Nutrition & Diabetes最新文献

Background/objectives: Vitamin D (VD) status has been linked to the development of diabetes. However, this relationship in the context of comorbid conditions remains understudied. Additionally, ethnic disparities in nutritional status and chronic disease prevalence within rural populations are a vastly underrepresented area of research. In our previous study, we explored VD levels and depression in a rural West Texas aging sample. In the present study, we investigated the associations between diabetes, vitamin D (VD) levels, depression, and Hispanic ethnicity (HE) among a sample of aging, rural West Texans from Project FRONTIER (PF; Facing Rural Obstacles to Health Care Now Through Intervention, Education, and Research).

Subjects/methods: A cohort of 299 PF participants (mean age 62.6 ± 11.8 years old, 70.9% female, 40.5% HE) was used. We examined relationships between diabetes diagnosis, blood-based diabetes-related biomarkers, VD level, Geriatric Depression Scale (GDS) score, and HE status. We developed a "VD-sensitive GDS score" composed of the 9 GDS questions that were significantly correlated with VD level in our previous study. We further created a complementary "VD-insensitive GDS score" composed of the remaining 21 GDS questions. Standard correlation and regression analyses were employed.

Results: VD level was significantly negatively associated with diabetes diagnosis, while VD-sensitive depression score was significantly positively associated with diabetes diagnosis. HE was associated with higher HbA1c levels, higher fasting blood glucose levels, and higher VD-sensitive depression scores.

Conclusions: In this rural West Texas cohort, diabetes was significantly associated with low VD levels and high VD-sensitive depression scores. HE was associated with higher levels of diabetes-related biomarkers and higher VD-sensitive depression scores. These disparities are crucial to consider when examining areas for healthcare improvement in West Texas, particularly among aging populations.

Background: Elderly patients with type 2 diabetes (T2DM) experience a significantly raised risk of cardiovascular disease. We aimed to determine the effect of the multi-species synbiotic supplementation in elderly patients with T2DM and high cardiovascular risk.

Methods: Ninety-six patients with T2DM, aged ≥65 years with high cardiovascular risk, were enrolled between January 2022 and May 2023 and randomly allocated to receive a synbiotic supplement, containing a multi-species probiotic, and fructooligosaccharide as a prebiotic, or placebo supplements for 4 months. The primary outcome was the mean difference in weight change between synbiotics and placebo. The secondary outcomes were the mean difference in modifications in the body fat mass (BFM), lean body mass (LBM), and biochemical parameters, including glucose metabolism indices, lipid profile, and adhesion molecules between the two groups due to the intervention.

Results: Eighty-five participants completed the study. The mean weight [-1.16 kg (-1.36 to -0.97)], body mass index (BMI) [-0.44 kg/m² (-0.36 to -0.51)], and BFM [-0.99 kg (-1.05 to -0.93)] decreased significantly in the synbiotic group compared to the placebo group in the linear mixed analysis of covariance analysis (all p < 0.001). The mean serum Low-density-Lipoprotein (LDL-C) [-10.83 mg/dl (-14.78 to -6.88)], and total cholesterol [-11.78 mg/dl (-16.44 to -7.11)], vascular cell adhesion molecule 1 (VCAM-1) [-85.70 ng/L (-150.14 to -21.26)], fasting plasma glucose (FPG) [-22.83 mg/dl (-31.30 to -14.36)], and homeostatic model assessment for insulin resistance (HOMA-IR.) [-1.31 (-1.75 to -0.86)] improved in the synbiotic group significantly compared to the placebo group (p = 0.002, p = 0.012, p = 0.017, p < 0.001, p = 0.003 and p = 0.001, respectively). No serious adverse events were detected.

Conclusion: A multi-species synbiotic preparation benefits elderly patients with T2DM and high cardiovascular risk and improves weight, BMI, BFM, and plasma levels of total cholesterol, LDL-C, VCAM-1, FPG, and HOMA-IR. These findings suggest synbiotics may have health-promoting impacts in older patients with diabetes.

