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Journal Cover Diabetes & Metabolism
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   ISSN (Print) 1262-3636
   Published by Elsevier Homepage  [2970 journals]
  • Relationship between achieved personalized glycaemic targets and
           monitoring of clinical events in elderly diabetic patients
    • Abstract: Publication date: Available online 15 June 2016
      Source:Diabetes & Metabolism
      Author(s): S. Bucher, H. Panjo, A. Al-Salameh, B. Bauduceau, L. Benattar-Zibi, P. Bertin, G. Berrut, E. Corruble, N. Danchin, G. Derumeaux, J. Doucet, B. Falissard, F. Forette, O. Hanon, R. Ourabah, F. Pasquier, C. Piedvache, M. Pinget, L. Becquemont, V. Ringa
      Aim Recent guidelines for the management of type 2 diabetes (T2DM) in the elderly recommend adjusting the therapeutic target (HbA1c) according to the patient's health. Our study aimed to explore the association between achieving the recommended personalized HbA1c target and the occurrence of major clinical events under real-life conditions. Methods The T2DM S.AGES cohort was a prospective multicentre study into which 213 general practitioners recruited 983 non-institutionalized T2DM patients aged>65 years. The recommended personalized HbA1c targets were<7%, <8% and <9% for healthy, ill and very ill patients, respectively. Major clinical events (death from any cause, major vascular events and/or hospitalization) were recorded during the 3-year follow-up. Mixed-effects logistic regression models were used for the analyses. Results Of the 747 patients analyzed at baseline, 551 (76.8%) were at their recommended personalized HbA1c target. During follow-up, 391 patients (52.3%) experienced a major clinical event. Of the patients who did not achieve their personalized HbA1c target (compared with those who did), the risk (OR) of a major clinical event was 0.95 (95% CI: 0.69–1.31; P =0.76). The risk of death, major vascular event and hospitalization were 0.88 (95% CI: 0.40–1.94; P =0.75), 1.14 (95% CI: 0.7–1.83; P =0.59) and 0.84 (95% CI: 0.60–1.18; P =0.32), respectively. Conclusion Over a 3-year follow-up period, our results showed no difference in risk of a major clinical event among patients, regardless of whether or not they achieved their personalized recommended HbA1c target. These results need to be confirmed before implementing a more permissive strategy for treating T2DM in elderly patients.


      PubDate: 2016-06-18T18:37:05Z
       
  • Low-dose erythropoietin promotes wound-healing of ulcers in diabetics:
           Evidence from a phase-IIa clinical study
    • Abstract: Publication date: Available online 17 June 2016
      Source:Diabetes & Metabolism
      Author(s): C. Chatzikyrkou, F.H. Bahlmann, N. Sushakova, F.G. Scurt, J. Menne, P. Nawroth, P.R. Mertens, H. Haller



      PubDate: 2016-06-18T18:37:05Z
       
  • Adverse effects of weight loss: Are persistent organic pollutants a
           potential culprit'
    • Abstract: Publication date: Available online 16 June 2016
      Source:Diabetes & Metabolism
      Author(s): M. Cheikh Rouhou, A.D. Karelis, D.H. St-Pierre, L. Lamontagne
      Health professionals commonly recommend weight loss to individuals with obesity. However, unexpected adverse health effects after a weight-loss program have been reported in several studies. The factors that could explain this phenomenon are currently poorly understood. However, one potential factor that has emerged is persistent organic pollutants (POPs). Due to their lipophilic nature, POPs are known to accumulate in the adipose tissue and their concentrations are found to be higher in obese individuals than lean subjects. There is evidence to suggest that weight loss induces a significant increase in POPs levels in the bloodstream. Furthermore, the increases in plasma POPs levels after weight loss are even greater with an intensive weight loss. Thus, a critical question that remains unresolved is whether POPs released from the adipose tissue to the bloodstream during intensive weight loss could increase the risk of cardiometabolic disturbances. In turn, the accumulation of POPs released in response to an intensive weight loss may impair energy metabolism and stimulate a subsequent weight regain. Thus, the purpose of this review is to provide insights about the role of POPs on cardiometabolic risk factors during weight loss and weight regain that could potentially explain, at least in part, the adverse effects observed in certain weight-loss studies. We will also discuss the potential synergistic or antagonistic POPs-dependent risks following weight-loss programs. Ultimately, this may lead in establishing new therapeutic boundaries to minimize potential health hazards related to weight loss.


      PubDate: 2016-06-18T18:37:05Z
       
  • Functional gastrointestinal disorders and incidence of type 2 diabetes:
           Evidence from the E3N–EPIC cohort study
    • Abstract: Publication date: June 2016
      Source:Diabetes & Metabolism, Volume 42, Issue 3
      Author(s): G. Fagherazzi, G. Gusto, B. Balkau, M.-C. Boutron-Ruault, F. Clavel-Chapelon, F. Bonnet
      Objective Functional gastrointestinal disorders (FGID) such as diarrhoea and constipation can reflect intestinal dysfunction, especially with regard to intestinal microbiota, which, in turn, have been associated with chronic conditions, including obesity and insulin resistance. However, little is known of the association between FGID and type 2 diabetes (T2D) risk. Design and methods This analysis aimed to determine the influence of diarrhoea, constipation and alternating bouts of diarrhoea/constipation on T2D risk in 62,683 women from the prospective E3N–EPIC cohort. Results A total of 1795 T2D cases were recorded during follow-up. Compared with women who had normal gastrointestinal transits, women with chronic diarrhoea or alternating diarrhoea/constipation were at increased risk of T2D (HR: 1.29, 95% CI: 1.00–1.65 vs. HR: 1.32, 95% CI: 1.15–1.52, respectively), whereas women with constipation had a decreased risk (HR: 0.67, 95% CI: 0.57–0.78). There was no interaction between FGID and body mass index for risk of T2D. Also, these associations were independent of dietary habits such as coffee, fruit and vegetable consumption, and even of the use of laxatives and psychotropic drugs. Conclusion The present analysis showed, for the first time, a limited association between FGID and T2D risk in a large prospective cohort, and supports the hypothesis of a relationship between gastrointestinal function and diabetes. The presence of gastrointestinal transit disorders may assist in screening for subjects at higher risk of diabetes beyond the conventional risk factors.


      PubDate: 2016-06-14T08:02:58Z
       
  • Family history of diabetes and the risk of subclinical atherosclerosis
    • Abstract: Publication date: June 2016
      Source:Diabetes & Metabolism, Volume 42, Issue 3
      Author(s): G.-M. Park, Y.-R. Cho, S.-W. Lee, S.-C. Yun, E.H. Gil, D.W. Kim, T.-S. Kim, C.J. Kim, J.S. Cho, M.-W. Park, S.H. Her, Y.-H. Kim, D.H. Yang, J.-W. Kang, T.-H. Lim, C.H. Jung, E.H. Koh, W.J. Lee, M.-S. Kim, K.-U. Lee, H.-K. Kim, J. Choe, J.-Y. Park
      Aim This study investigated the influence of a family history of diabetes on the risk of subclinical coronary atherosclerosis according to coronary computed tomography angiography (CCTA) in asymptomatic individuals. Methods A total of 6434 consecutive asymptomatic individuals with no prior history of coronary artery disease voluntarily underwent CCTA evaluation as part of a general health examination. Coronary atherosclerotic plaque and significant coronary artery stenosis (degree of stenosis ≥50%) on CCTA were assessed. Logistic regression analysis was used to determine the association between a family history of diabetes and atherosclerotic plaque or significant coronary artery stenosis according to the degree of diabetes (normal, prediabetic and diabetic). Results Mean age of study participants was 53.7±7.6 years, and 4694 (73.0%) were male. A total of 1593 (24.8%) participants had a family history of diabetes in a first-degree relative. Among the study participants, 1115 (17.3%), 3122 (48.5%) and 2197 (34.1%) were categorized as diabetic, prediabetic and normal, respectively. In diabetic participants, after stepwise adjustments for clinical and laboratory variables, a family history of diabetes was significantly associated with non-calcified plaque (P <0.05 for all), but did not appear to be associated with either calcified or mixed plaques or with significant coronary artery stenosis (P >0.05 for all). In prediabetic and normal participants, a family history of diabetes was not associated with either atherosclerotic plaque or significant coronary artery stenosis (P >0.05 for all). Conclusion In asymptomatic diabetic individuals, a family history of diabetes is consistently associated with non-calcified coronary plaque after adjusting for risk factors.


