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Journal Cover Diabetes & Metabolism
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   ISSN (Print) 1262-3636
   Published by Elsevier Homepage  [3041 journals]
  • All-cause mortality in patients with diabetes under glucagon-like
           peptide-1 agonists: A population-based, open cohort study
    • Abstract: Publication date: Available online 18 March 2017
      Source:Diabetes & Metabolism
      Author(s): K.A. Toulis, W. Hanif, P. Saravanan, B.H. Willis, T. Marshall, B. Kumarendran, K. Gokhale, S. Ghosh, K.K. Cheng, P. Narendran, G.N. Thomas, K. Nirantharakumar
      Aim The glucagon-like peptide-1 receptor agonist (GLP1a) liraglutide has been described to benefit patients with type 2 diabetes mellitus (T2DM) at high cardiovascular risk. However, there are still uncertainties relating to these cardiovascular benefits: whether they also apply to an unselected diabetic population that includes low-risk patients, represent a class-effect, and could be observed in a real-world setting. Methods We conducted a population-based, retrospective open cohort study using data derived from The Health Improvement Network database between Jan 2008 to Sept 2015. Patients with T2DM exposed to GLP1a (n =8345) were compared to age, gender, body mass index, duration of T2DM and smoking status-matched patients with T2DM unexposed to GLP1a (n =16,541). Results Patients with diabetes receiving GLP1a were significantly less likely to die from any cause compared to matched control patients with diabetes (adjusted incidence rate ratio [aIRR]: 0.64, 95% CI: 0.56–0.74, P-value<0.0001). Similar findings were observed in low-risk patients (aIRR: 0.64, 95% CI: 0.53–0.76, P -value=0.0001). No significant difference in the risk of incident CVD was detected in the low-risk patients (aIRR: 0.93, 95% CI: 0.83–1.12). Subgroup analyses suggested that effect is persistent in the elderly or across glycated haemoglobin categories. Conclusions GLP1a treatment in a real-world setting may confer additional mortality benefit in patients with T2DM irrespective of their baseline CVD risk, age or baseline glycated haemoglobin and was sustained over the observation period.

      PubDate: 2017-03-21T11:30:58Z
       
  • Characteristics and predictors of obstructive sleep apnoea in patients
           with type 2 diabetes
    • Abstract: Publication date: Available online 17 March 2017
      Source:Diabetes & Metabolism
      Author(s): M. José M.C. Souza, A. Kelley L. Medeiros, M.M.B. Carvalho, C.A. Medeiros, T.C. Lustosa, T. Leiane Guerra de Couto, R.R.M. Silva, M.A.B.B. Correia, R.A.P. Oliveira, M.V.F.P. Silva, I.V. Secundo, R.P. Pedrosa


      PubDate: 2017-03-21T11:30:58Z
       
  • Less liver fibrosis in metabolically healthy compared with metabolically
           unhealthy obese patients with non-alcoholic fatty liver disease
    • Abstract: Publication date: Available online 16 March 2017
      Source:Diabetes & Metabolism
      Author(s): Y. Gutiérrez-Grobe, E. Juárez-Hernández, B.A. Sánchez-Jiménez, M.H. Uribe-Ramos, M.H. Ramos-Ostos, M. Uribe, N.C. Chávez-Tapia
      Aim This cross-sectional study evaluated liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD), and compared the characteristics of metabolically healthy obese (MHO) with metabolically unhealthy obese (MUHO) patients. Methods The study was nested within a randomized clinical trial (RCT) and included obese patients with NAFLD, as determined by liver ultrasonography. Fibrosis was assessed by transient elastography, and AST-to-platelet ratio index (APRI) and NAFLD score. Patients were compared according to obesity phenotype using various accepted criteria. Results The RCT included 1024 patients with NAFLD, of whom 428 (41.7%) were included in the present study. The prevalence of MHO ranged from 1.2% to 63%, depending on the criteria used. According to various criteria for metabolic health, obese patients had less liver fibrosis. MHO patients, as defined by all criteria, showed a significantly lower prevalence of advanced liver fibrosis (F3–F4) than MUHO on transient elastography (16.5% vs. 28%, respectively; P ≤0.05). Conclusion MUHO patients are at higher risk of liver fibrosis and, therefore, the identification of obese patients with ‘healthy’ characteristics is imperative as their entire clinical work-ups are likely to differ.

      PubDate: 2017-03-21T11:30:58Z
       
  • Diabetes remission after bariatric surgery in obese patients with
           haemochromatosis
    • Abstract: Publication date: Available online 14 March 2017
      Source:Diabetes & Metabolism
      Author(s): F. Phan, C. Vatier, C. Vauloup-Soupault, C. Poitou, J.-L. Bouillot, J.-M. Oppert, J. Aron-Wisnewsky


      PubDate: 2017-03-16T11:19:21Z
       
  • Increase in cortisol/ACTH ratio after chronic treatment with liraglutide
           in patients with type 2 diabetes
    • Abstract: Publication date: Available online 7 March 2017
      Source:Diabetes & Metabolism
      Author(s): S. Kamei, H. Kaneto, A. Tanabe, T. Kinoshita, A. Obata, T. Kimura, H. Hirukawa, F. Tatsumi, M. Shimoda, K. Kohara, Takatoshi Anno, S. Nakanishi, T. Mune, K. Kaku


      PubDate: 2017-03-09T10:08:53Z
       
  • Hyperglycaemia within the first month after allogeneic haematopoietic
           stem-cell transplantation is an independent risk factor for overall
           survival in patients with acute myeloid leukaemia
    • Abstract: Publication date: Available online 6 March 2017
      Source:Diabetes & Metabolism
      Author(s): F. Aberer, S. Kremser, J.K. Mader, W. Zinke-Cerwenka, H. Greinix, N.J. Tripolt, T.R. Pieber, A. Zebisch, H. Sill, A. Oulhaj, H. Sourij, A. Wölfler


      PubDate: 2017-03-09T10:08:53Z
       
  • Oxidative and energetic stresses mediate beta-cell dysfunction induced by
           PGC-1α
    • Abstract: Publication date: Available online 1 March 2017
      Source:Diabetes & Metabolism
      Author(s): A. Besseiche, J.-P. Riveline, L. Delavallée, F. Foufelle, J.-F. Gautier, B. Blondeau
      Aim Alteration of functional beta-cell mass in adults can be programmed by adverse events during fetal life. Previously, it was demonstrated that high glucocorticoid (GC) levels during fetal life participate in this programming by inhibition of beta-cell development. More specifically, GC levels stimulate expression of peroxisome proliferator-activated receptor-gamma coactivator 1-alpha (PGC-1α), a transcriptional co-regulator of the GC receptor (GR), which per se impairs beta-cell mass and function when overexpressed. As PGC-1α is also a potent inducer of mitochondrial biogenesis, our study aimed to determine how PGC-1α modifies mitochondrial function in beta cells and how it might regulate insulin secretion. Methods Beta-cell function was studied in mice overexpressing PGC-1α specifically in beta cells and in MIN6 cells overexpressing PGC-1α in vitro. Results PGC-1α overexpression in beta cells in vivo leads to a reduced beta-cell mass early in fetal life, whereas PGC-1α overexpression in vitro stimulates mitochondrial biogenesis and respiratory activity without improving ATP production, while increasing oxidative stress and impairing insulin secretion in response to glucose. While oxidative stress with PGC-1α overexpression in beta cells activates AMPK, it has also been revealed that blocking such oxidative stress or AMPK activation restores insulin secretion. Conclusion PGC-1α induces oxidative stress, which disrupts insulin secretion by AMPK activation. Thus, control of oxidative or energetic stress in beta cells may help to restore insulin secretion.

