Pub Date : 2018-05-31DOI: 10.2174/1876524601808010001
H. Kluess, Leslie E Neidert
Whey protein may have an effect directly on the muscle to affect exercise glucose response.The study aimed to measure post-exercise glucose recovery with supplementation and the role of DPP-IV and IL-6.Twenty-four participants were randomly assigned to one of three supplementation conditions (CTL: water, WPI: 31g whey protein isolate, and CHO: 32g fructose beverage; WPI and CHO beverages were isocaloric). During the Baseline Visit, participants performed an Oral Glucose Tolerance Test (OGTT) with no exercise or supplementation. On their second and third visits, participants consumed their assigned beverage then completed a maximal treadmill protocol until volitional fatigue. An OGTT was completed on the second visit, and blood samples were collectedviavenipuncture on the third visit for IL-6, Insulin and DPP-IV.Glucose delta peak was attenuated in WPI+exercise by -45±25% and CHO+exercise by -49±21%, compared to baseline (p<0.05). Glucose area under the curve was only attenuated with WPI+exercise (5,993±1,013mg/dl*min), compared to baseline (10,604±4,589mg/dl*min; p<0.05). Insulin was elevated in the WPI+exercise (111±57pmol/L) and CHO+exercise (119±70pmol/L), compared to rest (WPI: 61±40pmol/L; CHO: 78±56pmol/L; p<0.05). IL-6 and DPP-IV activated T-cells (CD26+) were not different among groups. However, plasma DPP-IV was higher in WPI (8±6U/L) compared to CTL (0.7±2U/L) and CHO (0.6±4U/L; p<0.05).We found that a single dose of whey protein given prior to exercise results in elevated DPP-IV activity in the plasma and improved glucose response. Together these data suggest that whey protein as a supplement to exercise may be beneficial for humans trying to manage their blood sugar.
{"title":"Post-exercise Glucose Response Following Whey Protein Ingestion in Healthy Young People: A Randomized Pilot Study","authors":"H. Kluess, Leslie E Neidert","doi":"10.2174/1876524601808010001","DOIUrl":"https://doi.org/10.2174/1876524601808010001","url":null,"abstract":"Whey protein may have an effect directly on the muscle to affect exercise glucose response.The study aimed to measure post-exercise glucose recovery with supplementation and the role of DPP-IV and IL-6.Twenty-four participants were randomly assigned to one of three supplementation conditions (CTL: water, WPI: 31g whey protein isolate, and CHO: 32g fructose beverage; WPI and CHO beverages were isocaloric). During the Baseline Visit, participants performed an Oral Glucose Tolerance Test (OGTT) with no exercise or supplementation. On their second and third visits, participants consumed their assigned beverage then completed a maximal treadmill protocol until volitional fatigue. An OGTT was completed on the second visit, and blood samples were collectedviavenipuncture on the third visit for IL-6, Insulin and DPP-IV.Glucose delta peak was attenuated in WPI+exercise by -45±25% and CHO+exercise by -49±21%, compared to baseline (p<0.05). Glucose area under the curve was only attenuated with WPI+exercise (5,993±1,013mg/dl*min), compared to baseline (10,604±4,589mg/dl*min; p<0.05). Insulin was elevated in the WPI+exercise (111±57pmol/L) and CHO+exercise (119±70pmol/L), compared to rest (WPI: 61±40pmol/L; CHO: 78±56pmol/L; p<0.05). IL-6 and DPP-IV activated T-cells (CD26+) were not different among groups. However, plasma DPP-IV was higher in WPI (8±6U/L) compared to CTL (0.7±2U/L) and CHO (0.6±4U/L; p<0.05).We found that a single dose of whey protein given prior to exercise results in elevated DPP-IV activity in the plasma and improved glucose response. Together these data suggest that whey protein as a supplement to exercise may be beneficial for humans trying to manage their blood sugar.","PeriodicalId":22762,"journal":{"name":"The Open Diabetes Journal","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85819604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-03-07DOI: 10.2174/1876524601407010005
R. Das
Diabetes mellitus is a very common and serious disease in many American Indian tribes, Indians, and many other populations in the world. Several well-known risk factors such as parental diabetes, genetic markers, obesity, diet are considered as the main risk factors for diabetes mellitus, while the precise nature of the gene or genes remains unknown. Objectives: The Pimas, Indians, and many other population in the world now suffer from the high prevalence rates of diabetes. Epidemiological research often seeks to identify a causal relationship between the risk factors and the disease. In the present article, two data sets from two different study groups (one for the Pima Indian mothers (768 subjects) and the other for the Indian medical students (64 subjects) are analyzed to determine the causal factors of diabetes mellitus. This article aims to identify the determinants of diabetes mellitus in the Pima Indian mothers and Indian young medical students. Results: The causal factors for diabetes mellitus of the Pima Indian mothers and young Indian medical students are identified. Statistical significant causal factors, namely, triceps skin fold thickness (P-value < 0.01), serum insulin (P- value < 0.01), body mass index (or obesity) (P-value < 0.01), diabetes pedigree function (P-value = 0.06), age (P-value < 0.01) are identified as the determinants of diabetes mellitus in the Pima Indian mothers. In