      PubDate: 2016-06-14T08:02:58Z
       
  • Parathyroid hormone is associated with incident diabetes in white, but not
           black adults: The Atherosclerosis Risk in Communities (ARIC) Study
    • Abstract: Publication date: June 2016
      Source:Diabetes & Metabolism, Volume 42, Issue 3
      Author(s): J.P. Reis, E. Selvin, J.S. Pankow, E.D. Michos, C.M. Rebholz, P.L. Lutsey
      Objective Accumulating evidence has linked elevated parathyroid hormone (PTH) with insulin resistance, beta cell dysfunction and dysglycaemia, however, its role in the development of diabetes is largely unclear, particularly among non-whites. We sought to examine the association of PTH with the incidence of diabetes. Methods We studied 8066 white and 2034 black adults aged 46–70 years at baseline (1990–92) from the ARIC Study with follow-up for incident diabetes ascertained during study visits conducted in 1993–95 and 1996–98. Hazard ratios (HR) and their 95% CIs for diabetes adjusted for demographics, lifestyle, and 25-hydroxyvitamin D were estimated according to PTH measured at baseline. Results PTH was higher among blacks than whites (median [IQR], 43.8 [35.0–55.8] vs. 37.9 [30.4–47.3] pg/mL; P <0.001). During a median follow-up of 6 years, 498 white and 167 black participants developed diabetes. The association of PTH with diabetes varied significantly by race (P-interaction 0.02). PTH was not associated with risk for diabetes among black adults. Among whites, HRs according to quintiles of PTH were 1 (referent), 0.95 (0.71, 1.29), 0.95 (0.70, 1.28), 1.12 (0.84, 1.51), and 1.31 (0.98, 1.76) (P-trend 0.03). When a clinical cut-point for PTH was applied (≥65pg/mL; 5.7% of whites), the HR for diabetes among whites was 1.38 (1.01, 1.88). Results were similar when restricted to participants with normal baseline kidney function. Conclusion In this large, population-based study, elevated PTH was independently associated with risk for diabetes among white, but not black adults. Further studies are needed to elucidate the mechanisms that may underlie this differential association of PTH with diabetes across race groups.


      PubDate: 2016-06-14T08:02:58Z
       
  • Editorial board
    • Abstract: Publication date: June 2016
      Source:Diabetes & Metabolism, Volume 42, Issue 3




      PubDate: 2016-06-14T08:02:58Z
       
  • Resting beta-cells – A functional reserve'
    • Abstract: Publication date: June 2016
      Source:Diabetes & Metabolism, Volume 42, Issue 3
      Author(s): M. Hara, J.L. Fowler, G.I. Bell, L.H. Philipson
      Pancreatic beta-cells play a pivotal role to synthesize and secrete insulin, as the solo source of the body. Physical as well as functional loss of beta-cells over a certain threshold result in diabetes. While the mechanisms underlying beta-cell loss in various types of diabetes have been extensively studied, less is known about residual beta-cells, found even in autoimmune type 1 diabetes and type 2 diabetes with a substantial amount. Why have these beta-cells been spared' Some patients with neonatal diabetes have demonstrated the life-changing restoration of functional beta-cells that were inactive for decades but awakened in several weeks following specific treatment. The recent striking outcomes of bariatric surgery in many obese diabetic patients indicate that their beta-cells are likely “preserved” rather than irreversibly lost even in the multifactorial polygenic state that is type 2 diabetes. Collectively, the preservation of residual beta-cells in various diabetic conditions challenges us regarding our understanding of beta-cell death and survival, where their sustenance may stem from the existence of resting beta-cells under physiological conditions. We posit that beta-cells rest and that studies of this normal feature of beta-cells could lead to new approaches for potentially reactivating and preserving beta-cell mass in order to treat diabetes.


      PubDate: 2016-06-14T08:02:58Z
       
  • Autoimmune diabetes superimposed on type 2 diabetes in a patient initiated
           on immunotherapy for lung cancer
    • Abstract: Publication date: Available online 10 June 2016
      Source:Diabetes & Metabolism
      Author(s): M. Alhusseini, J. Samantray



      PubDate: 2016-06-14T08:02:58Z
       
  • Skin and subcutaneous tissue thickness at insulin injection sites in
           Chinese diabetes patients: Clinical implications
    • Abstract: Publication date: Available online 8 June 2016
      Source:Diabetes & Metabolism
      Author(s): W. Wang, X. Guo, G. Shen, G. Bai, Z. Wei, J. Liu, L. Hirsch, K. Strauss



      PubDate: 2016-06-14T08:02:58Z
       
  • T-cadherin gene variants are associated with type 2 diabetes and the Fatty
           Liver Index in the French population
    • Abstract: Publication date: Available online 8 June 2016
      Source:Diabetes & Metabolism
      Author(s): A. Nicolas, R. Aubert, N. Bellili-Muñoz, B. Balkau, F. Bonnet, J. Tichet, G. Velho, M. Marre, R. Roussel, F. Fumeron
      Aim Adiponectin is an adipocyte-secreted protein associated with insulin sensitivity. T-cadherin is a receptor for high and medium molecular weight adiponectin. In GWAS, T-cadherin gene (CDH13) polymorphisms are associated with circulating adiponectin levels. This study investigated the associations between genetic variants of CDH13 and type 2 diabetes (T2D), and its related parameters, in a Caucasian population. Methods Two polymorphisms of CDH13 (rs11646213 and rs3865188) were genotyped in two French cohorts, a general population from the D.E.S.I.R. study (n =5212) and people with T2D in the DIABHYCAR study (n =3123). Baseline adiponectin levels were measured in D.E.S.I.R. participants who were normoglycaemic at baseline, but hyperglycaemic after 3 years (n =230), and in controls who remained normoglycaemic (n =226) throughout. Results In a cross-sectional analysis, CDH13 genotype distributions differed between those with and without T2D, with T2D odds ratios (OR) of 1.11 (95% CI: 1.04–1.18; P =0.001) and 0.92 (95% CI: 0.87–0.98; P =0.01) for rs11646213 and rs3865188, respectively. The rs11646213 variant, associated with a higher OR for T2D, was also associated with higher BMI (P =0.03) and HbA1c (P =0.006), and lower plasma adiponectin levels (P =0.03) in the D.E.S.I.R. participants. Conversely, the rs3865188 variant, associated with a lower OR for T2D, was also associated with lower BMI (P =0.03), HbA1c (P =0.02) and Fatty Liver Index (FLI; P ≤0.01), and higher plasma adiponectin levels (P =0.002). Associations with HbA1c, FLI and adiponectin levels persisted after adjusting for BMI. Conclusion CDH13 polymorphisms are associated with prevalent T2D in this French population study. The association may be mediated through effects on BMI and/or plasma adiponectin.


