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Journal Cover Diabetes & Metabolism
  [SJR: 1.252]   [H-I: 70]   [70 followers]  Follow
    
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   ISSN (Print) 1262-3636
   Published by Elsevier Homepage  [3089 journals]
  • LOW-DOSE ASPIRIN FOR PRIMARY PREVENTION OF CARDIOVASCULAR EVENTS IN
           PATIENTS WITH DIABETES: BENEFIT OR RISK'
    • Abstract: Publication date: Available online 14 November 2017
      Source:Diabetes & Metabolism
      Author(s): Massimo Leggio, Maria Grazia Bendini, Elisa Caldarone, Mario Lombardi, Paolo Severi, Stefania D’Emidio, Diana Claudia Stavri, Massimo Armeni, Veronica Bravi, Andrea Mazza
      Primary prevention aims to avert the onset of cardiovascular disease (CVD) by targeting its natural causes and risk factors; secondary prevention includes strategies and therapies that address preclinical or clinical evidence of CVD progression. The value of aspirin for primary CVD prevention is controversial because of increased bleeding, which may offset the overall modest benefits in patients with no overt CVD. In contrast, the benefits of aspirin for secondary prevention have been repeatedly and convincingly demonstrated to outweigh the risk of bleeding.Diabetes mellitus is a strong risk factor for cardiovascular events, and has been associated with an increased risk of both first and recurrent atherothrombotic events. Therefore, prevention of CVD, the major cause of mortality in patients with diabetes, is one of the most important therapeutic goals.Although the benefit of low-dose aspirin for secondary prevention of CVD is well established, its role for primary prevention remains inconclusive and controversial in diabetes patients.The benefit of aspirin for patients with CVD clearly exceeds the risk of bleeding, and even though a modest benefit has also been demonstrated in primary prevention, the trade-off for aspirin initiation against the increased risk of intracranial and gastrointestinal bleeding is more uncertain. Thus, aspirin for primary CVD prevention should be highly individualized, based on a benefit–risk ratio assessment for the given patient.In conclusion, the mere presence of diabetes is apparently not enough for aspirin to confer a benefit that clearly outweighs the risk of bleeding, and further evidence to the contrary is now needed.

      PubDate: 2017-11-18T15:10:00Z
       
  • Pharmacological variability of insulins degludec and glargine 300 U/mL:
           Equivalent or not'
    • Abstract: Publication date: Available online 14 November 2017
      Source:Diabetes & Metabolism
      Author(s): L. Monnier, C. Colette


      PubDate: 2017-11-18T15:10:00Z
       
  • Renal outcomes with dipeptidyl peptidase-4 inhibitors
    • Abstract: Publication date: Available online 13 November 2017
      Source:Diabetes & Metabolism
      Author(s): A.J. Scheen, P. Delanaye
      Dipeptidyl peptidase-4 inhibitors (DPP-4is) are increasingly being used in the management of type 2 diabetes (T2D). The present review summarizes the current knowledge of the effects of DPP-4is on renal outcomes by analyzing the experimental preclinical data, the effects of DPP-4is on urinary albumin–creatinine ratios (UACRs) and estimated glomerular filtration rates (eGFRs) from observational studies and clinical trials, and renal events (including kidney failure requiring renal replacement therapy) in recent large prospective cardiovascular outcome trials. Renal protection has been demonstrated in various animal models that have implicated different underlying mechanisms independent of glucose control, whereas prevention of new onset microalbuminuria and/or progression of albuminuria has been reported in some clinical studies, but with no significant effects on eGFR in most of them. The long-term clinical effects of DPP-4is on renal outcomes and the development of end-stage renal disease remain largely unknown and, thus, demand further investigations in prospective trials and long-term observational studies. In conclusion, despite promising results in animal models, data on surrogate biological markers of renal function and clinical renal outcomes remain rather scanty in patients with T2D, and mostly demonstrate the safety rather than true efficacy of DPP-4is.