      PubDate: 2017-03-03T09:43:31Z
       
  • Association between diabetes and changes in hearing: A cross-sectional
           study
    • Abstract: Publication date: Available online 1 March 2017
      Source:Diabetes & Metabolism
      Author(s): S. Lebech Cichosz, O. Hejlesen


      PubDate: 2017-03-03T09:43:31Z
       
  • Moderate intensity sports and exercise is associated with glycaemic
           control in women with gestational diabetes
    • Abstract: Publication date: Available online 24 February 2017
      Source:Diabetes & Metabolism
      Author(s): S.F. Ehrlich, M.M. Hedderson, S.D. Brown, B. Sternfeld, L. Chasan-Taber, J. Feng, J. Adams, J. Ching, Y. Crites, C.P. Quesenberry, A. Ferrara
      Aim To assess the association of regular, unsupervised sports and exercise during pregnancy, by intensity level, with glycaemic control in women with gestational diabetes (GDM). Methods Prospective cohort study of 971 women who, shortly after being diagnosed with GDM, completed a Pregnancy Physical Activity Questionnaire assessing moderate and vigorous intensity sports and exercise in the past 3 months. Self-monitored capillary glucose values were obtained for the 6-week period following the questionnaire, with optimal glycaemic control defined≥80% values meeting the targets<5.3mmol/L for fasting and <7.8mmol/L 1-hour after meals. Logistic regression estimated the odds of achieving optimal control; linear regression estimated activity level-specific least square mean glucose, as well as between-level mean glucose differences. Results For volume of moderate intensity sports and exercise ([MET×hours]/week), the highest quartile, compared to the lowest, had significantly increased odds of optimal control (OR=1.82 [95% CI: 1.06–3.14] P =0.03). There were significant trends for decreasing mean 1-hour post breakfast, lunch and dinner glycaemia with increasing quartile of moderate activity (all P <0.05). Any participation in vigorous intensity sports and exercise was associated with decreased mean 1-hour post breakfast and lunch glycaemia (both P <0.05). No associations were observed for fasting. Conclusion Higher volumes of moderate intensity sports and exercise, reported shortly after GDM diagnosis, were significantly associated with increased odds of achieving glycaemic control. Clinicians should be aware that unsupervised moderate intensity sports and exercise performed in mid-pregnancy aids in subsequent glycaemic control among women with GDM.

      PubDate: 2017-02-24T09:22:30Z
       
  • Multicentre randomized controlled trial with sensor-augmented pump vs
           multiple daily injections in hospitalized patients with type 2 diabetes in
           China: Time to reach target glucose
    • Abstract: Publication date: Available online 21 February 2017
      Source:Diabetes & Metabolism
      Author(s): W. Gu, Y. Liu, Y. Chen, W. Deng, X. Ran, L. Chen, D. Zhu, J. Yang, J. Shin, S.W. Lee, T.L. Cordero, Y. Mu
      Aim Sensor-augmented pump (SAP) technology, which combines continuous subcutaneous insulin infusion (CSII) and real-time continuous glucose monitoring (RT-CGM), has been available for several years in China. In this study, the time required to reach predefined glycaemic targets with SAP vs multiple daily injection (MDI) therapy was compared in hospitalized patients with type 2 diabetes mellitus (T2DM). Methods Adults (aged 18–65 years) with T2DM treated with insulin and admitted to hospital for glucose management were randomized to either SAP (Medtronic MiniMed™ Paradigm™ 722 system) or MDI with blinded CGM (Medtronic MiniMed CGMS System Gold™) for a 2-week period. Glycaemic targets were defined as three preprandial measurements between 80 and 130mg/dL (4.4 and 7.2mmol/L) and three 2-h postprandial measurements between 80 and 180mg/dL (4.4 and 10.0mmol/L) within the same day. Results When data from 81 patients (40 SAP, 41 MDI) were analysed, 21 patients using SAP therapy, compared with six using MDI therapy, achieved their glycaemic targets within 3 days, and their time to reach their glucose targets was significantly shorter (3.7±1.1 vs 6.3±3.1 days for MDI; P <0.001), while three MDI patients failed to reach glycaemic targets within 14 days. SAP vs MDI patients experienced significantly less hypoglycaemia [sensor glucose<50mg/dL (2.8mmol/L): 0.04% vs 0.32%, respectively; P <0.05] and significantly less hyperglycaemia [sensor glucose>180mg/dL (10mmol/L): 21.56% vs 35.03%, respectively; P <0.05]. Conclusion SAP vs MDI therapy in hospitalized patients with T2DM significantly reduced the time required to achieve glycaemic targets, and such systems may be a cost-effective way to improve glucose control and reduce hospital stays in T2DM patients.

      PubDate: 2017-02-24T09:22:30Z
       
  • The novel adipokine/hepatokine fetuin B in severe human and murine
           diabetic kidney disease
    • Abstract: Publication date: Available online 14 February 2017
      Source:Diabetes & Metabolism
      Author(s): S. Kralisch, A. Hoffmann, N. Klöting, A. Bachmann, J. Kratzsch, M. Blüher, M.-Z. Zhang, R.C. Harris, M. Stumvoll, M. Fasshauer, T. Ebert


      PubDate: 2017-02-17T08:43:37Z
       
  • Maternal and paternal family history of diabetes in second-degree
           relatives and metabolic outcomes at age 5–6 years: The ABCD Study
    • Abstract: Publication date: Available online 10 February 2017
      Source:Diabetes & Metabolism
      Author(s): A.J.J.M. Oostvogels, C.P. Landstra, L. Britsemmer, R. Lodewijkx, K. Stronks, T.J. Roseboom, T.G.M. Vrijkotte
      Aim To investigate whether children with a family history of diabetes (FHD) in second-degree relatives (grandparents, aunts/uncles) are at increased risk of developing obesity and diabetes, and whether the risk differs between maternal or paternal transmission. Methods In the multiethnic population-based cohort Amsterdam-Born Children and Their Development (ABCD) Study, body mass index (BMI), waist-to-height ratio (WHR), fat percentage (fat%), fasting glucose and C-peptide in 5- or 6-year-old children with no second-degree FHD (n =2226) were compared with children with maternal-only (n =353), paternal-only (n =281) or both maternal and paternal (n =164) second-degree FHD. Children of diabetic mothers or fathers were excluded. Results None of the children in any of our FHD categories differed in body composition after adjusting for maternal, paternal and childhood lifestyle covariates. However, children with both maternal and paternal second-degree FHD had increased C-peptide levels (0.03nmol, 95% CI: 0.01–0.05) compared with those in the other three study groups. Results were similar when analyses were restricted to only the Dutch children. Conclusion Children with FHD in second-degree relatives on both maternal and paternal sides already have higher C-peptide levels at an early age. This might be the result of a double burden of a shared obesogenic lifestyle, or of more diverse diabetogenic genes compared to children without FHD or with only FHD in one side of the family. In any case, second-degree FHD could be used as a public-health screening tool to identify children at risk of adverse metabolic outcomes and of possible future disease.