      PubDate: 2016-06-14T08:02:58Z
       
  • Reappraisal of the diuretic effect of empagliflozin in the EMPA-REG
           OUTCOME trial: Comparison with classic diuretics
    • Abstract: Publication date: Available online 10 June 2016
      Source:Diabetes & Metabolism
      Author(s): A.J. Scheen
      Aims Empagliflozin, a sodium–glucose cotransporter type 2 (SGLT2) inhibitor, has been associated with a remarkable reduction in cardiovascular and all-cause mortality in patients with type 2 diabetes and antecedents of cardiovascular disease. This effect was attributed to a diuretic (haemodynamic) rather than metabolic (antiatherogenic) effect. The aim of this review is to offer arguments that either support or challenge this ‘diuretic hypothesis’. Methods The literature was scrutinized to: (1) examine the diuretic effects of SGLT2 inhibitors vs. hydrochlorothiazide as the reference diuretic; (2) analyze the effects of classic diuretics on cardiovascular outcomes and mortality in diabetic patients; and (3) reconsider some of the specific analyses of the EMPA-REG OUTCOME trial possibly related to a diuretic effect. Results The diuretic effect of empagliflozin has so far been poorly investigated, although SGLT2 inhibitors have actions distinct from those of classic diuretics. The effects of thiazide-like diuretics on cardiovascular and overall mortality have been limited in diabetic patients with hypertension, whereas the effects of mineralocorticoid receptor antagonists in subgroups of diabetic patients with heart failure were more impressive, but still largely inferior to those reported in EMPA-REG, where relative reductions in mortality with empagliflozin were observed in diabetic patients with or without heart failure, arterial hypertension, renal impairment or diuretic background therapy. Conclusion Although the diuretic hypothesis was put forward to explain the remarkable reduction in mortality with empagliflozin in EMPA-REG, the available results do not support a major contribution of this mechanism, unless the specific diuretic effect of SGLT2 inhibitors turns out to be markedly different from those of classic diuretics.


      PubDate: 2016-06-14T08:02:58Z
       
  • History of diabetes and risk of suicide and accidental death in Japan: The
           Japan Public Health Centre-based Prospective Study, 1990–2012
    • Abstract: Publication date: June 2016
      Source:Diabetes & Metabolism, Volume 42, Issue 3
      Author(s): T. Yamauchi, M. Inagaki, N. Yonemoto, M. Iwasaki, T. Akechi, N. Sawada, H. Iso, M. Noda, S. Tsugane
      Aim This study looked at whether a history of diabetes mellitus (DM) is associated with a higher risk of externally caused death (by suicide and accident), using data for a large population-based prospective cohort from an Asian population. Methods Data collected between 1990 and 2012 from the Japan Public Health Centre-based Prospective Study were analyzed, and Poisson regression models were used to calculate adjusted risk ratios (RR) for external causes of death. Results The population-based cohort comprised 105,408 Japanese residents (49,484 men and 55,924 women; mean age: 51.2 [SD 7.9] years). At baseline, 3250 (6.6%) men and 1648 (3.0%) women had a history of DM. During the follow-up period, 113 external deaths (41 suicides and 72 accidents) were noted among those with a history of DM, with 1304 external deaths (577 suicides and 727 accidents) among those without such a history. A higher risk of external death (men, RR: 1.4, 95% CI: 1.2–1.8; women, RR: 1.6, 95% CI: 1.01–2.4) was observed in those with a history of DM. Also, among those aged 40–49 years (RR: 1.9, 95% CI: 1.3–2.7) and 50–59 years (RR: 1.4, 95% CI: 1.05–1.9) at baseline, the risk of external death was significantly higher in those with a history of DM. Conclusion Compared with people with no history of DM, those with such a history had a significantly greater risk of externally caused death (particularly accidental deaths) in both genders and in those aged≤59 years at baseline.


      PubDate: 2016-06-14T08:02:58Z
       
  • A pilot study of gestational diabetes mellitus not controlled by diet
           alone: First-line medical treatment with myoinositol may limit the need
           for insulin
    • Abstract: Publication date: June 2016
      Source:Diabetes & Metabolism, Volume 42, Issue 3
      Author(s): V. Lubin, R. Shojai, P. Darmon, E. Cosson
      Aim This study assessed whether myoinositol might be a first-line medical treatment for gestational diabetes mellitus (GDM). Methods For 12 months, women with GDM not controlled by diet (n =32) were prospectively treated with myoinositol 1200mg and folic acid 400μg/day, while consecutive women (n =28) with insulin-requiring GDM treated during the previous year at our centre constituted the control group. Baseline characteristics and care were similar in both groups. Results Insulin was required in eight women (25%) in the myoinositol group who, compared with the 24 who did not need insulin, were older (37±5 vs. 32±5 years, respectively; P =0.018) and had a larger percentage of high self-monitored glucose values (45±8% vs. 32±14%; P <0.0001) during the week prior to the introduction of myoinositol treatment. All of the women had similar pregnancy outcomes regardless of their GDM management, although less labour induction was required in the myoinositol group (OR: 0.22 [0.07–0.65]), which had no side effects. Conclusion This pilot study suggests that myoinositol may be a safe first-line medical treatment for uncontrolled GDM.


      PubDate: 2016-06-14T08:02:58Z
       
  • Effects of ethinylestradiol–cyproterone acetate vs.
           pioglitazone–flutamide–metformin on plasma FGF21 levels in
           adolescent girls with androgen excess
    • Abstract: Publication date: June 2016
      Source:Diabetes & Metabolism, Volume 42, Issue 3
      Author(s): M. Díaz, J.M. Gallego-Escuredo, F. de Zegher, F. Villarroya, L. Ibáñez



      PubDate: 2016-06-14T08:02:58Z
       
  • Carotid extra-medial thickness does not predict adverse cardiovascular
           outcomes in high-risk adults
    • Abstract: Publication date: June 2016
      Source:Diabetes & Metabolism, Volume 42, Issue 3
      Author(s): T.Y. Cai, C. Magnussen, B. Haluska, D.W. Johnson, P.M. Mottram, N. Isbel, D.S. Celermajer, T.H. Marwick, M.R. Skilton



      PubDate: 2016-06-14T08:02:58Z
       
  • Metabolic features associated with positivity to ZnT8 autoantibody in
           sub-Saharan African young-onset diabetes patients
    • Abstract: Publication date: June 2016
      Source:Diabetes & Metabolism, Volume 42, Issue 3
      Author(s): A. Mbanya, A. Ngandeu, V. Kamwa, O.T. Donfack, É. Lontchi, R. Leke, J.-C. Mbanya, E. Sobngwi



      PubDate: 2016-06-14T08:02:58Z
       
  • Difficulties describing feelings to others still predicts glycaemic
           control up to 24 months later in children with type 1 diabetes
    • Abstract: Publication date: June 2016
      Source:Diabetes & Metabolism, Volume 42, Issue 3
      Author(s): M. Housiaux, O. Luminet, H. Dorchy



      PubDate: 2016-06-14T08:02:58Z
       
  • A common rs7903146 variant of the transcription factor 7-like 2 gene is
           associated with type 2 diabetes mellitus and fasting glucose in a
           Taiwanese population
    • Abstract: Publication date: Available online 7 June 2016
      Source:Diabetes & Metabolism
      Author(s): T.-J. Hsiao, E. Lin



      PubDate: 2016-06-08T07:52:27Z
       
  • Elevated parathyroid hormone predicts high asymmetric dimethylarginine
           (ADMA) concentrations in obese diabetic patients
    • Abstract: Publication date: Available online 7 June 2016
      Source:Diabetes & Metabolism
      Author(s): A.T. Amarasekera, A.L. Sverdlov, J.D. Horowitz, D.T. Ngo



      PubDate: 2016-06-08T07:52:27Z
       
  • Visceral adipose tissue dysfunction and mortality among a population-based
           sample of males and females
    • Abstract: Publication date: Available online 6 June 2016
      Source:Diabetes & Metabolism
      Author(s): J.C. Brown, M.O. Harhay, M.N. Harhay



      PubDate: 2016-06-08T07:52:27Z
       
  • Family history of diabetes predisposes to cardiovascular disease among
           
    • Abstract: Publication date: Available online 30 May 2016
      Source:Diabetes & Metabolism
      Author(s): F. Bonnet, B. Balkau, A. Natali



      PubDate: 2016-06-03T07:48:54Z
       
  • Relationship between HHV8 infection markers and insulin sensitivity in
           ketosis-prone diabetes
    • Abstract: Publication date: Available online 1 June 2016
      Source:Diabetes & Metabolism
      Author(s): J.-L. Nguewa, E. Lontchi-Yimagou, F. Agbelika, M. AitDjoudi, P. Boudou, S. Choukem, E. Sobngwi, J.-F. Gautier
      Background and objectives Peripheral tissue resistance to insulin action is a characteristic of type 2 diabetes mellitus (T2DM). It has also been reported that some chronic viral infections can contribute to insulin resistance. Human herpesvirus (HHV)-8 infection has been detected in T2DM patients in previous studies. Our study investigated whether the presence of the virus is associated with insulin resistance in patients with ketosis-prone type 2 diabetes (KPD), as reported with other viruses. Research design and methods A total of 11 insulin-free KPD patients positive (+) and seven patients who were negative (−) for HHV-8 infection were recruited; the latter had KPD that was well controlled (HbA1c =6.2±0.7%). A two-step euglycaemic–hyperinsulinaemic clamp test coupled with deuterated [6,6-2H2]glucose was used to assess insulin sensitivity, non-esterified fatty acid (NEFA) suppression and endogenous glucose production. Results In KPD patients, whether HHV-8+ or HHV-8−, there were no differences in NEFA release, endogenous glucose production or insulin sensitivity (M value). Conclusion Asymptomatic HHV-8 infection does not appear to be associated with decreased insulin sensitivity in diabetic patients. These results should now be confirmed in a larger sample population.