      PubDate: 2017-11-18T15:10:00Z
       
  • Practical implementation, education and interpretation guidelines for
           continuous glucose monitoring: A French position statement
    • Abstract: Publication date: Available online 11 November 2017
      Source:Diabetes & Metabolism
      Author(s): S. Borot, P.Y. Benhamou, C. Atlan, E. Bismuth, E. Bonnemaison, B. Catargi, G. Charpentier, A. Farret, N. Filhol, S. Franc, D. Gouet, B. Guerci, I. Guilhem, C. Guillot, N. Jeandidier, M. Joubert, V. Melki, E. Merlen, A. Penfornis, S. Picard, E. Renard, Y. Reznik, J.P. Riveline, S. Rudoni, P. Schaepelynck, A. Sola-Gazagnes, N. Tubiana-Rufi, O. Verier-Mine, H. Hanaire
      The use by diabetes patients of real-time continuous interstitial glucose monitoring (CGM) or the FreeStyle Libre® (FSL) flash glucose monitoring (FGM) system is becoming widespread and has changed diabetic practice. The working group bringing together a number of French experts has proposed the present practical consensus. Training of professionals and patient education are crucial for the success of CGM. Also, institutional recommendations must pay particular attention to the indications for and reimbursement of CGM devices in populations at risk of hypoglycaemia. The rules of good practice for CGM are the precursors of those that need to be enacted, given the oncoming emergence of artificial pancreas devices. It is necessary to have software combining user-friendliness, multiplatform usage and average glucose profile (AGP) presentation, while integrating glucose and insulin data as well as events. Expression of CGM data must strive for standardization that facilitates patient phenotyping and their follow-up, while integrating indicators of variability. The introduction of CGM involves a transformation of treatment support, rendering it longer and more complex as it also includes specific educational and technical dimensions. This complexity must be taken into account in discussions of organization of diabetes care.

      PubDate: 2017-11-18T15:10:00Z
       
  • Early worsening of diabetic retiNOpathy AFTER RAPID improvement of BLOOD
           glucose control IN PATIENTS WITH DIABETES
    • Abstract: Publication date: Available online 11 November 2017
      Source:Diabetes & Metabolism
      Author(s): Sylvie Feldman-Billard, Etienne Larger, Pascale Massin
      Aim To review the frequency, importance of and risk factors for ‘early worsening of diabetic retinopathy’ (EWDR) after rapid improvement of blood glucose in patients with diabetes. Methods This was a systematic review of key references (PubMed 1980–2016) and the current international recommendations for the above-mentioned topics. Results EWDR has been described during intensive treatment (IT) in patients with uncontrolled type 1 or 2 diabetes, and after pancreas transplantation or bariatric surgery. EWDR arises in 10–20% of patients within 3–6 months after abrupt improvement of glucose control, and in nearly two times that proportion in patients with advanced baseline diabetic retinopathy (DR). While EWDR is often transient and predominantly driven by the development of cotton-wool spots and intraretinal microvascular abnormalities in patients with no or minimal DR, it can lead to irreversible retinal damage in patients with advanced DR before IT. Its identified risk factors include higher baseline levels and larger magnitudes of reduction of HbA1c, longer diabetes durations and previous severity of DR. Conclusion Intensive diabetes treatment inducing a rapid fall in glucose should prompt vigilance and caution, particularly in patients with long-term and uncontrolled diabetes and DR prior to IT. Careful retinal examination should be performed in all patients before initiating IT; however, in patients with severe non-proliferative or proliferative DR, panretinal photocoagulation therapy should be performed immediately. During the year following IT, quarterly eye monitoring is required in patients at high risk of EWDR (long-term uncontrolled diabetes, previous advanced DR), whereas follow-up every 6 months can be applied in patients with short-term diabetes and no/minimal DR before IT. To date, there is no evidence that controlling the speed or magnitude of HbA1c decreases will reduce the risk of EWDR in patients with diabetes.