      PubDate: 2017-02-11T08:08:37Z
       
  • Basal insulin treatment intensification in patients with type 2 diabetes
           mellitus: A comprehensive systematic review of current options
    • Abstract: Publication date: Available online 4 February 2017
      Source:Diabetes & Metabolism
      Author(s): D. Raccah
      Aim As type 2 diabetes mellitus progresses, most patients require treatment with basal insulin in combination with another agent to achieve recommended glycaemic targets. The purpose of this systematic review was to examine the evidence supporting the use of the available add-on treatments [rapid-acting insulin (RAI), glucagon-like peptide-1 receptor agonists (GLP-1 RAs), dipeptidyl peptidase (DPP)-4 inhibitors and sodium–glucose cotransporter-2 (SGLT-2) inhibitors] to basal insulin. Methods MEDLINE, EMBASE and EBSCOhost were searched for English-language articles, and all those captured were original articles (case studies and narrative reviews were omitted). Data on study design, population demographics, interventions and outcomes were tabulated. The extracted outcome data included changes in glycated haemoglobin (HbA1c), fasting plasma glucose (FPG) and postprandial plasma glucose (PPG), as well as body weight and safety data. Results A total of 88 publications were deemed relevant. All treatments reduced HbA1c and FPG. The most pronounced reductions in PPG, an unmet need in patients not controlled by basal insulin, were seen following administration of RAIs and short-acting GLP-1 RAs, although data for this outcome are generally lacking. Body weight benefits were observed with GLP-1 RAs and SGLT-2 inhibitors. However, as only articles in English were included, the result was a possible publication bias, while the diversity of study designs and drug combinations limited comparisons between studies. Conclusion The evidence supports effectiveness of the available add-on treatments to basal insulin. However, other factors, such as potential body-weight increases, convenience/compliance and adverse events, particularly hypoglycaemia, should be considered on a patient-by-patient basis to optimalize treatment outcomes.

      PubDate: 2017-02-05T01:29:20Z
       
  • Exercise and ectopic fat in type 2 diabetes: A systematic review and
           meta-analysis
    • Abstract: Publication date: Available online 2 February 2017
      Source:Diabetes & Metabolism
      Author(s): A. Sabag, K.L. Way, S.E. Keating, R.N. Sultana, H.T. O’Connor, M.K. Baker, V.H. Chuter, J. George, N.A. Johnson
      Ectopic adipose tissue surrounding the intra-abdominal organs (visceral fat) and located in the liver, heart, pancreas and muscle, is linked to cardio-metabolic complications commonly experienced in type 2 diabetes. A systematic review and meta-analysis was performed to determine the effect of exercise on ectopic fat in adults with type 2 diabetes. Relevant databases were searched to February 2016. Included were randomised controlled studies, which implemented≥4 weeks of aerobic and/or resistance exercise and quantified ectopic fat via magnetic resonance imaging, computed tomography, proton magnetic resonance spectroscopy or muscle biopsy before and after intervention. Risk of bias and study quality was assessed using Egger's funnel plot test and modified Downs and Black checklist, respectively. Of the 10,750 studies retrieved, 24 were included involving 1383 participants. No studies were found assessing the interaction between exercise and cardiac or pancreas fat. One study assessed the effect of exercise on intramyocellular triglyceride concentration. There was a significant pooled effect size for the meta-analysis comparing exercise vs. control on visceral adiposity (ES=−0.21, 95% CI: −0.37 to −0.05; P =0.010) and a near-significant pooled effect size for liver steatosis reduction with exercise (ES=−0.28, 95% CI: −0.57 to 0.01; P =0.054). Aerobic exercise (ES=−0.23, 95% CI: −0.44 to −0.03; P =0.025) but not resistance training exercise (ES=−0.13, 95% CI: −0.37 to 0.12; P =0.307) was effective for reducing visceral fat in overweight/obese adults with type 2 diabetes. These data suggest that exercise effectively reduces visceral and perhaps liver adipose tissue and that aerobic exercise should be a key feature of exercise programs aimed at reducing visceral fat in obesity-related type 2 diabetes. Further studies are required to assess the relative efficacy of exercise modality on liver fat reduction and the effect of exercise on pancreas, heart, and intramyocellular fat in type 2 diabetes and to clarify the effect of exercise on ectopic fat independent of weight loss.

      PubDate: 2017-02-05T01:29:20Z
       
  • What is the evidence for metabolic surgery for type 2 diabetes? A
           critical perspective
    • Abstract: Publication date: February 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 1
      Author(s): C. Amouyal, F. Andreelli
      Bariatric surgery has emerged as a highly effective treatment not only for obesity, but also for type 2 diabetes (T2D). A meta-analysis has reported the complete resolution of T2D in 78.1% of cases of morbidly obese patients after bariatric surgery. Such extraordinary results obtained in diabetic patients with body mass index (BMI) scores>35kg/m2 have led investigators to question whether similar results might be achieved in patients with BMIs<35kg/m2. Preliminary studies suggest that metabolic surgery is safe and effective in patients with T2D and a BMI<35kg/m2, whereas other studies report that metabolic surgery is less effective for promoting T2D remission in these patients. Thus, the results are discordant. Long-term studies would be useful for determining the safety, efficacy and cost-effectiveness of metabolic surgery for this population with T2D. In 2015, it is probably premature to say that metabolic surgery is an accepted treatment option for T2D patients with BMIs<35kg/m2.