      PubDate: 2016-06-03T07:48:54Z
       
  • The vitamin D metabolites 25(OH)D and 1,25(OH)2D are not related to either
           glucose metabolism or insulin action in obese women
    • Abstract: Publication date: Available online 1 June 2016
      Source:Diabetes & Metabolism
      Author(s): K.W. ter Horst, R.I. Versteeg, P.W. Gilijamse, M.T. Ackermans, A.C. Heijboer, J.A. Romijn, S.E. la Fleur, R. Trinko, R.J. DiLeone, M.J. Serlie
      Aim Vitamin D deficiency has been proposed to be involved in obesity-induced metabolic disease. However, data on the relationship between 25-hydroxycholecalciferol (25(OH)D) and insulin resistance have been inconsistent, and few studies have investigated the active vitamin D metabolite, 1,25-dihydroxycholecalciferol (1,25(OH)2D). This study aimed to determine the relationship between circulating levels of both 25(OH)D and 1,25(OH)2D and direct measures of glucose metabolism and insulin action in obese women. Methods Serum levels of 25(OH)D and 1,25(OH)2D, and glucose metabolism and tissue-specific insulin action, as assessed in the basal state and during a two-step euglycaemic–hyperinsulinaemic clamp study with [6,6-2H2]glucose infusion, were measured in 37 morbidly obese women (age: 43±10 years; body mass index: 44±6kg/m2). Results Sixteen subjects had circulating 25(OH)D levels<50nmol/L, consistent with vitamin D deficiency, and 21 had normal 25(OH)D levels. There were no differences in either baseline characteristics or parameters of glucose metabolism and insulin action between the groups. Serum 25(OH)D, but not 1,25(OH)2D, was negatively correlated with both body mass index (r =−0.42, P =0.01) and total body fat (r =−0.46, P <0.01). Neither 25(OH)D nor 1,25(OH)2D levels were related to any measured metabolic parameters, including fasting glucose, fasting insulin, basal endogenous glucose production, and hepatic, adipose-tissue and skeletal muscle insulin sensitivity. Conclusion Obesity was associated with lower levels of circulating 25(OH)D, but not with the hormonally active metabolite 1,25(OH)2D. Neither 25(OH)D nor 1,25(OH)2D were related to glucose metabolism and tissue-specific insulin sensitivity in obese women, suggesting that vitamin D does not play a major role in obesity-related insulin resistance.


      PubDate: 2016-06-03T07:48:54Z
       
  • The autoimmune hypothesis for acute bilateral cataract in type 1
           diabetes
    • Abstract: Publication date: Available online 18 May 2016
      Source:Diabetes & Metabolism
      Author(s): D.T. Papadimitriou, C. Bothou, F. Skarmoutsos, T.K. Alexandrides, V. Papaevangelou, A. Papadimitriou



      PubDate: 2016-05-19T05:28:26Z
       
  • Impaired RBC deformability is associated with diabetic retinopathy in
           patients with type 2 diabetes
    • Abstract: Publication date: Available online 18 May 2016
      Source:Diabetes & Metabolism
      Author(s): J.S. Moon, J.H. Kim, J.H. Kim, I.R. Park, J.H. Lee, H.J. Kim, J. Lee, Y.K. Kim, J.S. Yoon, K.C. Won, H.W. Lee
      Aim Red blood cell (RBC) deformability, the ability of RBCs to change shape under stress, is known to be decreased in type 2 diabetes (T2D). However, as yet little is known of the association between RBC deformability and diabetic complications in T2D. For this reason, this study has investigated the association between RBC deformability and diabetic complications. Methods In this cross-sectional study, 452 T2D patients were initially enrolled. RBC deformability was measured using a microfluidic ektacytometer and expressed as an elongation index at 3Pa (EI@3Pa, %). Results A final total of 373 patients (mean age: 60.04±11.93 years; males: 201) were included in the study. When categorized into quartiles of RBC deformability, the lower EI@3Pa groups had higher glycated haemoglobin (HbA1c), triglycerides and prevalence of diabetic retinopathy compared with the higher quartiles (P <0.05 for trend). In particular, the EI@3Pa was significantly lower in patients with retinopathy than in those without retinopathy (30.53±1.95 vs 31.20±1.53, P =0.001). Between the lowest EI@3Pa quartile (Q1) to the highest (Q4, reference), the odds ratio (OR) for Q1 was 2.81 (95% CI: 1.21–6.49, P =0.004 for trend), after adjusting for age, gender, presence of hypertension and smoking, duration of diabetes, HbA1c, glomerular filtration rate and triglycerides. Conclusion In terms of diabetic complications, the lowest EI@3Pa group was closely associated with only the risk of diabetic retinopathy in our study. These results suggest that RBC deformability might be contributory to the development of the microvascular complication.


      PubDate: 2016-05-19T05:28:26Z
       
  • Effects of probiotic supplementation on glycaemic control and lipid
           profiles in gestational diabetes: A randomized, double-blind,
           placebo-controlled trial
    • Abstract: Publication date: Available online 18 May 2016
      Source:Diabetes & Metabolism
      Author(s): M. Karamali, F. Dadkhah, M. Sadrkhanlou, M. Jamilian, S. Ahmadi, M. Tajabadi-Ebrahimi, P. Jafari, Z. Asemi
      Background To our knowledge, data on the effects of probiotic supplementation on glycaemic control and lipid concentrations in patients with gestational diabetes mellitus (GDM) are scarce. Aim The aim of the present study was to determine the effects of probiotic supplementation on glycaemic control and lipid profiles in GDM patients. Methods Sixty pregnant women with GDM, primigravida and aged 18–40years, were divided into two groups to receive either probiotic capsules (n =30) or a matching placebo (n =30) in this randomized double-blind, placebo-controlled trial. The patients in the probiotic group took a daily capsule that contained three viable freeze-dried strains: Lactobacillus acidophilus (2×109 CFU/g), L. casei (2×109 CFU/g) and Bifidobacterium bifidum (2×109 CFU/g) for 6weeks. The placebo group took capsules filled with cellulose for the same time period. Fasting blood samples were taken at the beginning and end of the study to quantify the relevant markers. Results After 6weeks of intervention, probiotic supplementation vs a placebo resulted in significant decreases in fasting plasma glucose (−9.2±9.2mg/dL vs +1.1±12.2mg/dL, P <0.001), serum insulin levels (−0.8±3.1μIU/mL vs +4.5±10.6μIU/mL, P =0.01), homoeostasis model assessment (HOMA) for insulin resistance (−0.4±0.9 vs +1.1±2.5, P =0.003) and HOMA for β-cell function (+1.1±9.8 vs +18.0±42.5, P =0.03), and a significant increase in the quantitative insulin sensitivity check index (+0.007±0.01 vs −0.01±0.02, P =0.007). In addition, significant decreases in serum triglycerides (−1.6±59.4mg/dL vs +27.1±37.9mg/dL, P =0.03) and VLDL cholesterol concentrations (−0.3±11.9mg/dL vs +5.4±7.6mg/dL, P =0.03) were seen following supplementation with the probiotics compared with the placebo. However, no significant changes in other lipid profiles were seen with the intervention. Conclusion Overall, the results of our study have demonstrated that taking probiotic supplements for 6weeks in patients with GDM had beneficial effects on glycaemic control, triglycerides and VLDL cholesterol concentrations, although there was no effect on other lipid profiles.