the young Indian medical students, age (P-value = 0.04), body mass index (P-value < 0.01), family history of diabetes mellitus (P-value < 0.01), sex (P-value < 0.01), low density lipoprotein (P-value = 0.01), total cholesterol (P-value = 0.11), serum triglyceride (P-value < 0.01), family blood pressure (P-value < 0.01), dietary habits like eating outside (P-value < 0.01) are identified as the determinants of diabetes mellitus. The effects of different causal factors on diabetes mellitus are explained based on probabilistic models. Conclusions: Impacts of biochemical parameters, personal characteristics, family history, and dietary factors on human plasma glucose concentration are explained based on mathematical relationships. The results of the present analyses support many earlier research findings. However, these analyses also identify many additional casual factors that explain the mean and the variance of plasma glucose concentration, which earlier researches have not reported.
{"title":"Determinants of Diabetes Mellitus in the Pima Indian Mothers and Indian Medical Students","authors":"R. Das","doi":"10.2174/1876524601407010005","DOIUrl":"https://doi.org/10.2174/1876524601407010005","url":null,"abstract":"Diabetes mellitus is a very common and serious disease in many American Indian tribes, Indians, and many other populations in the world. Several well-known risk factors such as parental diabetes, genetic markers, obesity, diet are considered as the main risk factors for diabetes mellitus, while the precise nature of the gene or genes remains unknown. Objectives: The Pimas, Indians, and many other population in the world now suffer from the high prevalence rates of diabetes. Epidemiological research often seeks to identify a causal relationship between the risk factors and the disease. In the present article, two data sets from two different study groups (one for the Pima Indian mothers (768 subjects) and the other for the Indian medical students (64 subjects) are analyzed to determine the causal factors of diabetes mellitus. This article aims to identify the determinants of diabetes mellitus in the Pima Indian mothers and Indian young medical students. Results: The causal factors for diabetes mellitus of the Pima Indian mothers and young Indian medical students are identified. Statistical significant causal factors, namely, triceps skin fold thickness (P-value < 0.01), serum insulin (P- value < 0.01), body mass index (or obesity) (P-value < 0.01), diabetes pedigree function (P-value = 0.06), age (P-value < 0.01) are identified as the determinants of diabetes mellitus in the Pima Indian mothers. In the young Indian medical students, age (P-value = 0.04), body mass index (P-value < 0.01), family history of diabetes mellitus (P-value < 0.01), sex (P-value < 0.01), low density lipoprotein (P-value = 0.01), total cholesterol (P-value = 0.11), serum triglyceride (P-value < 0.01), family blood pressure (P-value < 0.01), dietary habits like eating outside (P-value < 0.01) are identified as the determinants of diabetes mellitus. The effects of different causal factors on diabetes mellitus are explained based on probabilistic models. Conclusions: Impacts of biochemical parameters, personal characteristics, family history, and dietary factors on human plasma glucose concentration are explained based on mathematical relationships. The results of the present analyses support many earlier research findings. However, these analyses also identify many additional casual factors that explain the mean and the variance of plasma glucose concentration, which earlier researches have not reported.","PeriodicalId":22762,"journal":{"name":"The Open Diabetes Journal","volume":"15 1","pages":"5-13"},"PeriodicalIF":0.0,"publicationDate":"2014-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88071116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-02-07DOI: 10.2174/1876524601407010001
H. El-busaidy, Mariam Dawood, Ahmed Kasay, Changambi Mwamlole, Nahida Koraya, Hafsa Parpia
Over 50% of all adult hospital admissions and 55% of hospital deaths in Kenya are non-communicable, of which diabetes is among the leading. We aimed to describe the impact of type II diabetes at a rural community in Kenya. 200 healthy adult patients underwent random blood sucrose (RBS) testing after ethical approval by the Isiolo County Hospital. Diabetes was defined as RBS ≥11.1 mmol/l. A thorough history, physical examination and dipstick urinalysis for urine protein was done to identify risk factors and/or evidence of end organ damage. 32 patients (16%) had RBS ≥11.1 mmol/l. 12 patients (37.5%) never knew they were diabetic and those who knew 63% were not taking any medication. The most common risk factors were high fat diet (59.4%), sedentary lifestyle (46.8%) and family history of diabetes in first degree relative (37.5%). 43.7% of patients (n=14) had abdominal obesity while 21.9% (n=7) had various foot abnormalities. 8 patients (25%) had proteinuria of ≥ +1 on dipstick urinalysis. The 16% diabetes prevalence is among the highest recorded for a community living on ≤ 1 dollar/day. Further, evidence of end organ damage as depicted by massive proteinuria warrants urgent attention to this underprivileged group. It is hoped the results will form basis for future screening of diabetic nephropathy and other diabetes-related end organs involvement in this part of the world.