      PubDate: 2017-02-05T01:29:20Z
       
  • Increase in resting heart rate over 2 years predicts incidence of
           diabetes: A 10-year prospective study
    • Abstract: Publication date: February 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 1
      Author(s): G. Kim, Y.-h. Lee, J.Y. Jeon, H. Bang, B.-W. Lee, E.S. Kang, I.-K. Lee, B.-S. Cha, C.S. Kim
      Objective The association between resting heart rate (RHR) and the development of diabetes has yet to be fully elucidated, and the relationship between changes in RHR and incidence of diabetes also remains unclear. Our study aimed to investigate the association between changes in RHR over 2 years and the risk of diabetes. Methods A total of 7416 adults without diabetes were included. All had participated in the Korean Genome and Epidemiology Study, a community-based, 10-year prospective study in which RHR was measured at baseline and 2 years later. Incident diabetes was defined as fasting blood glucose ≥126mg/dL, 2-h post-load glucose ≥200mg/dL during a 75-g oral glucose tolerance test or current use of diabetes medication. The relative risk of diabetes associated with the 2-year change in RHR was calculated using Cox models. Results During the 10-year follow-up, 1444 (19.5%) developed diabetes. Compared with RHR increases <5 beats per minute (bpm) over 2 years, increases >10bpm were significantly associated with development of diabetes (adjusted hazard ratio: 1.31, 95% confidence interval: 1.06–1.60), even after adjusting for glycometabolic parameters and baseline RHR. This significant association was attenuated in people who exercised regularly (P =0.650), but remained significant in those not doing any regular exercise (P =0.010). Conclusion An increase in RHR over a 2-year follow-up period is significantly associated with a risk of diabetes, independently of baseline RHR and glycometabolic parameters. Further investigations into ways to control RHR as a potential preventative measure against the development of diabetes are now needed.

      PubDate: 2017-02-05T01:29:20Z
       
  • T-cadherin gene variants are associated with type 2 diabetes and the Fatty
           Liver Index in the French population
    • Abstract: Publication date: February 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 1
      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: 2017-02-05T01:29:20Z
       
  • Usefulness of the plasma glucose concentration-to-HbA1c ratio in
           predicting clinical outcomes during acute illness with extreme
           hyperglycaemia
    • Abstract: Publication date: February 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 1
      Author(s): Y.-W. Su, C.-Y. Hsu, Y.-W. Guo, H.-S. Chen
      Aims To evaluate the correlation between the plasma glucose-to-glycated haemoglobin ratio (GAR) and clinical outcome during acute illness. Methods This retrospective observational cohort study enrolled 661 patients who visited the emergency department of our hospital between 1 July 2008 and 30 September 2010 with plasma glucose concentrations>500mg/dL. Systolic blood pressure, heart rate, white blood cells, neutrophils, haematocrit, blood urea nitrogen, serum creatinine, liver function and plasma glucose concentration were recorded at the initial presentation to the emergency department. Data on glycated haemoglobin over the preceding 6 months were reviewed from our hospital database. The glucose-to-HbA1c ratio (GAR) was calculated as the plasma glucose concentration divided by glycated haemoglobin. Results The GAR of those who died was significantly higher than that of the survivors (81.0±25.9 vs 67.6±25.0; P <0.001). There was a trend towards a higher 90-day mortality rate in patients with higher GARs (log-rank test P <0.0001 for trend). On multivariate Cox regression analysis, the GAR was significantly related to 90-day mortality (hazard ratio [HR] for 1 standard deviation [SD] change: 1.41, 95% confidence interval [CI]: 1.22–1.63; P <0.001), but not to plasma glucose (HR: 0.89, 95% CI: 0.70–1.13; P =0.328). Rates of intensive care unit (ICU) admission and mechanical ventilator use were also higher in those with higher GARs. Conclusion GAR independently predicted 90-day mortality, ICU admission and use of mechanical ventilation. It was also a better predictor of patient outcomes than plasma glucose alone in patients with extremely high glucose levels.

      PubDate: 2017-02-05T01:29:20Z
       
  • Efficacy and safety of DPP-4 inhibitors in patients with type 2 diabetes:
           Meta-analysis of placebo-controlled randomized clinical trials
    • Abstract: Publication date: February 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 1
      Author(s): M.B. Rehman, B.V. Tudrej, J. Soustre, M. Buisson, P. Archambault, D. Pouchain, H. Vaillant-Roussel, F. Gueyffier, J.-L. Faillie, M.-C. Perault-Pochat, C. Cornu, R. Boussageon
      Background Guidelines for type 2 diabetes (T2D) recommend reducing HbA1c through lifestyle interventions and glucose-lowering drugs (metformin, then combination with dipeptidyl peptidase-4 inhibitors [DPP-4Is] among other glucose-lowering drugs). However, no double-blind randomized clinical trial (RCT) compared with placebo has so far demonstrated that DDP-4Is reduce micro- and macrovascular complications in T2D. Moreover, the safety of DPP-4Is (with increased heart failure and acute pancreatitis) remains controversial. Methods A systematic review of the literature (PubMed, Cochrane Library Central Register of Controlled Trials [CENTRAL] and https://clinicaltrials.gov), including all RCTs vs placebo published up to May 2015 and the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS), published June 2015, was performed. Primary endpoints were all-cause mortality and death from cardiovascular causes; secondary endpoints were macrovascular and microvascular events. Safety endpoints were acute pancreatitis, pancreatic cancer, serious adverse events and severe hypoglycaemia. Results A total of 36 double-blind RCTs were included, allowing analyses of 54,664 patients. There were no significant differences in all-cause mortality (RR=1.03, 95% confidence interval [CI]=0.95–1.12), cardiovascular mortality (RR=1.02, 95% CI=0.92–1.12), myocardial infarction (RR=0.98, 95% CI=0.89–1.08), strokes (RR=1.02, 95% CI=0.88–1.17), renal failure (RR=1.06, 95% CI=0.88–1.27), severe hypoglycaemia (RR=1.14, 95% CI=0.95–1.36) and pancreatic cancer (RR=0.54, 95% CI=0.28–1.04) with the use of DPP-4Is. However, DDP-4Is were associated with an increased risk of heart failure (RR=1.13, 95% CI=1.01–1.26) and of acute pancreatitis (RR=1.57, 95% CI=1.03–2.39). Conclusion There is no significant evidence of short-term efficacy of DPP-4Is on either morbidity/mortality or macro-/microvascular complications in T2D. However, there are warning signs concerning heart failure and acute pancreatitis. This suggests a great need for additional relevant studies in future.