      PubDate: 2016-05-19T05:28:26Z
       
  • Tailoring nutrient sequence and content to improve glucose tolerance: Why
           and how to do it
    • Abstract: Publication date: Available online 13 May 2016
      Source:Diabetes & Metabolism
      Author(s): L. Monnier, F. Bonnet, C. Colette



      PubDate: 2016-05-14T04:05:31Z
       
  • Impact of gut microbiota on diabetes mellitus
    • Abstract: Publication date: Available online 11 May 2016
      Source:Diabetes & Metabolism
      Author(s): G. Blandino, R. Inturri, F. Lazzara, M. Di Rosa, L. Malaguarnera
      Various functions of the gut are regulated by sophisticated interactions among its functional elements, including the gut microbiota. These microorganisms play a crucial role in gastrointestinal mucosa permeability. They control the fermentation and absorption of dietary polysaccharides to produce short-chain fatty acids, which may explain their importance in the regulation of fat accumulation and the subsequent development of obesity-related diseases, suggesting that they are a crucial mediator of obesity and its consequences. In addition, gut bacteria play a crucial role in the host immune system, modulation of inflammatory processes, extraction of energy from the host diet and alterations of human gene expression. Dietary modulation of the human colonic microbiota has been shown to confer a number of health benefits to the host. Simple therapeutic strategies targeted at attenuating the progression of chronic low-grade inflammation and insulin resistance are urgently required to prevent or slow the development of diabetes in susceptible individuals. The main objective of this review is to address the pathogenic association between gut microbiota and diabetes, and to explore any novel related therapeutic targets. New insights into the role of the gut microbiota in diabetes could lead to the development of integrated strategies using probiotics to prevent and treat these metabolic disorders.


      PubDate: 2016-05-14T04:05:31Z
       
  • Exenatide treatment decreases fasting fibroblast growth factor 21 levels
           in patients with newly diagnosed type 2 diabetes mellitus
    • Abstract: Publication date: Available online 10 May 2016
      Source:Diabetes & Metabolism
      Author(s): Y. Hu, J. Liu, H. Zhang, Y. Xu, T. Hong, G. Wang
      Aim Fibroblast growth factor 21 (FGF21) has been demonstrated to be a metabolic regulator with beneficial effects. Several studies have shown that type 2 diabetes mellitus (T2DM) patients have increased FGF21 levels and decreased expression of FGF receptors, suggesting a state of ‘FGF21 resistance’. The aim of this study was to investigate the effects of the glucagon-like peptide (GLP)-1 receptor agonist exenatide on FGF21 levels and other metabolic parameters in patients with newly diagnosed T2DM. Methods A total of 100 participants, comprising 47 newly diagnosed T2DM patients and 53 age-matched healthy controls, were recruited. T2DM patients were assigned to 12 weeks of exenatide treatment. Their FGF21 levels and other metabolic parameters were measured before and after exenatide treatment. Results T2DM patients had significantly higher FGF21 levels than the controls. No difference in FGF21 was found between overweight and non-overweight control subgroups. In T2DM patients, exenatide treatment resulted in decreases in BMI, HbA1c, total cholesterol and triglycerides, and also in FGF21 (149.17±81.36 vs 102.17±64.12ng/mL; P <0.01). Homoeostasis model assessment for insulin resistance (HOMA-IR) was also decreased [3.02 (2.10–4.63) vs 2.56 (1.80–4.13); P <0.05] while homoeostasis model assessment for β-cell function (HOMA-B) was significantly higher after treatment [32.30 (17.82–59.42) vs 72.56 (46.63–99.58); P <0.05]. The change in FGF21 (ΔFGF21) was negatively correlated with changes in fasting insulin (Δinsulin, r =−0.306; P <0.05) and C-peptide (ΔC-peptide, r =−0.319; P <0.05) levels. Conclusion Besides the improvement in insulin resistance and recovery of β-cell function, 12 weeks of exenatide treatment may also play a role in lowering FGF21 levels in T2DM patients.


      PubDate: 2016-05-14T04:05:31Z
       
  • Skin pigmentation is inversely associated with insulin resistance in
           healthy Japanese women
    • Abstract: Publication date: Available online 6 May 2016
      Source:Diabetes & Metabolism
      Author(s): C. Nagata, K. Konish, T. Tamura, K. Wada, M. Hayashi, N. Takeda, K. Yasuda
      Aim As a low-pigment skin type is prevalent in men and women with type 1 diabetes, it is possible that skin pigmentation may be associated with insulin resistance. This study aimed to cross-sectionally examine this association in healthy women. Methods Study participants were 792 Japanese women who attended a health examination and were not taking any medication for diabetes. Skin pigmentation on the inner upper and lower arms and forehead was measured using a Mexameter® skin colorimeter, a narrow-band reflective spectrophotometer. Data are expressed as a melanin index, which quantifies melanin content. Fasting blood glucose and insulin levels were also measured, and homoeostasis model assessment for insulin resistance (HOMA-IR) scores were calculated. Information on medical history and lifestyle factors were obtained by a self-administered questionnaire, while data on sun exposure were collected through interviews. Plasma 25-hydroxyvitamin D levels were measured in a subsample of women (n =464). Results Melanin indices at the inner upper and lower arms were significantly and inversely associated with fasting insulin levels and HOMA-IR after controlling for age, body mass index, smoking status, indicators for rater effects, cumulative sun exposure and season at the time of measurement. Additional adjustment for plasma 25-hydroxyvitamin D levels did not alter the results. Conclusion These data suggest that skin pigmentation is associated with insulin resistance, and encourage future studies into the potential role of melanin and related factors in glucose homoeostasis.


      PubDate: 2016-05-09T02:32:49Z
       
  • Risk of type 2 diabetes in patients with non-alcoholic fatty liver
           disease: Causal association or epiphenomenon'
    • Abstract: Publication date: Available online 30 April 2016
      Source:Diabetes & Metabolism
      Author(s): G. Targher, G. Marchesini, C.D. Byrne
      Non-alcoholic fatty liver disease (NAFLD) has become the leading cause of chronic liver diseases worldwide, causing considerable liver-related mortality and morbidity. Over the last 10years, it has also become increasingly evident that NAFLD is a multisystem disease, affecting many extra-hepatic organ systems and interacting with the regulation of multiple metabolic pathways. NAFLD is potentially involved in the aetiology and pathogenesis of type 2 diabetes via its direct contribution to hepatic/peripheral insulin resistance and the systemic release of multiple hepatokines that may adversely affect glucose metabolism and insulin action. In this updated review, we discuss the rapidly expanding body of clinical and epidemiological evidence that supports a strong link between NAFLD and the risk of developing type 2 diabetes. We also briefly examine the conventional and the more innovative pharmacological approaches for the treatment of NAFLD that may influence the risk of developing type 2 diabetes.


      PubDate: 2016-05-05T00:06:42Z
       
  • Association between metformin and vitamin B12 deficiency in patients with
           type 2 diabetes: A systematic review and meta-analysis
    • Abstract: Publication date: Available online 26 April 2016
      Source:Diabetes & Metabolism
      Author(s): L.E. Chapman, A.L. Darling, J.E. Brown
      Aim Metformin is the most widely used oral hypoglycaemic drug, but it may lower B12 status, which could have important clinical implications. We undertook a systematic review and meta-analysis of the relationship between metformin use and vitamin B12 deficiency in persons with type 2 diabetes. Methods Electronic database searches were undertaken (1st January 1957–1st July 2013) using the Cochrane library, Scopus, CINAHL, Grey literature databases, Pub Med Central, NICE Clinical Guidelines UK, and ongoing clinical trials. Included studies were of any study design, with data from patients with type 2 diabetes of any age or gender, taking any dose or duration of metformin. Planned primary outcomes were serum vitamin B12 levels, % prevalence or incidence of vitamin B12 deficiency and risk of vitamin B12 deficiency. Results Twenty-six papers were included in the review. Ten out of 17 observational studies showed statistically significantly lower levels of vitamin B12 in patients on metformin than not on metformin. Meta-analysis performed on four trials demonstrated a statistically significant overall mean B12 reducing effect of metformin of 57pmol/L [WMD (fixed)=–0.57 (95% CI: –35 to –79pmol/L)] after 6weeks to 3months of use. Conclusion The evidence from this review demonstrates an association between metformin usage and lower levels of vitamin B12 by 57pmol/L, which leads to frank deficiency or borderline status in some patients with type 2 diabetes. This suggests that it is prudent to monitor B12 levels in these patients who are at increased risk of deficiency.