Background: The skin serves as a fundamental protective barrier against environmental insults, with the epidermis, particularly the stratum corneum and tight junctions (TJs) connecting keratinocytes, playing a crucial role. Chronic hyperglycemia can impair these TJs, leading to compromised epidermal barrier function and diabetic skin complications. This study aimed to investigate the effects of umbelliferone on epidermal barrier function under type 2 diabetic conditions.

Methods: HaCaT keratinocytes were cultured under hyperglycemic conditions induced by 33 mM glucose with or without 1-20 μM umbelliferone to evaluate cellular protection and barrier-related protein regulation. Type 2 diabetic db/db mice were administered umbelliferone orally at 10 mg/kg per day for 10 weeks. The expression of epidermal barrier-related proteins in HaCaT cells and skin tissues was quantified by Western blot analysis.

Results: Umbelliferone enhanced multiple components essential for maintaining the skin barrier. It upregulated filaggrin, increased the expression of the TJ proteins ZO-1 and Occludin, and elevated AQP3 and HAS2 levels to support epidermal hydration, while reducing HYAL1 expression. Under impaired wound healing conditions induced by hyperglycemia, umbelliferone promoted cell migration via modulation of F-actin organization, Rho GTPase signaling, and integrin β1 expression. Additionally, it reduced ROS accumulation and alleviated high glucose-induced apoptosis.

Conclusions: Umbelliferone preserves epidermal barrier integrity by strengthening cell-cell junctions, enhancing hydration, promoting cell migration, and providing protection against oxidative stress and apoptosis. These findings suggest the therapeutic potential of umbelliferone in managing and preventing diabetic skin complications.

Background and objective: High fasting plasma glucose (HFPG) is a major risk factor for diseases, posing a serious public health challenge. This study examines the global burden of 13 non-communicable diseases (NCDs) attributed to HFPG.

Methods: We used the 2021 GBD Study to analyze deaths and DALYs linked to HFPG( > 4.90-5.30 mmol/L). Socio-Demographic Index (SDI) was used to assess development levels, with subgroup analyses by geography, year, gender, and SDI.

Results: In 2021, HFPG contributed to 5.15 million deaths and 151.95 million DALYs globally. From 1990 to 2021, the estimated annual percentage change (EAPC) in deaths and DALYs were 0.11 and 0.55, respectively. Diabetes, ischemic heart disease (IHD), and stroke accounted for the most deaths (1.66, 1.35, and 0.84 million). Liver cancer, chronic kidney disease (CKD), and pancreatic cancer showed the fastest mortality increases, with EAPCs of 1.90, 1.69, and 1.34, respectively. IHD and stroke had declining mortality burdens, with EAPCs of -0.13 and -0.98.

Conclusion: Over 30 years, HFPG-related NCDs have increased globally. Diabetes, IHD, and stroke remain the top burdens, while liver cancer, CKD, and pancreatic cancer are rising fastest. The disease burden in men is higher than in women, except for people with Alzheimer's disease and other dementias and people with blindness and vision loss (BVL).

Background: Human adenovirus Ad36-derived protein, termed INSPARIN, up-regulates cellular glucose uptake through insulin-independent cell signaling. Transgenic or viral vector mediated delivery of INSPARIN exhibits significant anti-diabetic potential in mice. To translate these findings for clinical use, this preclinical study determined the short- and long-term effectiveness of nano-liposome-mediated delivery of INSPARIN to improve glucose metabolism in cell and animal models.

Methods: Void or INSPARIN Nanoparticles (NP) composed of soy-phosphatidylcholine were prepared freshly before use. Glucose uptake was measured in 3T3-L1, C2C12, and HepG2 cells following 72 h treatment with void or INSPARIN NP using a [³H]-2-deoxyglucose uptake assay. Male C57BL/6J mice fed a 45% high-fat diet received single or repeated subcutaneous injections of INSPARIN NP, followed by oral glucose tolerance tests, serum insulin, and HbA1c measurements. Biodistribution was assessed by DiD-labeled nanoparticle imaging, and long-term safety was evaluated by histopathology of major organs.