      PubDate: 2017-02-05T01:29:20Z
       
  • Relationship between achieved personalized glycaemic targets and
           monitoring of clinical events in elderly diabetic patients
    • Abstract: Publication date: February 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 1
      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: 2017-02-05T01:29:20Z
       
  • Relationship between HHV8 infection markers and insulin sensitivity in
           ketosis-prone diabetes
    • Abstract: Publication date: February 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 1
      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: 2017-02-05T01:29:20Z
       
  • 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: February 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 1
      Author(s): T.-J. Hsiao, E. Lin


      PubDate: 2017-02-05T01:29:20Z
       
  • Autoimmune diabetes superimposed on type 2 diabetes in a patient initiated
           on immunotherapy for lung cancer
    • Abstract: Publication date: February 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 1
      Author(s): M. Alhusseini, J. Samantray


      PubDate: 2017-02-05T01:29:20Z
       
  • Adiposity induced by interleukin-17A blockade
    • Abstract: Publication date: February 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 1
      Author(s): T. Nakamura, Y. Iwasaki, S. Yamane, M. Ogura, A. Yasoda, K. Nagashima, N. Inagaki


      PubDate: 2017-02-05T01:29:20Z
       
  • Hypoglycaemia revealing heterozygous insulin receptor mutations
    • Abstract: Publication date: February 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 1
      Author(s): V. Preumont, C. Feincoeur, O. Lascols, C. Courtillot, P. Touraine, D. Maiter, C. Vigouroux


      PubDate: 2017-02-05T01:29:20Z
       
  • Fasting serum C-peptide levels (>1.6ng/mL) can predict the presence of
           insulin resistance in Japanese patients with type 2 diabetes
    • Abstract: Publication date: February 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 1
      Author(s): H. Yanai, Y. Hirowatari


      PubDate: 2017-02-05T01:29:20Z
       
  • Increased fibrosis and angiogenesis in subcutaneous gluteal adipose tissue
           in nascent metabolic syndrome
    • Abstract: Publication date: Available online 1 February 2017
      Source:Diabetes & Metabolism
      Author(s): I. Jialal, B. Adams-Huet, A. Major, S. Devaraj
      Aims Metabolic syndrome (MetS) is globally a common disorder that predisposes to both diabetes and cardiovascular disease (CVD). There is a paucity of data on fibrosis and angiogenesis in adipose tissue (AT) in patients with nascent MetS uncomplicated by diabetes or CVD. Hence, we assayed various indices of fibrosis and angiogenesis in subcutaneous AT (SAT). Methods In both patients with MetS and matched controls, we determined fibrosis and the densities of CD31, VEGF and Angiopoietin (Angio) 2 and 1 by immunohistochemistry in gluteal SAT. Results The fibrosis score was significantly increased in SAT of Met S. Also, both CD31 and VEGF densities were significantly increased. Surprisingly, Angio-2 was not increased and the ratio of Angio2:1 was decreased. Both indices of fibrosis and angiogenesis correlated with biomediators of inflammation. Conclusions In conclusion, we report increased fibrosis and paradoxical increased angiogenesis in gluteal SAT and speculate that the increased angiogenesis is a protective mechanism in mitigating further adipose tissue dysregulation in this depot.

      PubDate: 2017-02-05T01:29:20Z
       
  • Early age at menarche and gestational diabetes mellitus risk: Results from
           the Healthy Baby Cohort study
    • Abstract: Publication date: Available online 1 February 2017
      Source:Diabetes & Metabolism
      Author(s): H. Li, L. Shen, L. Song, B. Liu, X. Zheng, S. Xu, Y. Wang
      Aim Early age at menarche has been reported to increase type 2 diabetes risk, but little is known of its impact on gestational diabetes mellitus (GDM) risk. The aim of this study was to examine the association between age at menarche and plasma glucose levels as well as GDM risk. Methods A total of 6900 pregnant women from the Healthy Baby Cohort Study were included in our analysis. Age at menarche was self-reported and categorized into five groups (9–11, 12, 13, 14 and 15–18 years of age). GDM was diagnosed using the International Association of Diabetes and Pregnancy Study Groups criteria. Comparisons of plasma glucose levels according to age at menarche categories were performed using analysis of covariance. Logistic regression models were used to estimate the association between age at menarche and GDM risk. Results Of our 6900 participants, 1015 (14.7%) were diagnosed with GDM. Mean age at menarche was 13.1±1.2 years. Early age at menarche (9–11 years) was associated with higher fasting, 1-h and 2-h plasma glucose levels (all P <0.05) compared with menarche at age 13 years. Furthermore, early age at menarche was linked to increased GDM risk after adjusting for potential confounders (OR: 1.41, 95% CI: 1.06–1.87). Conclusion Early age at menarche is an independent risk factor for GDM and, as such, may help to identify women at higher GDM risk who would benefit from early preventative strategies.

      PubDate: 2017-02-05T01:29:20Z
       
  • Successful endoscopic ultrasound-guided ethanol ablation of a symptomatic
           sporadic insulinoma in a patient with severe comorbidities not suitable
           for pancreatic surgery
    • Abstract: Publication date: Available online 1 February 2017
      Source:Diabetes & Metabolism
      Author(s): K. Burghardt, D. Kaemmerer, A. Michael, R. Aschenbach, U.A. Müller, C. Kloos, G. Wolf


      PubDate: 2017-02-05T01:29:20Z
       
  • Predicting severe hypoglycaemia with self-monitoring of blood glucose in
           type 1 diabetes
    • Abstract: Publication date: Available online 1 February 2017
      Source:Diabetes & Metabolism
      Author(s): A. Moutairou, R. Roussel, B. Charbonnel, A. Leye, B. Detournay, K. Mohammedi, L. Potier


      PubDate: 2017-02-05T01:29:20Z
       
  • Increased odds of metabolic syndrome with consumption of high dietary
           advanced glycation end products in adolescents
    • Abstract: Publication date: Available online 1 February 2017
      Source:Diabetes & Metabolism
      Author(s): A. Saha, P. Poojary, L. Chan, K. Chauhan, G. Nadkarni, S. Coca, J. Uribarri


      PubDate: 2017-02-05T01:29:20Z
       
  • Effects of reducing blood pressure on renal outcomes in patients with type
           2 diabetes: Focus on SGLT2 inhibitors and EMPA-REG OUTCOME
    • Abstract: Publication date: Available online 30 January 2017
      Source:Diabetes & Metabolism
      Author(s): A.J. Scheen, P. Delanaye
      Empagliflozin, a sodium–glucose cotransporter type 2 (SGLT2) inhibitor, has enabled remarkable reductions in cardiovascular and all-cause mortality as well as in renal outcomes in patients with type 2 diabetes (T2D) and a history of cardiovascular disease in the EMPA-REG OUTCOME. These results have been attributed to haemodynamic rather than metabolic effects, in part due to the osmotic/diuretic action of empagliflozin and the reduction in arterial blood pressure (BP). The present narrative review includes the results of meta-analyses of trials evaluating the effects on renal outcomes of lowering BP in patients with T2D, with a special focus on the influence of baseline and achieved systolic BP, and compares the renal outcome results of the EMPA-REG OUTCOME with those of other major trials with inhibitors of the renin–angiotensin system in patients with T2D and the preliminary findings with other SGLT2 inhibitors, and also evaluates post hoc analyses from the EMPA-REG OUTCOME of special interest as regards the BP-lowering hypothesis and renal function. While systemic BP reduction associated to empagliflozin therapy may have contributed to the renal benefits reported in EMPA-REG OUTCOME, other local mechanisms related to kidney homoeostasis most probably also played a role in the overall protection observed in the trial.