      PubDate: 2016-04-29T22:41:22Z
       
  • The association between endostatin and kidney disease and mortality in
           patients with type 2 diabetes
    • Abstract: Publication date: Available online 11 April 2016
      Source:Diabetes & Metabolism
      Author(s): A.C. Carlsson, C.J. Östgren, T. Länne, A. Larsson, F.H. Nystrom, J. Ärnlöv
      Aim Circulating endostatin, a biologically active derivate of collagen XVIII, is considered to be a marker of kidney disease and a risk factor for its related mortality. However, less is known of the role of endostatin in diabetes and the development of diabetic nephropathy. For this reason, our study investigated the associations between circulating endostatin and the prevalence and progression of kidney disease, and its mortality risk in patients with type 2 diabetes (T2D). Methods This was a cohort study of 607 patients with T2D (mean age: 61 years, 44% women). Estimated glomerular filtration rate (eGFR), calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation, was used to assess the patients’ kidney function decline and mortality. Results Of the total study cohort, 20 patients declined by ≥20% in eGFR over 4 years, and 44 died during the follow-up (mean duration: 6.7 years). At baseline, participants with diabetic nephropathy (defined as eGFR<60mL/min/1.73m2) and/or microalbuminuria [defined as a urinary albumin-to-creatinine ratio (ACR)>3g/mol] had higher median levels of endostatin than those without nephropathy (62.7μg/L vs 57.4μg/L, respectively; P =0.031). In longitudinal analyses adjusted for age, gender, baseline eGFR and ACR, higher endostatin levels were associated with a higher risk of decline (≥20% in eGFR, OR per 1 SD increase: 1.73, 95% CI: 1.13–2.65) and a higher risk of mortality (HR per 1 SD increase: 1.57, 95% CI: 1.19–2.07). Conclusion In patients with T2D, circulating endostatin levels can predict the progression of kidney disease and mortality independently of established kidney disease markers. The clinical usefulness of endostatin as a risk marker in such patients merits further studies.


      PubDate: 2016-04-29T22:41:22Z
       
  • Sustained effects of a protein and lipid preload on glucose tolerance in
           type 2 diabetes patients
    • Abstract: Publication date: Available online 12 April 2016
      Source:Diabetes & Metabolism
      Author(s): D. Tricò, E. Filice, S. Baldi, S. Frascerra, A. Mari, A. Natali
      Background Small amounts of nutrients given as a ‘preload’ can reduce post-meal hyperglycaemic peaks in type 2 diabetes (T2D) patients by activating a number of mechanisms involved in glucose homoeostasis. This study was undertaken to ascertain whether this positive effect extends to the late absorptive phase and to identify the main mechanisms involved. Material and methods Eight well-controlled T2D patients, aged 40–70 years, were randomized to consume a ‘preload’ of either water or non-glucidic nutrients (50g of Parmesan cheese, one boiled egg) 30min before a 300-min oral glucose tolerance test. Results After the nutrient preload, significant reductions were observed in peak glucose (−49%; P <0.02), total plasma glucose (iAUC: −28%; P <0.03), exogenous glucose (iAUC: −30%; P <0.03) and insulin clearance (−28%; P <0.04), with enhancement of insulin secretion (iAUC: +22%; P <0.003). These effects were associated with higher plasma levels of GLP-1 (iAUC: +463%; P <0.002), GIP (iAUC: +152%; P <0.0003) and glucagon (iAUC: +144%; P <0.0002). Conclusion In T2D patients, a protein and lipid preload improves glucose tolerance throughout the whole post-absorptive phase mainly by reducing the appearance of oral glucose, and improving both beta-cell function and insulin bioavailability.


      PubDate: 2016-04-29T22:41:22Z
       
  • Deletion of microRNA miR-146a does not prevent streptozotocin-induced
           murine autoimmune type 1 diabetes
    • Abstract: Publication date: Available online 25 April 2016
      Source:Diabetes & Metabolism
      Author(s): C. Yin, M. Weiland, Z.-M. Miao, C. Li, L. Zhou, Q.-S. Mi



      PubDate: 2016-04-29T22:41:22Z
       
  • Using continuous glucose monitoring to assess contributions of premeal and
           
    • Abstract: Publication date: Available online 7 April 2016
      Source:Diabetes & Metabolism
      Author(s): S.-D. Lin, S.-L. Su, S.-Y. Wang, S.-T. Tu, S.-R. Hsu
      Aim This study aimed to determine the contributions of basal excess glycaemia (BEG) and prandial excess glycaemia (PEG) to overall excess glycaemia in type 2 diabetes (T2D) patients treated with metformin alone. Methods Outpatients with T2D treated with metformin alone (n =46) who underwent continuous glucose monitoring (CGM) were divided into tertiles according to glycated haemoglobin (HbA1c) levels. For each CGM trace, the glucose area under the curve (AUC)>5.5mmol/L was expressed as the AUCoverall, representing overall excess glycaemia. The sum of glucose AUCs above the premeal glucose level at 4h after breakfast, lunch and dinner was expressed as the AUCpeg, representing PEG. The contribution of PEG to overall excess glycaemia was calculated as (AUCpeg/AUCoverall)×100%. The contribution of BEG was calculated as [(AUCoverall −AUCpeg)/AUCoverall]×100%. Factors related to PEG contribution were also analysed. Results BEG constituted more than half the overall excess glycaemia in all HbA1c tertiles. The contribution of PEG was negatively correlated with HbA1c and mean glucose values before each meal. Prebreakfast and predinner glucose values were the dominant factors affecting PEG contribution and was independent of HbA1c. Conclusion In patients treated with metformin alone, BEG was the major contributor to excess glycaemia at HbA1c levels ≥7.7%, while PEG and BEG contributions were similar and stable below this level. For HbA1c levels ≥7.7%, add-on therapy to metformin should preferentially target control of BEG, whereas targeting both BEG and PEG could be of equivalent importance with lower HbA1c levels.


      PubDate: 2016-04-09T08:04:41Z
       
  • Effect of insulin analogues on frequency of non-severe hypoglycaemia in
           patients with type 1 diabetes prone to severe hypoglycaemia: The
           HypoAna trial
    • Abstract: Publication date: Available online 7 April 2016
      Source:Diabetes & Metabolism
      Author(s): R.M. Agesen, P.L. Kristensen, H. Beck-Nielsen, K. Nørgaard, H. Perrild, J.S. Christiansen, T. Jensen, P. Hougaard, H.H. Parving, B. Thorsteinsson, L. Tarnow, U. Pedersen-Bjergaard
      Aim Insulin analogues reduce the risk of hypoglycaemia compared with human insulin in patients with type 1 diabetes (T1D) and minor hypoglycaemia problems. The HypoAna trial showed that, in patients with recurrent severe hypoglycaemia, treatment based on insulin analogues reduces the risk of severe hypoglycaemia. The present study aims to assess whether this also applies to non-severe hypoglycaemia events during the day and at night. Methods This 2-year investigator-initiated multicentre, prospective, randomized, open, blinded endpoint (PROBE) trial involved patients with T1D and at least two episodes of severe hypoglycaemia during the previous year. Using a balanced crossover design, patients were randomized to basal–bolus therapy based on analogue (detemir/aspart) or human (NPH/regular) insulins. A total of 114 participants were included. Endpoints were the number of severe hypoglycaemic events and non-severe events, including documented symptomatic and asymptomatic episodes occurring during the day and at night (ClinicalTrials.gov number: NCT00346996). Results Analogue-based treatment resulted in a 6% (2–10%; P =0.0025) overall relative risk reduction of non-severe hypoglycaemia. This was due to a 39% (32–46%; P <0.0001) reduction of non-severe nocturnal hypoglycaemia, seen for both symptomatic (48% [36–57%]; P <0.0001) and asymptomatic (28% [14–39%]; P =0.0004) nocturnal hypoglycaemia episodes. No clinically significant differences in hypoglycaemia occurrence were observed between the insulin regimens during the day. The time needed to treat one patient with insulin analogues to avoid one episode (TNT1) of non-severe nocturnal hypoglycaemia was approximately 3 months. Conclusion In T1D patients prone to severe hypoglycaemia, treatment with analogue insulin reduced the risk of non-severe nocturnal hypoglycaemia compared with human insulin.


