Aims: To find an index of glycemic exposure that predicts retinopathy by a simple regression setting regardless of duration in type 1 diabetes which might be useful for the care of diabetes.
Materials and methods: To exclude the possible disturbing effect of metabolic memory, we examined a subgroup of patients with glycohemoglobin A1c (A1C) data for the total period of type 1 diabetes selected from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications data. Three indices-(1) mean value of yearly A1C (mA1C), (2) sum of yearly A1C values (ƩA1C), and (3) sum of yearly A1C values above 6.5% (ƩexcessA1C)-were assessed as potential candidates. Development of retinopathy was defined by ≥ 3-steps' progression of retinopathy from baseline.
Results: The areas under the receiver operating characteristics curves of the indices for development of retinopathy at years 5, 9, and 13 after the onset of diabetes were the same: 0.8481, 0.8762, and 0.8213, respectively, indicating that each index was substantially capable of predicting development of retinopathy at each timepoint. Linear regression analyses showed that each index had significant and substantial linear relations to retinopathy at each timepoint: all P < 0.0001 for slopes; contribution rate R2 = 0.21 (year 5), 0.46 (year 9), and 0.48 (year 13) for each index. But only ƩexcessA1C index appeared to have similar linear relations to retinopathy at all three timepoints (interactions by timepoint: for slopes: P = 0.1393; for intercepts: P = 0.9366).
Conclusion: ƩexcessA1C may have the potential to predict retinopathy by just one linear regression setting regardless of duration in type 1 diabetes.
{"title":"ƩexcessA1C index, the sum of yearly excess HbA1c values during the total period of diabetes, may have the potential to predict retinopathy by a linear regression setting regardless of duration in type 1 diabetes: a subgroup analysis of DCCT/EDIC data.","authors":"Akira Hirose, Yasutaka Maeda, Atsushi Goto, Masae Minami, Shigehiko Kitano, Yasuko Uchigata","doi":"10.1007/s13340-023-00654-w","DOIUrl":"10.1007/s13340-023-00654-w","url":null,"abstract":"<p><strong>Aims: </strong>To find an index of glycemic exposure that predicts retinopathy by a simple regression setting regardless of duration in type 1 diabetes which might be useful for the care of diabetes.</p><p><strong>Materials and methods: </strong>To exclude the possible disturbing effect of metabolic memory, we examined a subgroup of patients with glycohemoglobin A1c (A1C) data for the total period of type 1 diabetes selected from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications data. Three indices-(1) mean value of yearly A1C (mA1C), (2) sum of yearly A1C values (ƩA1C), and (3) sum of yearly A1C values above 6.5% (ƩexcessA1C)-were assessed as potential candidates. Development of retinopathy was defined by ≥ 3-steps' progression of retinopathy from baseline.</p><p><strong>Results: </strong>The areas under the receiver operating characteristics curves of the indices for development of retinopathy at years 5, 9, and 13 after the onset of diabetes were the same: 0.8481, 0.8762, and 0.8213, respectively, indicating that each index was substantially capable of predicting development of retinopathy at each timepoint. Linear regression analyses showed that each index had significant and substantial linear relations to retinopathy at each timepoint: all <i>P</i> < 0.0001 for slopes; contribution rate <i>R</i><sup>2</sup> = 0.21 (year 5), 0.46 (year 9), and 0.48 (year 13) for each index. But only ƩexcessA1C index appeared to have similar linear relations to retinopathy at all three timepoints (interactions by timepoint: for slopes: <i>P</i> = 0.1393; for intercepts: <i>P</i> = 0.9366).</p><p><strong>Conclusion: </strong>ƩexcessA1C may have the potential to predict retinopathy by just one linear regression setting regardless of duration in type 1 diabetes.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 4","pages":"440-444"},"PeriodicalIF":1.3,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10533424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41132381","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}