      PubDate: 2017-02-05T01:29:20Z
       
  • Septic ketoacidosis: Evidence from patient autopsies
    • Abstract: Publication date: Available online 27 January 2017
      Source:Diabetes & Metabolism
      Author(s): C. Palmiere, M.P. Scarpelli


      PubDate: 2017-01-30T00:58:07Z
       
  • FGF21 deficiency is associated with childhood obesity, insulin resistance
           and hypoadiponectinaemia: The BCAMS Study
    • Abstract: Publication date: Available online 27 January 2017
      Source:Diabetes & Metabolism
      Author(s): G. Li, J. Yin, J. Fu, L. Li, S.F.A. Grant, C. Li, M. Li, J. Mi, M. Li, S. Gao
      Objective Fibroblast growth factor 21 (FGF21) exerts beneficial effects on metabolic homoeostasis and has been reported to be regulated by adiponectin, leptin and resistin. However, while an association between increased circulating FGF21 and metabolic disorders has been reported in adults, paediatric-specific data are lacking. Design and methods This study investigated the relationship between FGF21 levels and obesity, insulin resistance (IR), the metabolic syndrome (MetS) and adipokines (adiponectin, leptin and resistin) in a cohort of 3231 Chinese youngsters aged 6–18. Results There were gender- and puberty-related differences in FGF21 levels. Unexpectedly, FGF21 levels were decreased in children with obesity, and negatively correlated with insulin, HOMA-IR and leptin levels after adjusting for age, gender, puberty and lifestyle factors. Moreover, multiple regression analyses showed that serum FGF21 positively predicted adiponectin levels while resistin positively predicted FGF21 levels independent of BMI (P <0.05). Children in the lowest FGF21 quintile were more likely to have IR (OR: 1.85, 95% CI: 1.41–2.42; P =0.002) and MetS (OR: 1.62, 95% CI: 1.14–2.28; P =0.007) than those in the highest quintile. Further adjusting for BMI and/or the three adipokines modified the association of FGF21 with MetS (P >0.10) but not with IR (P <0.01). Conclusion Although the associations between adiponectin, leptin, resistin and metabolic abnormalities in our paediatric population were similar to those in adults, correlations of FGF21 levels with obesity, IR and MetS were the inverse of those found in adults. Our present findings suggest that FGF21 deficiency, rather than resistance, contribute to IR and hypoadiponectinaemia independently of obesity in young people.

      PubDate: 2017-01-30T00:58:07Z
       
  • Brain-derived neurotrophic factor and insulin resistance during
           hyperinsulinaemic–euglycaemic clamp in type 1 diabetes patients in the
           PoProStu
    • Abstract: Publication date: Available online 27 January 2017
      Source:Diabetes & Metabolism
      Author(s): A. Uruska, P. Niedzwiecki, A. Araszkiewicz, D. Zozulinska-Ziolkiewicz


      PubDate: 2017-01-30T00:58:07Z
       
  • Predictors of cardiovascular risk among patients with type 1 diabetes: A
           critical analysis of the metabolic syndrome and its components
    • Abstract: Publication date: Available online 27 January 2017
      Source:Diabetes & Metabolism
      Author(s): V. Gingras, C. Leroux, A. Fortin, L. Legault, R. Rabasa-Lhoret
      Patients with type 1 diabetes (T1D) are at increased risk for cardiovascular diseases. The metabolic syndrome (MetS), a complex disorder defined by a cluster of interconnected factors including abdominal obesity, hypertension, dyslipidaemia and insulin resistance, has been proposed to identify patients with T1D at high cardiovascular risk. The MetS has been identified in 8–45% of patients with T1D, depending on the definition and cohort studied. However, clinicians and researchers face several issues with the criteria for MetS in patients with T1D, therefore questioning its value in routine care. For example, three criteria can lead to overestimation of MetS prevalence; the impaired fasting glucose criterion is irrelevant as it is automatically fulfilled; and the widespread use of antihypertensive and lipid-lowering medications for cardiac and renal preventative purposes can contribute to overestimations of the prevalence of raised blood pressure and elevated triglycerides. In cross-sectional studies, the MetS has been associated mostly with an increased risk of microvascular complications whereas, in prospective cohorts, the predictive value of MetS for micro- and macrovascular outcomes has been inconsistent. While identifying diabetes patients at increased risk for cardiovascular complications and early mortality is crucial from a prevention standpoint, for patients with T1D, the current definition of MetS may not be the most suitable tool. The aims of the present report are to review the applicability and limitations of the MetS in patients with T1D, and to discuss alternative avenues to identify high-risk patients.

      PubDate: 2017-01-30T00:58:07Z
       
  • Adipose tissue is influenced by hypoxia of obstructive sleep apnea
           syndrome independent of obesity
    • Abstract: Publication date: Available online 26 January 2017
      Source:Diabetes & Metabolism
      Author(s): C.E. Thorn, B. Knight, E. Pastel, L.J. McCulloch, B. Patel, A.C. Shore, K. Kos
      Aims Obstructive sleep apnea syndrome (OSAS) is associated with increased cardiovascular risk and diabetes independent of obesity. We investigated whether adipose tissue dysfunction is exacerbated due to increased tissue hypoxia. Methods Adipose tissue (AT) oxygenation was measured with a Clarke-type electrode (pATO2) in 16 men with OSAS before and after 4 months of continuous positive airway pressure therapy (CPAP) and in BMI-matched controls. Oxygenation was simultaneously monitored in arterial blood by pulse oximetry (SaO2); mixed blood in AT microcirculation by reflectance spectroscopy (SATO2) along with blood flow. Markers of hypoxia, adipo- and angiogenesis, inflammation and fibrosis were analysed in AT and serum. Results OSAS subjects were more insulin resistant. Despite lower arterial SaO2 (95.4±1.3% vs. 97.1±1.6%, P =0.013) in subjects with OSAS, there was no difference in the oxygen content of AT microcirculation (61.6±18.4 vs. 72.2±7.0%, P =0.07) or pATO2 (49.2±7.5 vs. 50.4±14.7mmHg, P =0.83) between groups. Resting AT blood flow was higher in OSAS compared to controls (108.5±22.7 vs. 78.9±24.9au, P <0.005) and strongly associated with inflammation markers IL-6 and MCP-1. AT of OSAS subjects showed increased inflammation (TNFA P =0.049) and fibrosis (COL3A1 P =0.02), a trend of higher HIF1A expression (P =0.06) and reduced adipogenesis (PPARG P =0.006). After CPAP, only expression of the lipid deposition marker LPL increased (30%, P =0.047). Conclusions Adipose tissue of awake OSAS subjects appears no more hypoxic than adipose tissue of BMI-matched controls despite daytime hypoxaemia. Increased adipose tissue blood flow may be explained by an increased inflammatory response. We observe features of adipose dysfunction in subjects with OSAS, which attribute to increased cardiometabolic risk associated with this condition.