      PubDate: 2017-11-18T15:10:00Z
       
  • Metabolic syndrome and impaired glucose metabolism during early postpartum
           after twin pregnancies complicated by gestational diabetes mellitus: Is
           the risk comparable to singleton pregnancies'
    • Abstract: Publication date: Available online 11 November 2017
      Source:Diabetes & Metabolism
      Author(s): M.A. Guillén, B. Barquiel, N. Hillman, M.A. Burgos, L. Herranz


      PubDate: 2017-11-18T15:10:00Z
       
  • Family history of diabetes is associated with enhanced adipose lipolysis:
           Evidence for the implication of epigenetic factors
    • Abstract: Publication date: Available online 11 November 2017
      Source:Diabetes & Metabolism
      Author(s): I. Dahlman, M. Ryden, P. Arner
      Aims Type 2 diabetes is associated with insulin resistance, adipose hypertrophy and increased lipolysis. The heritability of these traits has been determined by associating them with a family history of diabetes. Methods Abdominal subcutaneous fat biopsies were obtained from 581 subjects in a cross-sectional study. Fat cells were isolated, and the difference between measured and expected fat-cell volume was used to determine adipose morphology (degree of hypertrophy or hyperplasia). Spontaneous lipolytic activity was determined in explants of adipose tissue by measuring glycerol release. Insulin-stimulated lipogenesis was assessed by measuring the incorporation of radiolabelled glucose into fat-cell lipids. Information on parental history of diabetes was gathered by a questionnaire. Results Adipose morphology correlated positively with lipolysis (P <0.0001) and inversely with insulin-stimulated lipogenesis (P <0.008). Also, 24% of probands had a family history of diabetes, which was associated with higher body mass index (BMI) scores, and more insulin resistance (HOMAIR) and adipose hypertrophy. Lipolytic activity was increased, and insulin-stimulated lipogenesis decreased, in probands with a parental history of diabetes. The results for HOMAIR, lipolysis and adipose morphology remained significant after adjusting for proband BMI. A maternal history of diabetes was associated with increased adipose lipolytic activity in probands. Conclusion A family history of diabetes is independent of proband BMI, but associated with adipocyte hypertrophy and enhanced lipolysis, which suggests that these factors are genetically linked to diabetes. Moreover, the influence on lipolysis was only observed in probands with a maternal history of diabetes, thereby supporting an epigenetic impact.

      PubDate: 2017-11-18T15:10:00Z
       
  • Inhibitory role of oxytocin on TNFα expression assessed in vitro and
           in vivo
    • Abstract: Publication date: Available online 10 November 2017
      Source:Diabetes & Metabolism
      Author(s): S. Garrido-Urbani, N. Deblon, A.L. Poher, A. Caillon, P. Ropraz, F. Rohner-Jeanrenaud, J. Altirriba
      Aim Oxytocin administration to diet-induced obese (DIO) rodents, monkeys and humans decreases body weight and fat mass with concomitant improvements in glucose metabolism. Moreover, several studies show an immunomodulatory role of oxytocin in a number of settings (such as atherosclerosis, injury, sepsis). This study aims to shed some light on the effects of oxytocin on macrophage polarization and cytokine production, as well as its possible impact on these parameters in adipose tissue in DIO mice with impaired glucose metabolism. Methods Mouse bone marrow cells were differentiated into macrophages and treated with oxytocin. Macrophage proliferation, cytokine secretion and macrophage populations were determined. For experiments in vivo, DIO mice were treated with oxytocin for 2 weeks. Body weight and composition and glucose tolerance were subsequently followed. At the end of treatment, adipose tissue macrophage populations, plasma cytokine levels and cytokine expression in adipose tissue were determined. Results In bone marrow-derived macrophages, oxytocin induced an anti-inflammatory phenotype (decreased M1/M2 ratio). In M1-derived macrophages, oxytocin decreased TNFα secretion, with no effects on the other cytokines tested nor any effect on cytokine secretion by M2-derived macrophages. Oxytocin treatment in DIO mice in vivo led to decreased body weight accompanied by an improvement in glucose tolerance, with no changes in plasma cytokine levels. In adipose tissue, oxytocin decreased Tnfα expression without modifying the M1/M2 macrophage ratio. Conclusion Oxytocin treatment decreases TNFα production both in vitro (in bone marrow-derived macrophages) and in vivo (in epididymal adipose tissue) in DIO mice. This effect may also be contributory to the observed improvement in glucose metabolism.