{"title":"How Serious is the Impact of Type II Diabetes in Rural Kenya","authors":"H. El-busaidy, Mariam Dawood, Ahmed Kasay, Changambi Mwamlole, Nahida Koraya, Hafsa Parpia","doi":"10.2174/1876524601407010001","DOIUrl":"https://doi.org/10.2174/1876524601407010001","url":null,"abstract":"Over 50% of all adult hospital admissions and 55% of hospital deaths in Kenya are non-communicable, of which diabetes is among the leading. We aimed to describe the impact of type II diabetes at a rural community in Kenya. 200 healthy adult patients underwent random blood sucrose (RBS) testing after ethical approval by the Isiolo County Hospital. Diabetes was defined as RBS ≥11.1 mmol/l. A thorough history, physical examination and dipstick urinalysis for urine protein was done to identify risk factors and/or evidence of end organ damage. 32 patients (16%) had RBS ≥11.1 mmol/l. 12 patients (37.5%) never knew they were diabetic and those who knew 63% were not taking any medication. The most common risk factors were high fat diet (59.4%), sedentary lifestyle (46.8%) and family history of diabetes in first degree relative (37.5%). 43.7% of patients (n=14) had abdominal obesity while 21.9% (n=7) had various foot abnormalities. 8 patients (25%) had proteinuria of ≥ +1 on dipstick urinalysis. The 16% diabetes prevalence is among the highest recorded for a community living on ≤ 1 dollar/day. Further, evidence of end organ damage as depicted by massive proteinuria warrants urgent attention to this underprivileged group. It is hoped the results will form basis for future screening of diabetic nephropathy and other diabetes-related end organs involvement in this part of the world.","PeriodicalId":22762,"journal":{"name":"The Open Diabetes Journal","volume":"110 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2014-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88060685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-10-18DOI: 10.2174/1876524620130905001
A. Marcus
Many patients are not optimally controlled on conventional insulin regimens. This review evaluates the practicalities and clinical success of continuous subcutaneous insulin infusion therapy with rapid-acting insulin analogs in insulin pumps in patients with type 1 and type 2 diabetes. In contrast to a multiple daily injection regimen, CSII provides patients with greater flexibility in the timing of meals and insulin dosing, resulting in improved quality of life and greater treatment adherence. CSII therapy with rapid-acting insulin analogs offers reliable glycemic control and proactive response to glucose variability, with a reduced risk of weight gain and hypoglycemia compared with regular human insulin in CSII. While the clinical benefits of CSII versus multiple daily injection therapy in patients with type 1 diabetes are quite evident in studies in appropriately-selected patients, the benefits are more equal in patients with type 2 diabetes. Appropriate patient selection for CSII therapy may help ensure successful outcomes in diabetes treatment. Patients who are very poorly controlled on multiple daily injections may benefit from CSII therapy, with the greatest glycemic improvement associated with high baseline HbA1c levels. CSII therapy may be of particular benefit to patients with type 1 diabetes who are prone to hypoglycemia and patients with type 2 diabetes who are obese and uncontrolled on high doses of insulin; however, most important as a predictor of success is that patients desire CSII therapy.