It is important to provide "Diabetes Self-Management Education and Support," the ongoing process of facilitating the knowledge, skills, and ability necessary for diabetes self-care, immediately after diagnosis. In this 12-month (12 M) longitudinal observational study, outpatients within 3 months of their first diagnosis of type 2 diabetes mellitus (T2DM) were surveyed at baseline (BL) and 12 M using a self-administered questionnaire used in the "Lifestyle Intervention Support Software for Diabetes Prevention" and medical record survey. To explore factors associated with the change extent in HbA1c level during the 12 M post-diagnosis, hierarchical multiple regression analysis was performed with sex, age, HbA1c level at BL, medication in the first 12 M post-diagnosis, and lifestyle behaviors related to diet and exercise therapy as independent variables. The HbA1c level of the 89 participants was 8.4% ± 2.2% at BL and 6.7% ± 1.0% at 12 M. "ND06 I add milk to coffee or tea (reverse item)" (β = -0.110, p = 0.015), "RD15 I eat vegetable dishes such as a vegetable side dish and/or a vinegar or pickle dish" (β = 0.151, p = 0.003), "ND02 I eat until I feel full (reverse item)" (β = -0.115, p = 0.024), and "RD14 I select udon or soba instead of Chinese noodles in soups" (β = -0.113, p = 0.007) were associated with the change extent in the HbA1c level during the 12 M post-diagnosis. Overall, it may be useful to support patients with T2DM early post-diagnosis to improve lifestyle behaviors associated with the extent of change in HbA1c level during the 12 M post-diagnosis.
{"title":"Lifestyle behaviors that reduce food and fat intake in patients with type 2 diabetes within 3 months of diagnosis lead to a reduction in the HbA1c level after 12 months.","authors":"Yuri Tokunaga-Nakawatase, Maki Aomori, Setsuko Watabe","doi":"10.1007/s13340-023-00650-0","DOIUrl":"10.1007/s13340-023-00650-0","url":null,"abstract":"<p><p>It is important to provide \"Diabetes Self-Management Education and Support,\" the ongoing process of facilitating the knowledge, skills, and ability necessary for diabetes self-care, immediately after diagnosis. In this 12-month (12 M) longitudinal observational study, outpatients within 3 months of their first diagnosis of type 2 diabetes mellitus (T2DM) were surveyed at baseline (BL) and 12 M using a self-administered questionnaire used in the \"Lifestyle Intervention Support Software for Diabetes Prevention\" and medical record survey. To explore factors associated with the change extent in HbA1c level during the 12 M post-diagnosis, hierarchical multiple regression analysis was performed with sex, age, HbA1c level at BL, medication in the first 12 M post-diagnosis, and lifestyle behaviors related to diet and exercise therapy as independent variables. The HbA1c level of the 89 participants was 8.4% ± 2.2% at BL and 6.7% ± 1.0% at 12 M. \"ND06 I add milk to coffee or tea (reverse item)\" (<i>β</i> = -0.110, <i>p</i> = 0.015), \"RD15 I eat vegetable dishes such as a vegetable side dish and/or a vinegar or pickle dish\" (<i>β</i> = 0.151, <i>p</i> = 0.003), \"ND02 I eat until I feel full (reverse item)\" (<i>β</i> = -0.115, <i>p</i> = 0.024), and \"RD14 I select <i>udon</i> or <i>soba</i> instead of Chinese noodles in soups\" (<i>β</i> = -0.113, <i>p</i> = 0.007) were associated with the change extent in the HbA1c level during the 12 M post-diagnosis. Overall, it may be useful to support patients with T2DM early post-diagnosis to improve lifestyle behaviors associated with the extent of change in HbA1c level during the 12 M post-diagnosis.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 4","pages":"413-421"},"PeriodicalIF":1.3,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10533453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41111391","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}
We investigated the association of glycemic control in the early phase of hospitalization with the prognosis of COVID-19 in patients with diabetes. We analyzed the relationship between various clinical indices, including preprandial blood glucose levels measured by self-monitoring devices in the early phase after admission, and severe prognosis in 189 patients with complicated diabetes who were admitted to our hospital between February 22, 2020 and June 20, 2021. Enrolled patients had a median age of 72 years, median body mass index of 24.7, median HbA1c of 7.1%, and median mean preprandial capillary glucose (PPCG) of 179.1 mg/dL. Sixty-six patients progressed to severe disease, and the mean PPCG in severe cases was significantly higher than that in non-severe cases, 195.2 vs 167.8 mg/dL (p = 0.005). Analysis of the receiver operating characteristic curve showed that 179 mg/dL was the cut-off value, and the risk of severity was significantly higher in patients with a mean PPCG of 180 mg/dL or higher (odds ratio (OR) 3.210, p = 0.017) in multiple regression analysis. In this study, we found that the risk of severe COVID-19 increased in patients with a high mean PPCG in the early phase of hospitalization, suggesting that good glucose control in the early phase of COVID-19 with diabetes may be effective in preventing disease severity.