      PubDate: 2017-11-18T15:10:00Z
       
  • Weight gain in early pregnancy and risk of gestational diabetes mellitus
           among Latinas
    • Abstract: Publication date: Available online 10 November 2017
      Source:Diabetes & Metabolism
      Author(s): T.A. Moore Simas, M.E. Waring, K. Callaghan, K. Leung, M. Ward Harvey, A. Buabbud, L. Chasan-Taber
      Aim To evaluate the association between gestational weight gain (GWG) in early pregnancy and incidence of abnormal glucose tolerance (AGT) and gestational diabetes mellitus (GDM) among Latinas. Methods We conducted a retrospective cohort study of 2039 Latinas using pooled data from two medical centres in Massachusetts. Gestational weights were abstracted from medical records and GWG was categorized as low, appropriate and excessive according to 2009 Institute of Medicine Guidelines. Diagnosis of AGT and GDM was confirmed by study obstetricians. Results A total of 143 women (7.0%) were diagnosed with GDM and 354 (17.4%) with AGT. After adjusting for age and study site, women with low GWG up to the time of GDM screen had a lower odds of GDM (OR: 0.51, 95% CI: 0.29–0.92). Among overweight women, women with excessive first-trimester GWG had 2-fold higher odds of AGT (OR: 1.96, 95% CI: 1.17–3.30) and GDM (OR: 2.07, 95% CI: 1.04–4.12) compared to those with appropriate GWG; however, these findings were not significant among normal weight or obese women. Conclusion Among Latinas, low GWG up to the time of GDM screen was associated with lower odds of AGT and GDM, while excessive GWG among overweight women was associated with higher odds. Findings highlight need for interventions in early pregnancy to help women meet GWG guidelines and to moderate GWG among overweight Latinas.

      PubDate: 2017-11-18T15:10:00Z
       
  • Hypoglycaemic episodes and risk of diabetic peripheral neuropathy in
           patients with type 2 diabetes
    • Abstract: Publication date: Available online 8 November 2017
      Source:Diabetes & Metabolism
      Author(s): Y.-W. Pai, C.-H. Lin, I.-T. Lee, M.-H. Chang


      PubDate: 2017-11-18T15:10:00Z
       
  • Predictors of the response of HbA1c and body weight after SGLT2 inhibition
    • Abstract: Publication date: Available online 8 November 2017
      Source:Diabetes & Metabolism
      Author(s): T. Abe, Y. Matsubayashi, A. Yoshida, H. Suganami, T. Nojima, T. Osawa, M. Ishizawa, M. Yamamoto, K. Fujihara, S. Tanaka, K. Kaku, H. Sone


      PubDate: 2017-11-18T15:10:00Z
       
  • Glycated heamoglobin A1c as a tool for epidemiological studies to assess
           diabetes prevalence: How has it been used since its official
           recommendation for diabetes diagnosis'
    • Abstract: Publication date: Available online 8 November 2017
      Source:Diabetes & Metabolism
      Author(s): D. Simon


      PubDate: 2017-11-18T15:10:00Z
       
  • Intravenous insulin therapy as a therapeutic option for severe
           hypertriglyceridaemia in a non-diabetes patient
    • Abstract: Publication date: Available online 8 November 2017
      Source:Diabetes & Metabolism
      Author(s): M. Popescu, T. Messiaen, M.M. Popescu, M. El Mokthari