{"title":"Continuous Subcutaneous Insulin Infusion Therapy with Rapid-ActingInsulin Analogs in Insulin Pumps: Does it Work, How Does it Work, andwhat Therapies Work Better than Others?","authors":"A. Marcus","doi":"10.2174/1876524620130905001","DOIUrl":"https://doi.org/10.2174/1876524620130905001","url":null,"abstract":"Many patients are not optimally controlled on conventional insulin regimens. This review evaluates the practicalities and clinical success of continuous subcutaneous insulin infusion therapy with rapid-acting insulin analogs in insulin pumps in patients with type 1 and type 2 diabetes. In contrast to a multiple daily injection regimen, CSII provides patients with greater flexibility in the timing of meals and insulin dosing, resulting in improved quality of life and greater treatment adherence. CSII therapy with rapid-acting insulin analogs offers reliable glycemic control and proactive response to glucose variability, with a reduced risk of weight gain and hypoglycemia compared with regular human insulin in CSII. While the clinical benefits of CSII versus multiple daily injection therapy in patients with type 1 diabetes are quite evident in studies in appropriately-selected patients, the benefits are more equal in patients with type 2 diabetes. Appropriate patient selection for CSII therapy may help ensure successful outcomes in diabetes treatment. Patients who are very poorly controlled on multiple daily injections may benefit from CSII therapy, with the greatest glycemic improvement associated with high baseline HbA1c levels. CSII therapy may be of particular benefit to patients with type 1 diabetes who are prone to hypoglycemia and patients with type 2 diabetes who are obese and uncontrolled on high doses of insulin; however, most important as a predictor of success is that patients desire CSII therapy.","PeriodicalId":22762,"journal":{"name":"The Open Diabetes Journal","volume":"12 1","pages":"8-19"},"PeriodicalIF":0.0,"publicationDate":"2013-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84553365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-04-05DOI: 10.2174/1876524601306010001
D. Sherifali, D. Fitzpatrick-Lewis, L. Peirson, D. Ciliska, D. Coyle
Background: This review was conducted to determine the clinical benefit and potential harms of screening for type 2 diabetes mellitus (T2DM) in asymptomatic adults. Methods: The search strategy from the 2008 US Preventive Services Task Force's framework on type 2 diabetes screening was updated. MEDLINE ® and the Cochrane Database of Systematic Reviews were searched from 2007 to 2012 for systematic reviews, randomized controlled trials and modeling studies. Study quality was assessed using the GRADE System and a standardized review process. Results: Previous results showing benefit of screening among those with high blood pressure were confirmed. No new or old trials were found regarding the effect of screening for T2DM on mortality, cardiovascular mortality and diabetes related complication outcomes. An observational study demonstrated a modest benefit in mortality in an initial cohort invited for T2DM screening (1990-1992), (HR 0.79; 95% CI 0.63, 1.00), but was not replicated in the second cohort invited for screening (2000-2003). Modeling studies reported that population based screening in high-risk individuals (age and hypertension as risk factors) might increase quality adjusted life years and was cost-effective if screening began at age 45 and every three to five years thereafter. Two new randomized controlled trials noted that screening was associated with higher levels of short-term anxiety and worry, but had limited overall psychological impact. Interpretation: This review found no controlled studies of the effectiveness of screening for T2DM, and one observational study demonstrating a modest benefit on mortality. Evidence for the harms associated with screening showed minimal clinical significance. Differences between current and previous evidence can be attributed to the current methodology that integrates the GRADE approach. Recommendations for screening reflect the best available evidence and include screening individuals at high risk for T2DM every 3-5 years with an A1C test, and individuals at very high risk annually with an A1C test.