      PubDate: 2017-01-30T00:58:07Z
       
  • Long-term risk of stroke in type 2 diabetes patients with diabetic
           ketoacidosis: A population-based, propensity score-matched, longitudinal
           follow-up study
    • Abstract: Publication date: Available online 24 January 2017
      Source:Diabetes & Metabolism
      Author(s): Y.-L. Chen, S.-F. Weng, C.-Y. Yang, J.-J. Wang, K.-J. Tien
      Aim To investigate the long-term risk of stroke in type 2 diabetes (T2D) patients with previous episodes of diabetic ketoacidosis (DKA). Methods This retrospective nationwide population-based cohort study was conducted using Taiwan's National Health Insurance database. Claims data from 2000 to 2002 were extracted for 3572 T2D patients with DKA and 7144 controls matched for age, gender, diabetes complications severity index, frequency of clinical visits and baseline comorbidities. Patients with type 1 diabetes (T1D), identified by glucagon C-peptide stimulation or glutamic acid decarboxylase (GAD) antibody blood tests and possession of a catastrophic illness certificate were excluded. All patients were tracked until a new stroke diagnosis, death or the end of 2011. Results Of the 3572 selected patients, 270 with DKA and 404 of the 7144 controls were diagnosed with a new stroke, giving an incidence rate ratio (IRR) of 1.56 (95% CI: 1.34–1.82; P <0.0001). DKA patients had a higher risk of ischaemic stroke than those without DKA (IRR: 1.62, 95% CI: 1.34–1.96; P <0.0001), and DKA patients with hypertension and hyperlipidaemia were at even greater risk of stroke. Also, DKA patients were at particular risk for stroke during the first half-year following DKA diagnosis. After adjusting for patient characteristics and comorbidities, these patients were 1.55 times more likely to have a stroke than those without DKA (95% CI: 1.332–1.813, P <0.0001). Conclusion T2D patients with previous DKA have a higher risk of stroke, especially ischaemic strokes.

      PubDate: 2017-01-30T00:58:07Z
       
  • Association between earlier age at natural menopause and risk of diabetes
           in middle-aged and older Chinese women: The Dongfeng–Tongji cohort study
           
    • Abstract: Publication date: Available online 24 January 2017
      Source:Diabetes & Metabolism
      Author(s): L. Shen, L. Song, H. Li, B. Liu, X. Zheng, L. Zhang, J. Yuan, Y. Liang, Y. Wang
      Aim Age at menopause is associated with cardiovascular disease, but little is known of its relationship with diabetes, and previous findings are controversial. The objective of this study was to evaluate the association between earlier menopause (at age ≤45 years) and the prevalence of diabetes in the Chinese population. Methods A total of 16,299 postmenopausal women, aged 42.0–94.3 years, who completed the study questionnaires, underwent medical examinations and provided blood samples, were included in our analysis. Participants self-reported their age at menopause and were then divided into three age groups (≤45, 46–52, ≥53years). Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results Of the study participants, 2811 (17.2%) had diabetes. The average age at menopause was 49.5±3.3 years. For each 1-year delay in menopausal age, the presence of diabetes was reduced by 2% (OR: 0.98, 95% CI: 0.97–0.99) after adjusting for potential confounding factors. Compared with those whose menopausal age was 46–52 years, the OR for diabetes was 1.20 (95% CI: 1.03–1.39) for those with an earlier menopausal age (≤45years). Conclusion Our findings suggest that earlier menopause may be independently associated with an increased prevalence of diabetes. Future prospective studies are needed to verify this relationship.

      PubDate: 2017-01-30T00:58:07Z
       
  • Effect of weightun heme oxygenase-1 tissue expression
    • Abstract: Publication date: Available online 24 January 2017
      Source:Diabetes & Metabolism
      Author(s): C. Ress, A.R. Moschen, V. Thoeni, C.F. Ebenbichler, H. Weiss, C. Molnar, G. Weiss, H. Tilg, S. Kaser


      PubDate: 2017-01-30T00:58:07Z
       
  • Reproducibility and least significant differences of oral glucose
           tolerance test-derived parameters in a postmenopausal population without
           diabetes
    • Abstract: Publication date: Available online 17 January 2017
      Source:Diabetes & Metabolism
      Author(s): F.P. Van de Velde, A. Dierickx, H. Depypere, J.R. Delanghe, J.-M. Kaufman, B. Lapauw


      PubDate: 2017-01-23T00:17:32Z
       
  • Comparison of two techniques of adiponectin assay, ELISA and
           immunoturbidimetry: Should we move towards standardization?
    • Abstract: Publication date: Available online 12 January 2017
      Source:Diabetes & Metabolism
      Author(s): S. Fellahi, L. Béraud, G. Marlin, C. Vigouroux, J. Warszawski, J. Capeau, J.-P. Bastard


      PubDate: 2017-01-16T09:28:24Z
       
  • An extended fatty liver index to predict non-alcoholic fatty liver disease
    • Abstract: Publication date: Available online 12 January 2017
      Source:Diabetes & Metabolism
      Author(s): K. Kantartzis, I. Rettig, H. Staiger, J. Machann, F. Schick, L. Scheja, A. Gastaldelli, E. Bugianesi, A. Peter, M.B. Schulze, A. Fritsche, H.-U. Häring, N. Stefan
      Background In clinical practice, there is a strong interest in non-invasive markers of non-alcoholic fatty liver disease (NAFLD). Our hypothesis was that the fold-change in plasma triglycerides (TG) during a 2-h oral glucose tolerance test (fold-change TGOGTT) in concert with blood glucose and lipid parameters, and the rs738409 C>G single nucleotide polymorphism (SNP) in PNPLA3 might improve the power of the widely used fatty liver index (FLI) to predict NAFLD. Methods The liver fat content of 330 subjects was quantified by 1H-magnetic resonance spectroscopy. Blood parameters were measured during fasting and after a 2-h OGTT. A subgroup of 213 subjects underwent these measurements before and after 9 months of a lifestyle intervention. Results The fold-change TGOGTT was closely associated with liver fat content (r =0.51, P <0.0001), but had less power to predict NAFLD (AUROC=0.75) than the FLI (AUROC=0.79). Not only was the fold-change TGOGTT independently associated with liver fat content and NAFLD, but so also were the 2-h blood glucose level and rs738409 C>G SNP in PNPLA3. In fact, a novel index (extended FLI) generated from these and the usual FLI parameters considerably increased its power to predict NAFLD (AUROC=0.79–0.86). The extended FLI also increased the power to predict changes in liver fat content with a lifestyle intervention (n =213; standardized beta coefficient: 0.23–0.29). Conclusion This study has provided novel data confirming that the OGTT-derived fold-change TGOGTT and 2-h glucose level, together with the rs738409 C>G SNP in PNPLA3, allow calculation of an extended FLI that considerably improves its power to predict NAFLD.