      PubDate: 2017-11-18T15:10:00Z
       
  • Gestational diabetes mellitus and the ghrelin system
    • Abstract: Publication date: Available online 8 November 2017
      Source:Diabetes & Metabolism
      Author(s): H.S. Brink, A. Jan van der Lely, P.J.D. Delhanty, M. Huisman, J. van der Linden


      PubDate: 2017-11-18T15:10:00Z
       
  • Association of sleep apnoea syndrome and autonomic neuropathy in type 1
           diabetes
    • Abstract: Publication date: Available online 7 November 2017
      Source:Diabetes & Metabolism
      Author(s): L. Meyer, M. Massuyeau, C. Canel, T. Bahougne, P. Assemi, A.-E. Perrin, E. Wurtz, B. Renaud-Picard, C. Iamandi, R. Kessler, L. Kessler


      PubDate: 2017-11-18T15:10:00Z
       
  • Skin autofluorescence improves the Finnish Diabetes Risk Score in the
           detection of diabetes in a large population-based cohort: The LifeLines
           Cohort Study
    • Abstract: Publication date: Available online 31 October 2017
      Source:Diabetes & Metabolism
      Author(s): B.T. Fokkens, R.P. van Waateringe, D.J. Mulder, B.H.R. Wolffenbuttel, A.J. Smit
      Aim The aim of the present study was to investigate whether skin autofluorescence would improve the Finnish Diabetes Risk Score (FINDRISC) in detecting undiagnosed diabetes in a large population-based cohort. Methods Included were participants from the Dutch LifeLines Cohort Study. Skin autofluorescence was assessed in an unselected subset of participants using the AGE Reader. After the exclusion of participants with previously diagnosed diabetes (n =1635), pregnant women (n =58) and those using corticosteroids (n =345), 79,248 subjects were eligible for analysis. Diabetes was defined as fasting plasma glucose ≥7.0mmol/L, non-fasting plasma glucose ≥11.1mmol/L or HbA1c ≥6.5% (48mmol/mol). Results Diabetes was detected in 1042 participants (aged 55±12 years; 54% male). Skin autofluorescence improved the area under the receiver operating characteristic (AUROC) curve of the FINDRISC model from 0.802 to 0.811 (P <0.001). Furthermore, the addition of skin autofluorescence to FINDRISC reclassified 8–15% of all participants into more accurate risk categories (NRI: 0.080, 95% CI: 0.052–0.110). The proportion of reclassified participants was especially high (>30%) in the intermediate (1% to <5% and 5% to<10%) risk categories. When skin autofluorescence was added to a simplified model (age+body mass index), its discriminatory performance was similar to the full model+skin autofluorescence (AUROC: 0.806, P =0.062). Conclusion Skin autofluorescence is a non-invasive tool that can be used to further improve the FINDRISC for diabetes detection. The new resultant model is especially useful for reclassifying people in the intermediate-risk categories, where additional blood glucose testing is needed to confirm the presence of diabetes.

      PubDate: 2017-11-18T15:10:00Z
       
  • Insulin secretion in response to high extracellular calcium is not a
           pathognomonic feature of insulinoma cells
    • Abstract: Publication date: Available online 31 October 2017
      Source:Diabetes & Metabolism
      Author(s): J. -C. Henquin, F. Pattou, M. Nenquin


      PubDate: 2017-11-18T15:10:00Z
       
  • Evacuation is a risk factor for diabetes development among evacuees of the
           Great East Japan earthquake: A 4-year follow-up of the Fukushima Health
           Management Survey
    • Abstract: Publication date: Available online 31 October 2017
      Source:Diabetes & Metabolism
      Author(s): H. Satoh, T. Ohira, M. Nagai, M. Hosoya, A. Sakai, S. Yasumura, A. Ohtsuru, Y. Kawasaki, H. Suzuki, A. Takahashi, Y. Sugiura, H. Shishido, Y. Hayashi, H. Takahashi, G. Kobashi, K. Ozasa, S. Hashimoto, H. Ohto, M. Abe, K. Kamiya