背景:本综述旨在确定无症状成人2型糖尿病(T2DM)筛查的临床获益和潜在危害。方法:更新了2008年美国预防服务工作组关于2型糖尿病筛查框架的搜索策略。检索MEDLINE®和Cochrane系统评价数据库2007 - 2012年的系统评价、随机对照试验和模型研究。使用GRADE系统和标准化的审查过程评估研究质量。结果:先前的研究结果证实了筛查对高血压患者的益处。没有新的或旧的试验发现筛查T2DM对死亡率、心血管死亡率和糖尿病相关并发症结局的影响。一项观察性研究表明，邀请进行2型糖尿病筛查的初始队列(1990-1992)在死亡率方面有一定的益处(HR 0.79;95% CI 0.63, 1.00)，但在受邀进行筛查的第二队列(2000-2003)中没有得到重复。模型研究报告，在高危人群中进行基于人群的筛查(年龄和高血压为危险因素)可能会增加质量调整生命年，如果筛查从45岁开始，此后每3至5年进行一次，则具有成本效益。两项新的随机对照试验指出，筛查与更高水平的短期焦虑和担忧有关，但对整体心理影响有限。解释:本综述未发现T2DM筛查有效性的对照研究，一项观察性研究显示对死亡率有一定的益处。与筛查相关的危害证据显示临床意义很小。当前和以前的证据之间的差异可归因于当前整合了GRADE方法的方法。筛查建议反映了现有的最佳证据，包括对T2DM高危人群每3-5年进行一次糖化血红蛋白检测，对高危人群每年进行一次糖化血红蛋白检测。
{"title":"Screening for Type 2 Diabetes in Adults: An Updated Systematic Review","authors":"D. Sherifali, D. Fitzpatrick-Lewis, L. Peirson, D. Ciliska, D. Coyle","doi":"10.2174/1876524601306010001","DOIUrl":"https://doi.org/10.2174/1876524601306010001","url":null,"abstract":"Background: This review was conducted to determine the clinical benefit and potential harms of screening for type 2 diabetes mellitus (T2DM) in asymptomatic adults. Methods: The search strategy from the 2008 US Preventive Services Task Force's framework on type 2 diabetes screening was updated. MEDLINE ® and the Cochrane Database of Systematic Reviews were searched from 2007 to 2012 for systematic reviews, randomized controlled trials and modeling studies. Study quality was assessed using the GRADE System and a standardized review process. Results: Previous results showing benefit of screening among those with high blood pressure were confirmed. No new or old trials were found regarding the effect of screening for T2DM on mortality, cardiovascular mortality and diabetes related complication outcomes. An observational study demonstrated a modest benefit in mortality in an initial cohort invited for T2DM screening (1990-1992), (HR 0.79; 95% CI 0.63, 1.00), but was not replicated in the second cohort invited for screening (2000-2003). Modeling studies reported that population based screening in high-risk individuals (age and hypertension as risk factors) might increase quality adjusted life years and was cost-effective if screening began at age 45 and every three to five years thereafter. Two new randomized controlled trials noted that screening was associated with higher levels of short-term anxiety and worry, but had limited overall psychological impact. Interpretation: This review found no controlled studies of the effectiveness of screening for T2DM, and one observational study demonstrating a modest benefit on mortality. Evidence for the harms associated with screening showed minimal clinical significance. Differences between current and previous evidence can be attributed to the current methodology that integrates the GRADE approach. Recommendations for screening reflect the best available evidence and include screening individuals at high risk for T2DM every 3-5 years with an A1C test, and individuals at very high risk annually with an A1C test.","PeriodicalId":22762,"journal":{"name":"The Open Diabetes Journal","volume":"10 1","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2013-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79160375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-11-26DOI: 10.2174/1876524601205010029
S. Shrestha, K. Kirtland, T. Thompson, L. Barker, E. Gregg, L. Geiss
Introduction: We examined whether spatial clusters of county-level diagnosed diabetes prevalence exist in the United States and whether socioeconomic and diabetes risk factors were associated with these clusters. Materials and Methods: We used estimated county-level age-adjusted data on diagnosed diabetes prevalence for adults in 3109 counties in the United States (2007 data). We identified four types of diabetes clusters based on spatial autocorrelations: high-prevalence counties with high-prevalence neighbors (High-High), low-prevalence counties with low-prevalence neighbors (Low-Low), low-prevalence counties with high-prevalence neighbors (Low-High), and high- prevalence counties with low-prevalence neighbors (High-Low). We then estimated relative risks for clusters being associated with several socioeconomic and diabetesrisk factors. Results: Diabetes prevalence in 1551 counties was spatially associated (p<0.05) with prevalence in neighboring counties. The rate of obesity, physical inactivity, poverty, and the proportion of non-Hispanic blacks were associated with a county being in a High-High cluster versus being a non-cluster county (7% to 36% greater risk) or in a Low-Low cluster (13% to 67% greater risk). The percentage of non-Hispanic blacks was associated with a 7% greater risk for being in a Low-High cluster. The rate of physical inactivity and the percentage of Hispanics or non-Hispanic American Indians were associated with being in a High-Low cluster (5% to 21% greater risk). Discussion: Distinct spatial clusters of diabetes prevalence exist in the United States. Strong association between diabetes clusters and socioeconomic and other diabetes risk factors suggests that interventions might be tailored according to the prevalence of modifiable factors in specific counties.