Supplementary information: The online version contains supplementary material available at 10.1007/s13340-023-00656-8.
{"title":"Glucose control in the early phase of hospitalization is associated with severe prognosis in coronavirus disease 2019 (COVID-19) patients with diabetes in Japan.","authors":"Yukiyoshi Okauchi, Ryuki Sakamoto, Tomoko Kaketaka, Eri Yamabayashi, Motohiro Kubori, Shinya Inada, Osamu Morimura, Yasushi Otani, Kinya Abe, Tsutomu Nishida, Hiromi Iwahashi","doi":"10.1007/s13340-023-00656-8","DOIUrl":"10.1007/s13340-023-00656-8","url":null,"abstract":"<p><p>We investigated the association of glycemic control in the early phase of hospitalization with the prognosis of COVID-19 in patients with diabetes. We analyzed the relationship between various clinical indices, including preprandial blood glucose levels measured by self-monitoring devices in the early phase after admission, and severe prognosis in 189 patients with complicated diabetes who were admitted to our hospital between February 22, 2020 and June 20, 2021. Enrolled patients had a median age of 72 years, median body mass index of 24.7, median HbA1c of 7.1%, and median mean preprandial capillary glucose (PPCG) of 179.1 mg/dL. Sixty-six patients progressed to severe disease, and the mean PPCG in severe cases was significantly higher than that in non-severe cases, 195.2 vs 167.8 mg/dL (<i>p</i> = 0.005). Analysis of the receiver operating characteristic curve showed that 179 mg/dL was the cut-off value, and the risk of severity was significantly higher in patients with a mean PPCG of 180 mg/dL or higher (odds ratio (OR) 3.210, <i>p</i> = 0.017) in multiple regression analysis. In this study, we found that the risk of severe COVID-19 increased in patients with a high mean PPCG in the early phase of hospitalization, suggesting that good glucose control in the early phase of COVID-19 with diabetes may be effective in preventing disease severity.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-023-00656-8.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 4","pages":"406-412"},"PeriodicalIF":1.3,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10533425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41105304","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/introduction: We aimed to identify the frequency and risk factors of pre-ulcerative lesions of foot in Japanese individuals with diabetes.
Materials and methods: This was a single-center cross-sectional observational study. We conducted a questionnaire survey of 5029 individuals with diabetes (mean age 63 years; 2185 women; 1015 individuals with type 1 diabetes and 4014 individuals with type 2 diabetes) who (a) participated in the Diabetes Study from the Center of Tokyo Women's Medical University: DIACET 2018, and (b) responded to the presence of pre-ulcerative lesions of foot. A pre-ulcerative lesions of foot was defined as a calluses, ingrown nails, or symptoms of fungal infection. The associations between pre-ulcerative lesions of foot and commonly available clinical information were examined using the logistic regression analysis.
Results: 412 of 1015 (40.6%) individuals with type 1 diabetes and 1585 of 4014 (39.5%) individuals with type 2 diabetes reported having any type of pre-ulcerative lesions of foot. The frequency of calluses, ingrown nails, and symptoms of fungal infection, respectively, were 16.8%, 15.8%, and 21.9% in type 1 diabetes and 10.5%, 18.5%, and 24.7% in type 2 diabetes. In the separate analysis by type of diabetes, common risk factors found to be significantly correlated with pre-ulcerative lesions of foot were female gender, numbness in the feet and foot deformation.