Results: INSPARIN NP upregulated glucose uptake in preadipocytes, hepatocytes, and myoblasts. In mice, INSPARIN NP delivered the drug to the liver when administered intravenously and to inguinal adipose tissue when administered subcutaneously. Single subcutaneous administration of INSPARIN NP promoted faster blood glucose clearance in a dose-dependent manner, but without leading to hypoglycemia. Daily subcutaneous administration of INSPARIN NP for seven weeks significantly reduced HbA1c levels despite continued high fat diet, and without any adverse effects on major organs studied.

Conclusions: These findings support suitability of nano-liposome mediated subcutaneous delivery of INSPARIN in clinical trials for treating diabetes.

GLP-1 and its synthetic analogs have emerged as significant therapeutic agents for the management of metabolic disorders, merging glycemic control with weight loss through innovative structural and delivery breakthroughs. This review provides a meticulous exploration of GLP-1, elucidating its origin, secretion, and the challenges associated with its clinical application due to its fragility in the presence of DPP-IV, resulting in a short half-life. To overcome this limitation, various modifications and delivery strategies to enhance the pharmacokinetic properties and therapeutic efficacy of GLP-1 analogs have been studied. The review delves into the intricacies of different modification approaches, including N and C-terminal modifications, Fatty acid Side chain Modifications, and Large Molecule Conjugation Modifications, highlighting their rationale and resulting improvements in half-life, stability, receptor binding, and bioactivity. Additionally, the importance of optimized delivery strategies to ensure sustained and controlled release of GLP-1 analogs is discussed. The culmination of these scientific advancements provides valuable insights for the development of more effective treatments for metabolic disorders, ultimately paving the way for improved patient outcomes in the realm of metabolic health.

Objective: To determine if a bedtime snack in young children with type 1 diabetes (T1D) prevents nocturnal hypoglycemia, and the impact on glycemia overnight.

Methods: In this randomized controlled crossover trial, 10 grams of carbohydrate (milk, yoghurt, and kefir) was given 150-180 minutes after dinner over three nights to 5-8-year-old children with T1D using multiple daily injection therapy. Continuous glucose monitoring (CGM) data were collected for 6 hours following the snacks on one control and three snack nights. Time in 70-180 mg/dL (3.9-10 mmol/L) range (TIR), time below 70 mg/dL (3.9 mmol/L) (TBR), and other metrics were analyzed according to international CGM consensus. Trial day was terminated if blood glucose exceeded 300 mg/dL (16.7 mmol/L) or fell below 70 mg/dL (3.9 mmol/L).

Results: Of 28 children (13 female, mean age 6.6 ± 0.8 years, HbA1c 7.0 ± 0.5% (53 mmol/mol)), mean glucose values before the test snacks were 137.8 ± 14.5 mg/dL (7.7 ± 0.8 mmol/L) for milk, 141.9 ± 16.9 mg/dL (7.9 ± 0.9 mmol/L) for yoghurt, 136 ± 19.1 mg/dL (7.6 ± 1.1 mmol/L) for kefir, and 140.8 ± 17.0 mg/dL (7.8 ± 0.9 mmol/L) for control without significant difference (p = 0.548). TIR was 34.7% for milk, 38.7%. for yoghurt, 45.9% for kefir, and 75.5% for control during the 6-hour post snack period, with TIR on the control day significantly higher than the three snack days (p < 0.001). TBR did not differ by group (p > 0.05). Of 112 trial days, 13 days were terminated due to hyperglycemia (>300 mg/dL) (16.7 mmol/L) (8 milk, 4 yoghurt, 1 kefir), and 3 trial days due to hypoglycemia (<70 mg/dL) (3.9 mmol/L) (1 yoghurt, 2 control).

Conclusion: Bedtime snacking in young children with T1D impairs nocturnal glycemia and reduces TIR, without decreasing the frequency of hypoglycemia.