{"title":"Spatial Clusters of County-Level Diagnosed Diabetes and Associated RiskFactors in the United States","authors":"S. Shrestha, K. Kirtland, T. Thompson, L. Barker, E. Gregg, L. Geiss","doi":"10.2174/1876524601205010029","DOIUrl":"https://doi.org/10.2174/1876524601205010029","url":null,"abstract":"Introduction: We examined whether spatial clusters of county-level diagnosed diabetes prevalence exist in the United States and whether socioeconomic and diabetes risk factors were associated with these clusters. Materials and Methods: We used estimated county-level age-adjusted data on diagnosed diabetes prevalence for adults in 3109 counties in the United States (2007 data). We identified four types of diabetes clusters based on spatial autocorrelations: high-prevalence counties with high-prevalence neighbors (High-High), low-prevalence counties with low-prevalence neighbors (Low-Low), low-prevalence counties with high-prevalence neighbors (Low-High), and high- prevalence counties with low-prevalence neighbors (High-Low). We then estimated relative risks for clusters being associated with several socioeconomic and diabetesrisk factors. Results: Diabetes prevalence in 1551 counties was spatially associated (p<0.05) with prevalence in neighboring counties. The rate of obesity, physical inactivity, poverty, and the proportion of non-Hispanic blacks were associated with a county being in a High-High cluster versus being a non-cluster county (7% to 36% greater risk) or in a Low-Low cluster (13% to 67% greater risk). The percentage of non-Hispanic blacks was associated with a 7% greater risk for being in a Low-High cluster. The rate of physical inactivity and the percentage of Hispanics or non-Hispanic American Indians were associated with being in a High-Low cluster (5% to 21% greater risk). Discussion: Distinct spatial clusters of diabetes prevalence exist in the United States. Strong association between diabetes clusters and socioeconomic and other diabetes risk factors suggests that interventions might be tailored according to the prevalence of modifiable factors in specific counties.","PeriodicalId":22762,"journal":{"name":"The Open Diabetes Journal","volume":"47 1","pages":"29-37"},"PeriodicalIF":0.0,"publicationDate":"2012-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80167439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-07-09DOI: 10.2174/1876524601205010020
M. Hydrie, A. Basit, Prof. Dr. Asher. Fawwad, M. Ahmedani, A. Shera, A. Hussain
Background: Insulin Resistance has been identified as an independent risk factor for a number of chronic diseases such as diabetes and cardiovascular diseases. Thus identifying insulin resistant cases would help to better prevent the progression of these diseases in such individuals. Objective: To identify a simple indirect method for detecting insulin resistance in our population by using fasting blood samples. Methods: Geographical Imaging Systems was used for randomly selecting the subjects during an epidemiological survey done. For visiting the 532 households selected by geographical imaging systems, nine field teams were developed. A total of 871 subjects older than 25 years were approached by these teams out of which 867 agreed to participate in the survey. Insulin resistance was assessed in 227 normal subjects by fasting insulin, Homeostasis model assessment for insulin resistance (HOMA-IR), Quantitative insulin-sensitivity check index (QUICKI) and McAuley Index. Results: Insulin Resistance was defined at 75 th percentile cut off of insulin levels (9.25 U/mL) and at 75 th percentile of HOMA-IR (1.82). The 25 th percentile cut off was used for defining insulin resistance in QUICKI (0.347) and McAuley Index (6.77). Conclusion: A common approach towards managing subjects with metabolic risk factors will help identify insulin resistance earlier by this fasting method and using insulin resistance reference values identified from simple indirect methods would be of value in such cases. However larger population based studies are needed to further define and validate these cutoff values for insulin resistance to be used for the general population.