Conclusion: Proactive foot screening by health care professionals was considered important, especially in individuals with type 1 and type 2 diabetes with advanced complications and foot deformation.
Supplementary information: The online version contains supplementary material available at 10.1007/s13340-023-00649-7.
{"title":"A fact-finding survey on pre-ulcerative lesions of foot in patients with diabetes: analysis using the Diabetes Study from the Center of Tokyo Women's Medical University 2018 (DIACET 2018).","authors":"Haruna Azuma, Kazuki Ikura, Junnosuke Miura, Tetsuya Babazono","doi":"10.1007/s13340-023-00649-7","DOIUrl":"10.1007/s13340-023-00649-7","url":null,"abstract":"<p><strong>Aims/introduction: </strong>We aimed to identify the frequency and risk factors of pre-ulcerative lesions of foot in Japanese individuals with diabetes.</p><p><strong>Materials and methods: </strong>This was a single-center cross-sectional observational study. We conducted a questionnaire survey of 5029 individuals with diabetes (mean age 63 years; 2185 women; 1015 individuals with type 1 diabetes and 4014 individuals with type 2 diabetes) who (a) participated in the Diabetes Study from the Center of Tokyo Women's Medical University: DIACET 2018, and (b) responded to the presence of pre-ulcerative lesions of foot. A pre-ulcerative lesions of foot was defined as a calluses, ingrown nails, or symptoms of fungal infection. The associations between pre-ulcerative lesions of foot and commonly available clinical information were examined using the logistic regression analysis.</p><p><strong>Results: </strong>412 of 1015 (40.6%) individuals with type 1 diabetes and 1585 of 4014 (39.5%) individuals with type 2 diabetes reported having any type of pre-ulcerative lesions of foot. The frequency of calluses, ingrown nails, and symptoms of fungal infection, respectively, were 16.8%, 15.8%, and 21.9% in type 1 diabetes and 10.5%, 18.5%, and 24.7% in type 2 diabetes. In the separate analysis by type of diabetes, common risk factors found to be significantly correlated with pre-ulcerative lesions of foot were female gender, numbness in the feet and foot deformation.</p><p><strong>Conclusion: </strong>Proactive foot screening by health care professionals was considered important, especially in individuals with type 1 and type 2 diabetes with advanced complications and foot deformation.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-023-00649-7.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 4","pages":"397-405"},"PeriodicalIF":1.3,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10533771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41113890","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}
Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been used worldwide since the 2020 coronavirus pandemic. However, several negative side-effects of these vaccines have been reported. Herein, we present a case of a patient with fulminant type 1 diabetes that developed shortly after administration of the SARS-CoV-2 vaccine. A 47-year-old man with no medical history presented with hyperglycemia-related symptoms shortly after receiving the third messenger ribonucleic acid SARS-CoV-2 vaccine. Based on hyperglycemia, diabetic ketoacidosis at onset, relatively low hemoglobin A1c levels, and complete depletion of endogenous insulin secretion, the patient was diagnosed with fulminant type 1 diabetes and insulin therapy was initiated. Through human leukocyte antigen genotyping, the disease-susceptible alleles for type 1 diabetes, DRB1*04:05 and DQB1*04:01, were identified. The patient tested positive for serum anti-glutamic acid decarboxylase antibodies, which are normally negative for fulminant type 1 diabetes, implying that immunomodulation triggered by SARS-CoV-2 vaccination influenced the onset of type 1 diabetes.