Cardiovascular diseases and diabetes are associated with significant mortality, morbidity, and economic burden, highlighting the need for alternative preventive strategies. Honey bee products, including honey, royal jelly, and propolis, are considered potential interventions for managing cardiometabolic risk factors. This umbrella review aimed to compare the effectiveness of these products in cardiometabolic health. PubMed, Scopus, and Web of Science databases were systematically searched from inception through 21^ST October 2024 to identify eligible meta-analyses and primary randomized controlled trials (RCTs). Random-effect pairwise analysis combined trial findings, while dose-response and influence analyses assessed result robustness. Evidence quality and certainty were evaluated using AMSTAR-II, ROB, GRADE, and ICEMAN criteria. Analysis of 69 RCTs with 3544 participants revealed that 10 g of honey daily may lower Hemoglobin A1C but adversely affect systolic blood pressure, Aspartate transferase, triglycerides, fasting blood glucose, and high-sensitive C-reactive protein. Royal jelly improved blood pressure, lipid profiles, glycemic indices, and total antioxidant capacity. Propolis demonstrated reductions in anthropometric measures and improvements in lipid profile, glycemic control, liver enzymes, and inflammation and oxidative stress markers. While long-term or high-dose honey consumption in individuals with health concerns warrants caution, RJ and propolis demonstrated dose-dependent benefits for cardiometabolic health with proper certainty. Future research should focus on population-specific characteristics and optimized dosages.

Background: Body mass index (BMI) is strongly associated with the development of type 2 diabetes. However, the association between long-term time in target range (TTR) for BMI and the incidence of new-onset diabetes remains unclear.

Methods and results: This study utilized a non-diabetic population aged 45 years or older from the China Health and Retirement Longitudinal Study (CHARLS). BMI-TTR was assessed in Waves 1, 2, and 3 over a 5-year period, with the target range defined as 18.5 kg/m² ≤ BMI < 23 kg/m². New-onset diabetes in Waves 2, 3, and 4 over a 6-year follow-up served as the study endpoint. After applying exclusion criteria, 6662 participants (3143 men and 3519 women; mean age 58.93 ± 8.85 years) were enrolled. Participants were categorized into four groups (TTR1-TTR4) based on the number of times BMI was within the target range (0-3 times). The risk of new-onset diabetes decreased progressively with increasing BMI-TTR during follow-up. Compared with the TTR1 group, participants in the TTR4 group exhibited a significantly lower risk of diabetes (adjusted HR: 0.577, 95% CI: 0.463-0.720, P < 0.001), even after adjusting for baseline BMI (adjusted HR: 0.685, 95% CI: 0.537-0.872, P = 0.002). This effect was even more pronounced in female subgroup and in individuals aged under 60 years of age.

Conclusion: In adults aged 45 years or older, regardless of baseline BMI, maintaining BMI within the target range over time was associated with a reduced risk of new-onset diabetes, particularly among women and individuals under 60 years of age. These findings highlight the importance of long-term weight management in diabetes prevention.

Background: Prediabetes is becoming increasingly widespread and often progresses to diabetes, thereby raising the risk of severe complications. High-protein diets, known to improve glucose control and prevent diabetes, can utilize rich-protein oral nutritional supplements. The study aims to evaluate the effectiveness of a diabetes-specific nutritional formula-pro (DSNF-Pro) with high-protein content and evaluate its clinical utility.

Methods: An open-label, cross-over clinical trial was conducted to compare the effects of DSNF-Pro versus Standard nutritional formula (STNF) on postprandial glycemic control. Fifteen subjects with prediabetes were enrolled and consumed DSNF-Pro on the first visit and STNF on the second. Postprandial plasma glucose, serum insulin, and serum c-peptide incremental area under the curve (iAUC), as well as the maximum concentration (C_max) and incremental maximal concentration (iC_max), were measured following the study. Statistical comparisons between DSNF-Pro and STNF were performed using Wilcoxon's signed-rank test.

Results: DSNF-Pro significantly reduced postprandial glucose iAUC by 73.4% (p = 0.0001) and postprandial c-peptide iAUC by 36.4% (p = 0.0001) compared to STNF. However, there was no significant difference in postprandial insulin iAUC between DSNF-Pro and STNF.

Conclusions: These results demonstrated that DSNF-Pro effectively improved postprandial glucose responses in prediabetes, providing a practical alternative for managing glycemic control without increasing insulin secretion.