{"title":"Detecting Insulin Resistance in Pakistani Subjects by Fasting Blood Samples","authors":"M. Hydrie, A. Basit, Prof. Dr. Asher. Fawwad, M. Ahmedani, A. Shera, A. Hussain","doi":"10.2174/1876524601205010020","DOIUrl":"https://doi.org/10.2174/1876524601205010020","url":null,"abstract":"Background: Insulin Resistance has been identified as an independent risk factor for a number of chronic diseases such as diabetes and cardiovascular diseases. Thus identifying insulin resistant cases would help to better prevent the progression of these diseases in such individuals. Objective: To identify a simple indirect method for detecting insulin resistance in our population by using fasting blood samples. Methods: Geographical Imaging Systems was used for randomly selecting the subjects during an epidemiological survey done. For visiting the 532 households selected by geographical imaging systems, nine field teams were developed. A total of 871 subjects older than 25 years were approached by these teams out of which 867 agreed to participate in the survey. Insulin resistance was assessed in 227 normal subjects by fasting insulin, Homeostasis model assessment for insulin resistance (HOMA-IR), Quantitative insulin-sensitivity check index (QUICKI) and McAuley Index. Results: Insulin Resistance was defined at 75 th percentile cut off of insulin levels (9.25 U/mL) and at 75 th percentile of HOMA-IR (1.82). The 25 th percentile cut off was used for defining insulin resistance in QUICKI (0.347) and McAuley Index (6.77). Conclusion: A common approach towards managing subjects with metabolic risk factors will help identify insulin resistance earlier by this fasting method and using insulin resistance reference values identified from simple indirect methods would be of value in such cases. However larger population based studies are needed to further define and validate these cutoff values for insulin resistance to be used for the general population.","PeriodicalId":22762,"journal":{"name":"The Open Diabetes Journal","volume":"29 1","pages":"20-24"},"PeriodicalIF":0.0,"publicationDate":"2012-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81005127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-04-25DOI: 10.2174/1876524601205010013
P. Wändell, B. Gigante, A. Andreasson, A. Carlsson
We aimed to analyze associations between adiponectin, ghrelin and leptin with anthropometric and metabolic markers in men and women with Metformin-treated type 2 diabetes (n=53), recruited from a trial of relaxation therapies. Anthropometrical measures and fasting blood samples were assessed on three occasions: at baseline, and after 10 and 24 weeks: BMI, waist, HbA1c, insulin, glucose, adiponectin, leptin, fasting ghrelin, high sensitivity C-reactive protein (CRP), tumor necrosis factor � (TNF- � ) and interleukin 6 (IL-6). HOMA2ir and HOMA2s were calculated from fasting glucose and insulin, and adiponectin/leptin and adiponectin/HOMA2ir ratios were calculated. In men, higher leptin and lower adiponectin/leptin ratio correlated with insulin and insulin resistance, and in women lower ghrelin with insulin and insulin resistance. In multivariate linear regression, higher levels of leptin were associated with insulin resistance among men, but not among women. Among women, insulin resistance was associated with lower adiponectin/leptin ratio and ghrelin. Factor analysis showed that leptin in women was closely related to anthropometric variables, but in men both related to anthropometric and inflammatory variables. Gender differences could indicate different pathophysiologic mechanisms of insulin resistance and type 2 diabetes among men and women, where leptin possibly could be a better marker among men, and ghrelin among women.
{"title":"Gender Differences Regarding Novel Biomarkers and Metabolic Risk Factors in Metformin Treated Type 2 Diabetic Patients","authors":"P. Wändell, B. Gigante, A. Andreasson, A. Carlsson","doi":"10.2174/1876524601205010013","DOIUrl":"https://doi.org/10.2174/1876524601205010013","url":null,"abstract":"We aimed to analyze associations between adiponectin, ghrelin and leptin with anthropometric and metabolic markers in men and women with Metformin-treated type 2 diabetes (n=53), recruited from a trial of relaxation therapies. Anthropometrical measures and fasting blood samples were assessed on three occasions: at baseline, and after 10 and 24 weeks: BMI, waist, HbA1c, insulin, glucose, adiponectin, leptin, fasting ghrelin, high sensitivity C-reactive protein (CRP), tumor necrosis factor � (TNF- � ) and interleukin 6 (IL-6). HOMA2ir and HOMA2s were calculated from fasting glucose and insulin, and adiponectin/leptin and adiponectin/HOMA2ir ratios were calculated. In men, higher leptin and lower adiponectin/leptin ratio correlated with insulin and insulin resistance, and in women lower