{"title":"Anti-GAD antibody-positive fulminant type 1 diabetes developed following SARS-CoV-2 vaccination.","authors":"Tomohito Izumi, Hironobu Takahashi, Hironori Takahashi","doi":"10.1007/s13340-023-00648-8","DOIUrl":"10.1007/s13340-023-00648-8","url":null,"abstract":"<p><p>Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been used worldwide since the 2020 coronavirus pandemic. However, several negative side-effects of these vaccines have been reported. Herein, we present a case of a patient with fulminant type 1 diabetes that developed shortly after administration of the SARS-CoV-2 vaccine. A 47-year-old man with no medical history presented with hyperglycemia-related symptoms shortly after receiving the third messenger ribonucleic acid SARS-CoV-2 vaccine. Based on hyperglycemia, diabetic ketoacidosis at onset, relatively low hemoglobin A1c levels, and complete depletion of endogenous insulin secretion, the patient was diagnosed with fulminant type 1 diabetes and insulin therapy was initiated. Through human leukocyte antigen genotyping, the disease-susceptible alleles for type 1 diabetes, DRB1*04:05 and DQB1*04:01, were identified. The patient tested positive for serum anti-glutamic acid decarboxylase antibodies, which are normally negative for fulminant type 1 diabetes, implying that immunomodulation triggered by SARS-CoV-2 vaccination influenced the onset of type 1 diabetes.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 4","pages":"422-426"},"PeriodicalIF":1.3,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10533421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41115312","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: This study analyzed the gait patterns of diabetic peripheral neuropathy (DPN) patients and changes in the center of mass sway to prevent the formation and recurrence of foot ulcers.
Methods: Forty-two subjects were divided into the diabetes mellitus (DM), DPN, and diabetic foot ulcer (DFU) groups. We measured the range of motion (ROM) of the lower limb joints in the resting position and the center of mass sway in the standing position. Joint angles, ROM during walking, and distance factors were evaluated.
Results: In the DFU group, ROM limitation during walking was detected at the knee joint, and functional and ROM limitations were found at the ankle joint. The step length ratio and step width in the DFU group were significantly lower and higher than those in the DM group, respectively. The sway distances in the DFU group were greater than those in the DM and DPN groups.
Conclusions: Functional joint limitations and gait changes due to the decreased ability to maintain the center of gravity were observed in the DFU group. As DPN progressed, the patients' gait became small, wide, and shuffled. Thus, supporting joint movement during walking may help reduce the incidence and recurrence of foot ulcers.
Supplementary information: The online version contains supplementary material available at 10.1007/s13340-023-00647-9.
{"title":"Effect of joint limitation and balance control on gait changes in diabetic peripheral neuropathy.","authors":"Hiroyuki Yamasaki, Yoshiro Abe, Shunsuke Mima, Mayu Bando, Shinji Nagasaka, Yutaro Yamashita, Kazuhide Mineda, Akio Kuroda, Munehide Matsuhisa, Masahiro Takaiwa, Ichiro Hashimoto","doi":"10.1007/s13340-023-00647-9","DOIUrl":"10.1007/s13340-023-00647-9","url":null,"abstract":"<p><strong>Aims: </strong>This study analyzed the gait patterns of diabetic peripheral neuropathy (DPN) patients and changes in the center of mass sway to prevent the formation and recurrence of foot ulcers.</p><p><strong>Methods: </strong>Forty-two subjects were divided into the diabetes mellitus (DM), DPN, and diabetic foot ulcer (DFU) groups. We measured the range of motion (ROM) of the lower limb joints in the resting position and the center of mass sway in the standing position. Joint angles, ROM during walking, and distance factors were evaluated.</p><p><strong>Results: </strong>In the DFU group, ROM limitation during walking was detected at the knee joint, and functional and ROM limitations were found at the ankle joint. The step length ratio and step width in the DFU group were significantly lower and higher than those in the DM group, respectively. The sway distances in the DFU group were greater than those in the DM and DPN groups.</p><p><strong>Conclusions: </strong>Functional joint limitations and gait changes due to the decreased ability to maintain the center of gravity were observed in the DFU group. As DPN progressed, the patients' gait became small, wide, and shuffled. Thus, supporting joint movement during walking may help reduce the incidence and recurrence of foot ulcers.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-023-00647-9.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 4","pages":"390-396"},"PeriodicalIF":1.3,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10533448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41106006","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/introduction: Diabetic cardiomyopathy (DCM) is characterized predominantly by diastolic dysfunction. The multiple mechanisms underlying DCM include altered energy substrate utilization. Recent studies indicate that PPARα plays an important role in the pathogenesis of lipotoxic cardiomyopathy. Pemafibrate is known to be a selective PPARα modulator (SPPARMα). We thus investigated the effects of pemafibrate on cardiac diastolic function in patients with type 2 diabetes.
