00591-0","DOIUrl":"https://doi.org/10.1007/s13340-022-00591-0","url":null,"abstract":"<p><p>Periodontal disease often develops in patients with diabetes, and further exacerbated with diabetic complications. It would be clinically important to clarify the relationship between diabetic microvascular diseases and periodontal disease. This study aimed to evaluate the association between periodontal disease and diabetic complications in patients with type 2 diabetes with poor glycemic control. A total of 447 patients with type 2 diabetes hospitalized at Rakuwakai Otowa Hospital, Japan, were initially recruited in this study. After excluding 134 patients who lacked clinical data or were edentulous, 312 were included in our study. The severity of periodontal disease was evaluated based on the average bone resorption rate. Patients with diabetic nephropathy developed severe periodontal disease (multivariate-adjusted odds ratio, 3.00 [95% CI 1.41-5.19]). Diabetic neuropathy was positively associated with the severity of periodontal disease; the multivariate-adjusted odds ratio (95% CI) was 1.62 (0.87‒2.99) for moderate and 4.26 (2.21‒8.20) for severe periodontal disease. In contrast, diabetic retinopathy was linked with moderate periodontal disease (multivariate-adjusted odds ratio 2.23 [95% CI 1.10-4.10]), but not with severe conditions (multivariate-adjusted odds ratio 0.92 [95% CI 0.67-3.07]). In conclusion, periodontal disease, evaluated by average bone resorption rate, was associated with diabetic nephropathy and neuropathy.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-022-00591-0.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 1","pages":"32-39"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9829934/pdf/13340_2022_Article_591.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9707752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: Muscle atrophy is a diabetic complication, which results in a deterioration in glycemic control in type 2 diabetes mellitus (T2DM) individuals. The psoas muscle mass index (PMI) is a reliable indicator for estimating whole-body muscle mass. We aimed to examine the relationship between clinical parameters and the PMI to clarify the mechanism underlying muscle atrophy in diabetes.
Methods: This retrospective, cross-sectional study examined 51 patients (31 men and 20 women) with T2DM and a mean HbA1c value of 9.9 ± 1.7%. These patients were admitted to Aichi Medical University Hospital and underwent abdominal computed tomography imaging from July 2020 to April 2021. Multiple clinical parameters were assessed with the PMI.
Results: In a multiple regression analysis adjusted for age and sex, the PMI was correlated with body weight, body mass index, serum concentrations of corrected calcium, aspartate aminotransferase, alanine aminotransferase, creatine kinase, thyroid-stimulating hormone (TSH), urinary C-peptide concentrations, the free triiodothyronine/free thyroxine (FT3/FT4) ratio, and the young adult mean score at the femur neck. Receiver operating characteristic curves were created using TSH concentrations and the FT3/FT4 ratio for diagnosing a low PMI. The area under the curve was 0.593 and 0.699, respectively. The cut-off value with maximum accuracy for TSH concentrations was 1.491 μIU/mL, sensitivity was 56.1%, and specificity was 80.0%. Corresponding values for the FT3/FT4 ratio were 1.723, 78.0, and 66.7%, respectively.
Conclusion: TSH concentrations and the FT3/FT4 ratio are correlated with the PMI, and their thresholds may help prevent muscle mass loss in Japanese individuals with T2DM.
{"title":"Clinical parameters correlated with the psoas muscle index in Japanese individuals with type 2 diabetes mellitus.","authors":"Emi Asano-Hayami, Yoshiaki Morishita, Tomohide Hayami, Yuka Shibata, Toshiki Kiyose, Sachiko Sasajima, Yusuke Hayashi, Mikio Motegi, Makoto Kato, Saeko Asano, Hiromi Nakai-Shimoda, Yuichiro Yamada, Emiri Miura-Yura, Tatsuhito Himeno, Masaki Kondo, Shin Tsunekawa, Yoshiro Kato, Jiro Nakamura, Hideki Kamiya","doi":"10.1007/s13340-022-00602-0","DOIUrl":"https://doi.org/10.1007/s13340-022-00602-0","url":null,"abstract":"<p><strong>Aims: </strong>Muscle atrophy is a diabetic complication, which results in a deterioration in glycemic control in type 2 diabetes mellitus (T2DM) individuals. The psoas muscle mass index (PMI) is a reliable indicator for estimating whole-body muscle mass. We aimed to examine the relationship between clinical parameters and the PMI to clarify the mechanism underlying muscle atrophy in diabetes.</p><p><strong>Methods: </strong>This retrospective, cross-sectional study examined 51 patients (31 men and 20 women) with T2DM and a mean HbA1c value of 9.9 ± 1.7%. These patients were admitted to Aichi Medical University Hospital and underwent abdominal computed tomography imaging from July 2020 to April 2021. Multiple clinical parameters were assessed with the PMI.</p><p><strong>Results: </strong>In a multiple regression analysis adjusted for age and sex, the PMI was correlated with body weight, body mass index, serum concentrations of corrected calcium, aspartate aminotransferase, alanine aminotransferase, creatine kinase, thyroid-stimulating hormone (TSH), urinary C-peptide concentrations, the free triiodothyronine/free thyroxine (FT3/FT4) ratio, and the young adult mean score at the femur neck. Receiver operating characteristic curves were created using TSH concentrations and the FT3/FT4 ratio for diagnosing a low PMI. The area under the curve was 0.593 and 0.699, respectively. The cut-off value with maximum accuracy for TSH concentrations was 1.491 μIU/mL, sensitivity was 56.1%, and specificity was 80.0%. Corresponding values for the FT3/FT4 ratio were 1.723, 78.0, and 66.7%, respectively.</p><p><strong>Conclusion: </strong>TSH concentrations and the FT3/FT4 ratio are correlated with the PMI, and their thresholds may help prevent muscle mass loss in Japanese individuals with T2DM.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 1","pages":"76-85"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9829932/pdf/13340_2022_Article_602.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10205212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}