ghrelin with insulin and insulin resistance. In multivariate linear regression, higher levels of leptin were associated with insulin resistance among men, but not among women. Among women, insulin resistance was associated with lower adiponectin/leptin ratio and ghrelin. Factor analysis showed that leptin in women was closely related to anthropometric variables, but in men both related to anthropometric and inflammatory variables. Gender differences could indicate different pathophysiologic mechanisms of insulin resistance and type 2 diabetes among men and women, where leptin possibly could be a better marker among men, and ghrelin among women.","PeriodicalId":22762,"journal":{"name":"The Open Diabetes Journal","volume":"10 1","pages":"13-19"},"PeriodicalIF":0.0,"publicationDate":"2012-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80199480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-02-17DOI: 10.2174/1876524601205010008
O. Akinola, M. Gabriel, Abdul-Azeez Suleiman, Felix Olorunsogbon
Neurobehavioural and cognitive impairments are reportedly associated with both types of diabetes mellitus; and the structural and molecular aberrations in support of these are emerging. In the present study, we report the effects of induced diabetes and its treatment with or without oral hypoglycaemic drugs on the morphology and oxidative stress status of the prefrontal cortex. Hyperglycaemia was induced in fasted Wistar rats with alloxan (150 mg/kg body weight). Hyperglycaemic rats were treated with or without oral hypoglycaemic drugs (metformin, 150 mg/kg/d; pioglitazone, 3 mg/kg/d; and rosiglitazone, 10 mg/kg/d). At 28 days of treatment, prefrontal morphology was studied by the cresyl fast violet (CFV) and luxol fast blue (LFB) techniques; and malondialdehyde (MDA) and superoxide dismutase (SOD) were assayed in prefrontal homogenate. Blood glucose was estimated by the glucose oxidase method. Prefrontal cortex neurons showed weak affinity for CFV and LFB in the untreated diabetic rats; as opposed to the relatively strong affinity for these stains in the non-diabetic control rats and diabetic rats on oral hypoglycaemic interventions. In the latter, blood glucose was not significantly different (P>0.05) from the control at 28 days of treatment. Moreover, prefrontal MDA and SOD were not significantly different between all the groups (P>0.05). These findings suggest that morphologic aberrations are provoked by untreated diabetes mellitus, even in the absence of oxidative stress; and that oral hypoglycaemic interventions are neuroprotective in alloxan-induced diabetic rats.
{"title":"Treatment of Alloxan-Induced Diabetic Rats with Metformin orGlitazones is Associated with Amelioration of Hyperglycaemia andNeuroprotection","authors":"O. Akinola, M. Gabriel, Abdul-Azeez Suleiman, Felix Olorunsogbon","doi":"10.2174/1876524601205010008","DOIUrl":"https://doi.org/10.2174/1876524601205010008","url":null,"abstract":"Neurobehavioural and cognitive impairments are reportedly associated with both types of diabetes mellitus; and the structural and molecular aberrations in support of these are emerging. In the present study, we report the effects of induced diabetes and its treatment with or without oral hypoglycaemic drugs on the morphology and oxidative stress status of the prefrontal cortex. Hyperglycaemia was induced in fasted Wistar rats with alloxan (150 mg/kg body weight). Hyperglycaemic rats were treated with or without oral hypoglycaemic drugs (metformin, 150 mg/kg/d; pioglitazone, 3 mg/kg/d; and rosiglitazone, 10 mg/kg/d). At 28 days of treatment, prefrontal morphology was studied by the cresyl fast violet (CFV) and luxol fast blue (LFB) techniques; and malondialdehyde (MDA) and superoxide dismutase (SOD) were assayed in prefrontal homogenate. Blood glucose was estimated by the glucose oxidase method. Prefrontal cortex neurons showed weak affinity for CFV and LFB in the untreated diabetic rats; as opposed to the relatively strong affinity for these stains in the non-diabetic control rats and diabetic rats on oral hypoglycaemic interventions. In the latter, blood glucose was not significantly different (P>0.05) from the control at 28 days of treatment. Moreover, prefrontal MDA and SOD were not significantly different between all the groups (P>0.05). These findings suggest that morphologic aberrations are provoked by untreated diabetes mellitus, even in the absence of oxidative stress; and that oral hypoglycaemic interventions are neuroprotective in alloxan-induced diabetic rats.","PeriodicalId":22762,"journal":{"name":"The Open Diabetes Journal","volume":"54 1","pages":"8-12"},"PeriodicalIF":0.0,"publicationDate":"2012-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88767400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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