      PubDate: 2017-11-18T15:10:00Z
       
  • Temporal characterization of cardiac expression of glucose transporters
           SGLT and GLUT in an experimental model of myocardial infarction
    • Abstract: Publication date: Available online 31 October 2017
      Source:Diabetes & Metabolism
      Author(s): J. Sánchez-Más, E. Saura-Guillén, M.C. Asensio-López, Á. Soriano-Filiu, M. Carmen Sánchez-Pérez, A.M. Hernandez-Martinez, A. Lax, D. Pascual-Figal


      PubDate: 2017-11-18T15:10:00Z
       
  • Type 2 diabetes mellitus and risk of open-angle glaucoma development in
           Koreans: An 11-year nationwide propensity-score-matched study
    • Abstract: Publication date: Available online 26 October 2017
      Source:Diabetes & Metabolism
      Author(s): Y. Jung, K. Han, H.-Y.L. Park, C.K. Park
      Purpose To evaluate the risk of primary open-angle glaucoma (POAG) development in type 2 diabetes mellitus (T2DM) patients. Methods In this 11-year longitudinal study based on the Korean National Health Insurance research database, the data collected comprised 1,025,340 (2.2%) participants who were randomly selected from 46,605,433 Korean residents in 2002. The database was analyzed to identify participants with an initial diagnosis of T2DM in 2003–2004. The control group was composed of participants without T2DM who were propensity-score-matched, five controls per T2DM patient, according to age, gender, household income, residential area and underlying diseases, including hypertension, dyslipidaemia, coronary heart disease, cerebrovascular disease and thyroid disease. Cox proportional-hazards regression was used to calculate the overall hazard ratios (HRs) in participants with and without T2DM for development of POAG before and after adjusting for confounding factors. Results There were 12,657 participants with T2DM and 63,285 propensity-score-matched controls without T2DM. POAG developed in 413 (3.3%) and 1188 (1.9%) participants in the T2DM and control groups, respectively. T2DM was associated with an increased risk of POAG development [HR: 1.80; 95% confidence interval (CI): 1.58–2.04] after adjusting for age, gender, household income and other potential confounders. Conclusion T2DM was significantly associated with the development of POAG after adjusting for potential confounders in the Korean population.

      PubDate: 2017-11-18T15:10:00Z
       
  • Fasting blood glucose and risk of prostate cancer: A systematic review and
           meta-analysis of dose-response
    • Abstract: Publication date: Available online 24 October 2017
      Source:Diabetes & Metabolism
      Author(s): A. Jayedi, K. Djafarian, F. Rezagholizadeh, A. Mirzababaei, M. Hajimohammadi, S. Shab-Bidar
      Aim This study aimed to test the dose-response relationship between fasting blood glucose (FBG) levels and risk of prostate cancer. Methods A systematic search was done of PubMed and Scopus from their inception up to January 2017. Prospective and retrospective studies reporting risk estimates of prostate cancer for two or more categories of blood glucose levels were identified, and two independent authors extracted the information. Relative risk (RR) was calculated using random-effects models and pooled. Results Ten prospective cohort studies, one nested case-control study, one case-cohort study and three case-control studies (total n =1,214,947) involving 12,494 cases of prostate cancer were reviewed. The pooled RR of prostate cancer for the highest vs. lowest category of FBG was 0.88 (95% CI: 0.78–0.98, I 2 =25.5%, n =15 studies). A 10mg/dL increment in FBG level was not associated with risk of prostate cancer (0.98, 95% CI: 0.96–1.00, I 2 =45.4%, n =11 studies). Subgroup analyses yielded a significant inverse association only in the subgroup of cohort studies. Non-linear dose-response meta-analysis showed a very slight decrement in risk with increasing FBG levels. Sensitivity analyses using cohort studies showed a steep decrease in risk along with an increase in FBG from baseline levels of ≈70mg/dL across prediabetes and diabetes ranges. Conclusion Higher FBG levels are associated with lower risk of prostate cancer in cohort studies, but not in case-control studies, findings that limit interpretation of our present results.