      PubDate: 2017-01-16T09:28:24Z
       
  • Inhibition or deletion of 11β-HSD1 does not increase angiogenesis in
           ischemic retinopathy
    • Abstract: Publication date: Available online 11 January 2017
      Source:Diabetes & Metabolism
      Author(s): C.T. Davidson, A.R. Dover, C.M. McVicar, R. Megaw, J.V. Glenn, P.W.F. Hadoke, A.W. Stitt, B.R. Walker


      PubDate: 2017-01-16T09:28:24Z
       
  • Branched-chain amino acids are associated with odd-chain fatty acids in
           normoglycaemic individuals
    • Abstract: Publication date: Available online 11 January 2017
      Source:Diabetes & Metabolism
      Author(s): M. Al-Majdoub, N. Geidenstam, A. Ali, M. Ridderstråle, P. Storm, L. Groop, L. Bennet, P. Spégel


      PubDate: 2017-01-16T09:28:24Z
       
  • Factors associated with reaching or not reaching target HbA1c after
           initiation of basal or premixed insulin in patients with type 2 diabetes
    • Abstract: Publication date: Available online 14 December 2016
      Source:Diabetes & Metabolism
      Author(s): A.J. Scheen, H. Schmitt, H.H. Jiang, T. Ivanyi
      Aims To evaluate factors associated with reaching or not reaching target glycated haemoglobin (HbA1c) levels by analysing the respective contributions of fasting hyperglycaemia (FHG), also referred to as basal hyperglycaemia, vs postprandial hyperglycaemia (PHG) before and after initiation of a basal or premixed insulin regimen in patients with type 2 diabetes. Methods This post-hoc analysis of insulin-naïve patients in the DURABLE study randomised to receive either insulin glargine or insulin lispro mix 25 evaluated the percentages of patients achieving a target HbA1c of <7.0% (<53mmol/mol) per baseline HbA1c quartiles, and the effect of each insulin regimen on the relative contributions of PHG and FHG to overall hyperglycaemia. Results Patients had comparable demographic characteristics and similar HbA1c and FHG values at baseline in each HbA1c quartile regardless of whether they reached the target HbA1c. The higher the HbA1c quartile, the greater was the decrease in HbA1c, but also the smaller the percentage of patients achieving the target HbA1c. HbA1c and FHG decreased more in patients reaching the target, resulting in significantly lower values at endpoint in all baseline HbA1c quartiles with either insulin treatment. Patients not achieving the target HbA1c had slightly higher insulin doses, but lower total hypoglycaemia rates. Conclusion Smaller decreases in FHG were associated with not reaching the target HbA1c, suggesting a need to increase basal or premixed insulin doses to achieve targeted fasting plasma glucose and improve patient response before introducing more intensive prandial insulin regimens.

      PubDate: 2016-12-23T07:07:01Z
       
  • Dipeptidyl peptidase-4 inhibitors and protection against stroke: A
           systematic review and meta-analysis
    • Abstract: Publication date: Available online 2 December 2016
      Source:Diabetes & Metabolism
      Author(s): F. Barkas, M. Elisaf, V. Tsimihodimos, H. Milionis
      Background Type 2 diabetes mellitus (T2DM) is associated with an increased risk of stroke and an unfavourable outcome following stroke. Apart from pioglitazone, glucose-lowering modalities have not been shown to protect against stroke. Nevertheless, there is evidence from experimental studies of potential neuroprotective effects with dipeptidyl peptidase (DPP)-4 inhibitors, especially if treatment starts before stroke. Objective To perform a meta-analysis of available evidence regarding the risk of stroke in individuals taking DPP-4 inhibitors. Methods All available data from prospective randomized placebo-controlled trials involving DPP-4 inhibitors in T2DM patients published up to December 2015 were considered. The included trials reported data on the incidence of stroke with a recruitment rate of at least 100 diabetes patients and a follow-up of at least 12 weeks. Results A total of 19 small randomized clinical trials (RCTs) evaluating the efficacy and safety of gliptins (n =9278), along with three multicentre prospective double-blind placebo-controlled RCTs assessing cardiovascular outcomes as the primary endpoint and involving 36,395 T2DM patients, were included in the analysis. Pooled analysis of the small RCTs showed a non-significant trend towards benefit with DPP-4 inhibitors against stroke [odds ratio (OR): 0.639, 95% confidence interval (CI): 0.336–1.212; P =0.170]. In contrast, in the analysis of RCTs reporting on cardiovascular safety, there was no difference in the risk of stroke with gliptin treatment compared with a placebo (OR: 0.996, 95% CI: 0.850–1.166; P =0.958). Conclusion The promising data from experimental studies regarding cardioprotective gliptin-associated effects against stroke were not supported by available data from trials specifically looking at cardiovascular safety.

      PubDate: 2016-12-08T05:52:40Z
       
  • Nut consumption is associated with lower incidence of type 2 diabetes: The
           Tehran Lipid and Glucose Study
    • Abstract: Publication date: Available online 16 November 2016
      Source:Diabetes & Metabolism
      Author(s): G. Asghari, Z. Ghorbani, P. Mirmiran, F. Azizi
      Aim Nuts are rich in unsaturated fatty acids as well as other bioactive constituents. The present study investigated the association between nut consumption and the incidence of type 2 diabetes mellitus (T2DM) in a Middle Eastern population. Methods The study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS), in which 1984 participants (920 men and 1064 women) free of DM, aged≥20 years, were followed from phase III (2005–2008) to phase V (2011–2014). Dietary data were obtained from valid and reliable food-frequency questionnaires at baseline. Using multiple logistic regression, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated, with adjustments for age, gender, BMI, serum cholesterol and triglycerides, smoking and energy intake. Results Study participants’ means±SD of age and of BMI were 40.1±13.1 years and 27.0±4.8kg/m2, respectively. The median±SE of their total daily consumption of nuts was 1.19±0.11 servings. After 6.2±0.7 years of follow-up, 150 cases of T2DM were confirmed. On comparing those who consumed ≥4 servings/week with those who consumed <1 serving/week, the age-/energy-adjusted OR of incident T2DM for total nut consumption was 0.64 (95% CI: 0.36–1.12; P for trend = 0.03). In a fully adjusted model, nut consumption was associated with a lower risk of T2DM, and the ORs (95% CIs) of risk for those consuming 2–3.99 and ≥4 servings/week of nuts were 0.51 (0.26–0.97) and 0.47 (0.25–0.90), respectively, compared with those consuming <1 serving/week (P <0.001 for trend). Conclusion Our findings suggest that consuming ≥4 servings/week of nuts reduced the risk of T2DM compared with <1 serving/week.

      PubDate: 2016-11-23T10:26:57Z
       
  • Intellectual disability in patients with MODY due to hepatocyte nuclear
           factor 1B (HNF1B) molecular defects
    • Abstract: Publication date: Available online 10 November 2016
      Source:Diabetes & Metabolism
      Author(s): D. Dubois-Laforgue, C. Bellanné-Chantelot, P. Charles, A. Jacquette, E. Larger, C. Ciangura, C. Saint-Martin, C. Rastel, B. Keren, J. Timsit


      PubDate: 2016-11-10T09:47:19Z
       
 
 
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