Materials and methods: Seventeen patients with type 2 diabetes (T2D) and hypertriglyceridemia were screened and treated with pemafibrate at a dose of 0.2 mg/day for 8-16 weeks. Fourteen patients were eligible for analysis. Echocardiography was used for assessment of diastolic function. Early diastolic filling velocity (E), late atrial filling velocity (A) and the E/A ratio were included in this study. Peak early diastolic annular velocities (e') were also assessed using color tissue Doppler images. The primary endpoints were changes in the ratio of E to A (E/A), e', and the ratio of E to e' (E/e') from baseline.
Results: Pemafibrate significantly increased average e' (7.24 ± 0.58 vs 7.94 ± 0.67, p = 0.019) and a significant reduction in E/e' (9.01 ± 0.94 vs 8.20 ± 0.91, p = 0.041). The increase in e' was significantly related to increases in fasting blood glucose (r = 0.607, p = 0.021) and non-esterified fatty acid (r = 0.592, p = 0.026).
Conclusion: Pemafibrate improved diastolic function in patients with T2D and hypertriglyceridemia, suggesting that PPARα activation by pemafibrate prevents the development of DCM at an early stage.
{"title":"Effects of pemafibrate on left ventricular diastolic function in patients with type 2 diabetes mellitus: a pilot study.","authors":"Kaoru Yamamoto, Yasuharu Ohta, Akihiko Taguchi, Masaru Akiyama, Hiroko Nakabayashi, Yuko Nagao, Hatanaka Ryoko, Yasuaki Wada, Takeshi Yamamoto, Masafumi Yano, Yukio Tanizawa","doi":"10.1007/s13340-023-00645-x","DOIUrl":"10.1007/s13340-023-00645-x","url":null,"abstract":"<p><strong>Aims/introduction: </strong>Diabetic cardiomyopathy (DCM) is characterized predominantly by diastolic dysfunction. The multiple mechanisms underlying DCM include altered energy substrate utilization. Recent studies indicate that PPARα plays an important role in the pathogenesis of lipotoxic cardiomyopathy. Pemafibrate is known to be a selective PPARα modulator (SPPARMα). We thus investigated the effects of pemafibrate on cardiac diastolic function in patients with type 2 diabetes.</p><p><strong>Materials and methods: </strong>Seventeen patients with type 2 diabetes (T2D) and hypertriglyceridemia were screened and treated with pemafibrate at a dose of 0.2 mg/day for 8-16 weeks. Fourteen patients were eligible for analysis. Echocardiography was used for assessment of diastolic function. Early diastolic filling velocity (E), late atrial filling velocity (A) and the E/A ratio were included in this study. Peak early diastolic annular velocities (e') were also assessed using color tissue Doppler images. The primary endpoints were changes in the ratio of E to A (E/A), e', and the ratio of E to e' (E/e') from baseline.</p><p><strong>Results: </strong>Pemafibrate significantly increased average e' (7.24 ± 0.58 vs 7.94 ± 0.67, <i>p</i> = 0.019) and a significant reduction in E/e' (9.01 ± 0.94 vs 8.20 ± 0.91, <i>p</i> = 0.041). The increase in e' was significantly related to increases in fasting blood glucose (<i>r</i> = 0.607, <i>p</i> = 0.021) and non-esterified fatty acid (<i>r</i> = 0.592, <i>p</i> = 0.026).</p><p><strong>Conclusion: </strong>Pemafibrate improved diastolic function in patients with T2D and hypertriglyceridemia, suggesting that PPARα activation by pemafibrate prevents the development of DCM at an early stage.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 4","pages":"434-439"},"PeriodicalIF":1.3,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10533442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41118230","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}