      PubDate: 2016-04-09T08:04:41Z
       
  • A common variation of the PTEN gene is associated with peripheral insulin
           resistance
    • Abstract: Publication date: Available online 8 April 2016
      Source:Diabetes & Metabolism
      Author(s): L. Grinder-Hansen, R. Ribel-Madsen, J.F.P. Wojtaszewski, P. Poulsen, L.G. Grunnet, A. Vaag
      Aim Phosphatase and tensin homologue (PTEN) reduces insulin sensitivity by inhibiting the phosphatidylinositol 3-kinase (PI3K)/v-akt murine thymoma viral oncogene homologue (Akt) pathway. This study investigated how a common single nucleotide polymorphism near PTEN, previously associated with fasting levels of plasma insulin and glucose, influences in vivo glucose metabolism and insulin signalling. The primary outcome measure was the gene variant's association with peripheral glucose disposal rate and, secondarily, whether this association was explained by altered activities of PTEN targets PI3K and Akt. Methods A total of 183 normoglycaemic Danes, including 158 twins and 25 singletons, were genotyped for PTEN rs11202614, which is in complete linkage disequilibrium with rs2142136 and rs10788575, which have also been reported in association with glycaemic traits and type 2 diabetes (T2D). Hepatic and peripheral insulin sensitivity was measured using tracer and euglycaemic–hyperinsulinaemic clamp techniques; insulin secretion was assessed by intravenous glucose tolerance test; and muscle biopsies were taken during insulin infusion from 150 twins for measurement of PI3K and Akt activities. Results The minor G allele of PTEN rs11202614 was associated with elevated fasting plasma insulin levels and a decreased peripheral glucose disposal rate, but not with the hepatic insulin resistance index or insulin secretion measured as the first-phase insulin response and disposition index. The single nucleotide polymorphism was not associated with either PI3K or Akt activities. Conclusion A common PTEN variation is associated with peripheral insulin resistance and subsequent risk of developing T2D. However, the association with insulin resistance is not explained by decreased proximal insulin signalling in skeletal muscle.


      PubDate: 2016-04-09T08:04:41Z
       
  • Determining the association between types of sedentary behaviours and
           cardiometabolic risk factors: A 6-year longitudinal study of French adults
           
    • Abstract: Publication date: April 2016
      Source:Diabetes & Metabolism, Volume 42, Issue 2
      Author(s): M. Menai, H. Charreire, E. Kesse-Guyot, V.A. Andreeva, S. Hercberg, P. Galan, J.-M. Oppert, L.K. Fezeu
      Aim This study identified the longitudinal associations between leisure-time sedentary behaviours [television (TV) viewing, computer use and reading (h/week)] and cardiometabolic risk factors, including the metabolic syndrome. Methods A total of 2517 participants (mean±SD age: 55.5±4.9years) were assessed in 2001 and in 2007 for physical activity and leisure-time sedentary behaviours, anthropometry, body composition, blood pressure, fasting blood glucose and lipids, using standardized methods. Multivariate generalized linear (beta, 95% CI and P values) and logistic (OR and 95% CI) regression models were used to assess cross-sectional associations between sedentary behaviours and cardiometabolic risk factors, while a 6-year longitudinal study explored these associations as well as the odds of developing the metabolic syndrome, as defined by the NCEP ATPIII. Results Increased TV viewing time over the follow-up period was positively associated with increases in body mass index (BMI; P <0.01) and percent body fat (P <0.001), and marginally with waist circumference (P =0.06). Reverse associations were also found, with changes in BMI, percent fat mass and waist circumference positively associated with TV viewing and computer use. Associations between reading and cardiometabolic risk factors were less consistent. Each 1-h/week increase in baseline TV viewing and in reading was associated with an increase in the chances of developing the metabolic syndrome (OR=1.031, 95% CI: 0.998–1.060, P =0.07; and OR=1.032, 95% CI: 1.002–1.065, P =0.02; respectively). Conclusion The present study data emphasizes the notion of differential associations of specific sedentary behaviours with cardiometabolic risk factors. They are also evidence that different longitudinal associations should be taken into account when designing public health objectives of interventions aimed at improving cardiometabolic health.


      PubDate: 2016-03-29T05:20:30Z
       
  • Neuregulin 1 improves glucose tolerance in adult and old rats
    • Abstract: Publication date: April 2016
      Source:Diabetes & Metabolism, Volume 42, Issue 2
      Author(s): K. Caillaud, N. Boisseau, G. Ennequin, V. Chavanelle, M. Etienne, X. Li, P. Denis, D. Dardevet, A. Lacampagne, P. Sirvent
      Aim Studies both in vitro and ex vivo of rodent skeletal muscle have highlighted the potential involvement of neuregulin 1 (NRG1) in glucose metabolism regulation, yet nothing is known of the role of NRG1 in systemic glucose homoeostasis. For this reason, it was hypothesized that systemic delivery of NRG1 might improve glucose tolerance and that the effect might be age-dependent. Methods Glucose tolerance tests were performed in 6-month-old (adult) and 22-month-old (old) male Wistar rats 15min after a single injection of either NRG1 (50μg/kg) or saline (controls). Skeletal muscle and liver samples were also collected 30min after the acute NRG1 or saline treatment, while the phosphorylation status of ErbB receptors and AKT was assessed by Western blotting. Results Acute NRG1 treatment decreased the glycaemic response to an oral glucose load in both adult and old rats. NRG1 injection did not activate ErbB receptors in skeletal muscle, whereas phosphorylation of ErbB3 and AKT was markedly increased in the liver of NRG1-treated adult and old rats compared with controls. Conclusion This study shows that NRG1 has a possible glucose-lowering effect in the liver and via an ErbB3/AKT signaling pathway. This NRG1 effect is also maintained in old rats, suggesting that the NRG1/ErbB signaling pathway might represent a promising therapeutic target in insulin resistance states.


      PubDate: 2016-03-29T05:20:30Z
       
  • Potential influence of Type A personality on plasma C-reactive protein
           levels in people with diabetes
    • Abstract: Publication date: April 2016
      Source:Diabetes & Metabolism, Volume 42, Issue 2
      Author(s): J.-C. Chauvet-Gélinier, B. Trojak, C. Lemogne, L.-S. Aho-Glélé, M.-C. Brindisi, B. Bouillet, E. Ponavoy, V. Meille, I. Simoneau, K. Chahraoui, G. Vaillant, J.-M. Petit, S.M. Consoli, B. Bonin, B. Vergès
      Aim Type A personality, although classically known as a factor linked to increased vascular risk, has recently been associated with increased survival in patients with diabetes. As low-grade inflammation predicts a poor outcome, the present study explored the potential associations between Type A and plasma levels of C-reactive protein (CRP) in diabetes. Methods Type A personality was assessed by the Bortner questionnaire in people with diabetes. The association between Type A and plasma CRP levels was examined by multivariable linear regression, and structural equation modelling (SEM) was performed to determine the impact of the major clinical, biological and psychological confounders. Results The study included 626 participants with type 1 and type 2 diabetes from the Diabetes and Psychological Profile study. Multivariable analyses showed an independent inverse association between Type A score and CRP levels. The structural model adjusted for age, gender, diabetes type and duration, body mass index (BMI), smoking status, alcohol abuse, oral antidiabetic and statin treatments, HbA1c levels, lipids, perceived stress, anxiety and depression revealed significant associations between CRP and Type A (β =−0.135, 95% CI: −0.242, −0.028; P =0.014), BMI (β =0.194, 95% CI: 0.038, 0.350; P =0.015) and HDL cholesterol (β =−0.132, 95% CI: −0.245, −0.020; P =0.014). Conclusion Our present study data indicate that Type A personality is independently associated with lower CRP levels. This lower level of inflammation might explain the better clinical outcomes associated with Type A personality in patients with diabetes.