The significance of diagnosing gestational diabetes mellitus (GDM) in early pregnancy is controversial. We used the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria to investigate whether clinical background and neonatal outcomes differ depending on when GDM is diagnosed in early or late pregnancy. This was a single-center, observational study conducted between November 2012 and March 2020 at St. Marianna University Hospital (Kawasaki, Japan). We compared the background and perinatal outcomes of patients with GDM depending on the time of diagnosis (at < 24 gestational weeks or ≥ 24 weeks). Insulin sensitivity index, homeostasis model assessment of insulin resistance, and β-cell function were calculated from a 75-g oral glucose tolerance test. Stratified analysis was performed by pre-pregnancy BMI in patients with early GDM. As a result, in the 507 patients, 89.9% gave birth at our hospital. The pre-pregnancy BMI was significantly higher in patients with early GDM than in those with late GDM (the median [interquartile range], 22.7 [20.3, 26.3] and 21.5 [19.3, 23.8] kg/m2, respectively; p = 0.001). Perinatal outcomes were not different between the two groups. However, in the subgroup analysis of patients with early GDM, the prevalence of large-for-gestational-age infants was significantly higher in the group with overweight (15.4% vs 2.1%, respectively; p = 0.008). In conclusion, patients with GDM using the IADPSG criteria in early pregnancy may be treated, especially in patients with pre-pregnancy overweight.
{"title":"Patients with gestational diabetes mellitus may be treated in both early and late pregnancy, especially in patients with pre-pregnancy overweight: A cross-sectional study in Japan.","authors":"Ayaka Takemoto, Yoshio Nagai, Shin Kawanabe, Tomoko Nakagawa, Kaho Matsumoto, Jyunichi Hasegawa, Nao Suzuki, Yasushi Tanaka, Masakatsu Sone","doi":"10.1007/s13340-023-00646-w","DOIUrl":"10.1007/s13340-023-00646-w","url":null,"abstract":"<p><p>The significance of diagnosing gestational diabetes mellitus (GDM) in early pregnancy is controversial. We used the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria to investigate whether clinical background and neonatal outcomes differ depending on when GDM is diagnosed in early or late pregnancy. This was a single-center, observational study conducted between November 2012 and March 2020 at St. Marianna University Hospital (Kawasaki, Japan). We compared the background and perinatal outcomes of patients with GDM depending on the time of diagnosis (at < 24 gestational weeks or ≥ 24 weeks). Insulin sensitivity index, homeostasis model assessment of insulin resistance, and β-cell function were calculated from a 75-g oral glucose tolerance test. Stratified analysis was performed by pre-pregnancy BMI in patients with early GDM. As a result, in the 507 patients, 89.9% gave birth at our hospital. The pre-pregnancy BMI was significantly higher in patients with early GDM than in those with late GDM (the median [interquartile range], 22.7 [20.3, 26.3] and 21.5 [19.3, 23.8] kg/m<sup>2</sup>, respectively; <i>p</i> = 0.001). Perinatal outcomes were not different between the two groups. However, in the subgroup analysis of patients with early GDM, the prevalence of large-for-gestational-age infants was significantly higher in the group with overweight (15.4% vs 2.1%, respectively; <i>p</i> = 0.008). In conclusion, patients with GDM using the IADPSG criteria in early pregnancy may be treated, especially in patients with pre-pregnancy overweight.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 4","pages":"381-389"},"PeriodicalIF":1.3,"publicationDate":"2023-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10533430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41105362","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 corrects the article DOI: 10.1007/s13340-022-00605-x.].