      PubDate: 2016-03-29T05:20:30Z
       
  • Editorial board
    • Abstract: Publication date: April 2016
      Source:Diabetes & Metabolism, Volume 42, Issue 2




      PubDate: 2016-03-29T05:20:30Z
       
  • Coffee consumption and risk of the metabolic syndrome: A meta-analysis
    • Abstract: Publication date: April 2016
      Source:Diabetes & Metabolism, Volume 42, Issue 2
      Author(s): F. Shang, X. Li, X. Jiang
      Aims The association between coffee consumption and risk of the metabolic syndrome (MetS) remains controversial. For this reason, a meta-analysis including dose–response analysis was conducted to quantitatively summarize the association between coffee intakes and MetS risk. Methods A search was made of PubMed and the China National Knowledge Infrastructure (CNKI) for relevant articles published between 1 January 1999 and 31 May 2015. All observational studies related to the relationship of coffee consumption and risk of MetS were included in the meta-analysis. The result was estimated by a random-effects model, while the dose–response relationship was assessed by a restricted cubic spline model. Results Eleven published reports including 13 studies with a total of 159,805 participants were eligible for our meta-analysis. The aggregated result (and 95% CI) for the highest vs lowest category of coffee consumption was 0.872 (0.781–0.975). After excluding one study with a relative risk (RR)<0.300, the aggregated result (and 95% CI) was 0.889 (0.801–0.986). A non-linear relationship was found between coffee consumption and the MetS in the dose–response analysis. Conclusion This meta-analysis suggests that coffee consumption is associated with a low risk of MetS, and further studies to address the question of causality are now needed.


      PubDate: 2016-03-29T05:20:30Z
       
  • Reduction in cardiovascular and all-cause mortality in the EMPA-REG
           OUTCOME trial: A critical analysis
    • Abstract: Publication date: Available online 5 February 2016
      Source:Diabetes & Metabolism
      Author(s): André J. Scheen



      PubDate: 2016-02-12T14:22:31Z
       
  • Indicators of iron status are correlated with adiponectin expression in
           adipose tissue of patients with morbid obesity
    • Abstract: Publication date: Available online 8 December 2015
      Source:Diabetes & Metabolism
      Author(s): F. Pihan-Le Bars, F. Bonnet, O. Loréal, A.-G. Le Loupp, M. Ropert, E. Letessier, X. Prieur, K. Bach, Y. Deugnier, B. Fromenty, B. Cariou
      Aim The aim of this study was to assess interactions between glucose and iron homoeostasis in the adipose tissue (AT) of obese subjects. Methods A total of 46 obese patients eligible for bariatric surgery were recruited into the study. Anthropometric and biochemical characteristics were assessed, and biopsies of subcutaneous (SCAT) and visceral adipose tissue (VAT) performed. The mRNA levels of genes involved in iron and glucose homoeostasis were measured in their AT and compared with a pool of control samples. Results Gene expression of hepcidin (HAMP) was significantly increased in the SCAT and VAT of obese patients, while transferrin receptor (TFRC) expression was reduced, compared with non-obese controls, suggesting a higher iron load in obese patients. Also, mRNA levels of adiponectin (ADIPOQ) were decreased in both SCAT and VAT in obese patients, and correlated negatively with hepcidin expression, while adiponectin expression was positively correlated with TFRC expression in both SCAT and VAT. Interestingly, TFRC expression in VAT correlated negatively with several metabolic parameters, such as fasting blood glucose and LDL cholesterol. Conclusion Iron content appears to be increased in the SCAT and VAT of obese patients, and negatively correlated with adiponectin expression, which could be contributing to insulin resistance and the metabolic complications of obesity.


      PubDate: 2016-01-22T11:00:12Z
       
  • The new long-acting insulin glargine U300 achieves an early steady
           state with low risk of accumulation
    • Abstract: Publication date: Available online 10 December 2015
      Source:Diabetes & Metabolism
      Author(s): L. Monnier, D.R. Owens, G.B. Bolli



      PubDate: 2016-01-22T11:00:12Z
       
  • Perinatal outcome in a Caucasian population with gestational diabetes and
           preexisting diabetes first diagnosed in pregnancy
    • Abstract: Publication date: Available online 21 December 2015
      Source:Diabetes & Metabolism
      Author(s): F. Corrado, B. Pintaudi, R. D’Anna, A. Santamaria, L. Giunta, A. Di Benedetto
      Aim Our objective was to compare, in a Caucasian population, the perinatal outcomes of pregnancies complicated by pregestational diabetes diagnosed in the first-trimester of pregnancy with those of pregnancies complicated by gestational diabetes. Methods A retrospective evaluation of maternal and neonatal outcomes was performed for all consecutive pregnancies complicated by gestational or pregestational diabetes that happened between 2005 and 2011. Pregestational diabetes was diagnosed for the first time in pregnancy if the first-trimester fasting glycaemia was≥126mg/dL. Gestational diabetes was diagnosed according to Carpenter–Coustan criteria until May 2010, and then according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) panel criteria modified by the American Diabetes Association. A specific diet, self-monitoring of blood glucose and, if required, insulin treatment were prescribed. Results Overall, 411 pregnant women were considered eligible for the study (379 with gestational diabetes and 32 with pregestational diabetes). Women with pregestational vs. gestational diabetes were diagnosed earlier in pregnancy (11.6±1.0 weeks vs. 25.9±1.7 weeks; P =0.0001), had a higher mean first-trimester fasting glycaemic level (129.5±3.6mg/dL vs. 81.6±10.5mg/dL; P =0.0001), more often had a family history of diabetes (46.9% vs. 25.9%; P =0.02) and more often needed insulin treatment (78.1% vs. 14.0%; P =0.0001). Furthermore, a higher rate of fetal malformations in women with pregestational diabetes was detected (9.4% vs. 1.6%, P =0.02). No other differences in neonatal outcomes were identified. Conclusion In a Caucasian population, the prevalence of fetal malformations and insulin requirements with pregestational diabetes first diagnosed in pregnancy were significantly higher compared with women with gestational diabetes. In any case, glucose impairment in pregnancy needs to be diagnosed in a timely fashion and appropriately treated to improve both maternal and fetal outcomes.


      PubDate: 2016-01-22T11:00:12Z
       
  • Carbohydrate metabolism improvement after Helicobacter pylori eradication
    • Abstract: Publication date: Available online 23 December 2015
      Source:Diabetes & Metabolism
      Author(s): M.M. Roca-Rodríguez, L. Coín-Aragüez, I. Cornejo-Pareja, J. Alcaide, C. Clu-Fernández, A. Muñoz-Garach, E. Durán-Martín, L. Mora-Navas, A.M. Gómez-Pérez, M. Molina-Vega, C. Díaz-Perdigones, I. Mancha-Doblas, F.J. Tinahones



      PubDate: 2016-01-22T11:00:12Z
       
  • Association between multiple skin tags and metabolic syndrome: A
           multicentre cross-sectional study in primary care
    • Abstract: Publication date: Available online 22 December 2015
      Source:Diabetes & Metabolism
      Author(s): E.S.Y. Hui, B.H.K. Yip, K.W. Tsang, F.T.T. Lai, K. Kung, S.Y.S. Wong



      PubDate: 2016-01-22T11:00:12Z
       
 
 
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