[这更正了文章DOI:10.1007/s1330-022-00605-x.]。
{"title":"Correction: A consensus statement from the Japan Diabetes Society (JDS): a proposed algorithm for pharmacotherapy in people with type 2 diabetes.","authors":"Ryotaro Bouchi, Tatsuya Kondo, Yasuharu Ohta, Atsushi Goto, Daisuke Tanaka, Hiroaki Satoh, Daisuke Yabe, Rimei Nishimura, Norio Harada, Hideki Kamiya, Ryo Suzuki, Toshimasa Yamauchi","doi":"10.1007/s13340-023-00644-y","DOIUrl":"10.1007/s13340-023-00644-y","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1007/s13340-022-00605-x.].</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 4","pages":"446"},"PeriodicalIF":2.2,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10533423/pdf/13340_2023_Article_644.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41113818","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}
Background: Previous meta-analyses have assessed the relationship between carbohydrate intake and type 2 diabetes (T2D) risk; however, they included few studies of Asian populations who have a higher carbohydrate intake and lower insulin secretory capacity than non-Asians. Since the publication of the previous meta-analyses, three further studies of Asian populations have been conducted. Based on this background, the present study aimed to perform an updated systematically examine observational studies concerning the link between dietary carbohydrate intake and T2D risk.
Methods: We conducted a systematic search for cohort studies that investigated the target association. For each analyzed study, parameter-adjusted risk ratios were used to compare the lowest and highest carbohydrate-intake groups in terms of their risk of incident T2D. The risk ratios were calculated using a random-effects model.
Results: Ten publications were analyzed. Overall, carbohydrate intake was found not to be associated with increased risk ratios of incident T2D (risk ratio [RR] = 1.07; 95% confidence interval [95% CI] = 0.94, 1.21; P < 0.01, I2 = 61.9%). However, studies of Asian populations reported that high carbohydrate intake is significantly associated with this risk (RR = 1.29; 95% CI 1.15, 1.45; P = 0.59, I2 = 0.0%).
Conclusions: This updated meta-analysis showed that, overall, carbohydrate intake is not associated with the risk of T2D; nevertheless, a significant association exists among Asian populations. To confirm the association between dietary carbohydrate intake and T2D risk observed in this study, further evidence from long-term observational studies of Asian populations is required.
Supplementary information: The online version contains supplementary material available at 10.1007/s13340-023-00642-0.
{"title":"Association between dietary carbohydrate intake and risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies.","authors":"Akinori Yaegashi, Satoshi Sunohara, Takashi Kimura, Wen Hao, Takato Moriguchi, Akiko Tamakoshi","doi":"10.1007/s13340-023-00642-0","DOIUrl":"10.1007/s13340-023-00642-0","url":null,"abstract":"<p><strong>Background: </strong>Previous meta-analyses have assessed the relationship between carbohydrate intake and type 2 diabetes (T2D) risk; however, they included few studies of Asian populations who have a higher carbohydrate intake and lower insulin secretory capacity than non-Asians. Since the publication of the previous meta-analyses, three further studies of Asian populations have been conducted. Based on this background, the present study aimed to perform an updated systematically examine observational studies concerning the link between dietary carbohydrate intake and T2D risk.</p><p><strong>Methods: </strong>We conducted a systematic search for cohort studies that investigated the target association. For each analyzed study, parameter-adjusted risk ratios were used to compare the lowest and highest carbohydrate-intake groups in terms of their risk of incident T2D. The risk ratios were calculated using a random-effects model.</p><p><strong>Results: </strong>Ten publications were analyzed. Overall, carbohydrate intake was found not to be associated with increased risk ratios of incident T2D (risk ratio [RR] = 1.07; 95% confidence interval [95% CI] = 0.94, 1.21; P < 0.01, I<sup>2</sup> = 61.9%). However, studies of Asian populations reported that high carbohydrate intake is significantly associated with this risk (RR = 1.29; 95% CI 1.15, 1.45; P = 0.59, I<sup>2</sup> = 0.0%).</p><p><strong>Conclusions: </strong>This updated meta-analysis showed that, overall, carbohydrate intake is not associated with the risk of T2D; nevertheless, a significant association exists among Asian populations. To confirm the association between dietary carbohydrate intake and T2D risk observed in this study, further evidence from long-term observational studies of Asian populations is required.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-023-00642-0.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"14 4","pages":"327-338"},"PeriodicalIF":1.3,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10533437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41118272","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}