      PubDate: 2017-11-18T15:10:00Z
       
  • Degree of ketonaemia and its association with insulin resistance after
           dapagliflozin treatment in type 2 diabetes
    • Abstract: Publication date: Available online 23 October 2017
      Source:Diabetes & Metabolism
      Author(s): S.H. Min, T.J. Oh, S.-I. Baek, D.-H. Lee, K.M. Kim, J.H. Moon, S.H. Choi, K.S. Park, H.C. Jang, S. Lim
      Background Euglycaemic ketoacidosis has been reported after sodium–glucose cotransporter 2 (SGLT2) inhibitor treatment. However, the degree of ketonaemia and its metabolic effects have not been well investigated. Our study examined the degree of ketonaemia induced by SGLT2 inhibition and its association with metabolic profiles in type 2 diabetes mellitus (T2DM). Methods Biochemical parameters, including insulin, glucagon, free fatty acid (FFA), β-hydroxybutyrate (BHB) and acetoacetate (ACA) levels, were measured in 119 T2DM patients after dapagliflozin treatment for>3 months, and compared with a matched control group. Results Levels of total ketones, BHB and ACA were significantly higher in the dapagliflozin group than in the control group: 283.7±311.0 vs 119.8±143.8μmol/L; 188.3±226.6 vs 78.0±106.7μmol/L; and 94.1±91.3 vs 41.8±39.1μmol/L, respectively (all P <0.001). After dapagliflozin treatment, BHB was higher than the upper limit of normal (>440μmol/L) in 13 (10.9%) patients who had no relevant symptoms. BHB level after dapagliflozin treatment correlated positively with HbA1c (r =0.280), FFA levels (r =0.596) and QUICKI (r =0.238), and negatively with BMI (r =−0.222), insulin-to-glucagon ratio (r =−0.199) and HOMA-IR (r =−0.205; all P <0.05). On multivariable linear regression analysis, QUICKI was independently associated with BHB level. Conclusion Ketone levels were higher in T2DM patients treated with dapagliflozin than in controls, but with no clinical symptoms or signs of ketonaemia. Low-grade ketonaemia after dapagliflozin treatment may also be associated with improved insulin sensitivity.

      PubDate: 2017-11-18T15:10:00Z
       
  • Changes in glucose-lowering drug use before and after cancer diagnosis in
           patients with diabetes
    • Abstract: Publication date: Available online 22 October 2017
      Source:Diabetes & Metabolism
      Author(s): M.M.J. Zanders, H.R. Haak, M.P.P. van Herk-Sukel, R.M.C. Herings, L.V. van de Poll-Franse, J.A. Johnson
      Aim This study explores the changes in glucose-lowering drug (GLD) use before and after cancer diagnosis among patients with diabetes. Methods New GLD users (1998–2011) living in the Dutch ECR–PHARMO catchment area were selected from the PHARMO Database Network (n =52,228). Those with a primary cancer diagnosis were considered cases (n =3281) and matched with eligible controls (n =12,891) without cancer during follow-up. Conditional logistic regression analysis was used to assess changes in GLD use, such as treatment add-ons, treatments drops and initiation of insulin, for cases compared with controls associated with specific cancer types in four time windows (6–3 and 0–3months before cancer diagnosis; 0–3 and 3–6months after cancer diagnosis). Results In the 3months before cancer diagnosis, patients with upper gastrointestinal (GI) cancers (oesophageal, stomach, pancreatic, liver cancers) had higher odds of initiating insulin (OR: 9.3; 95% CI: 3.6–24.1); to a lesser extent, this was also observed in the 3months prior to that (at 6months, OR: 3.9; 95% CI: 1.3–12.1). Diagnosis of colorectal (OR: 3.4; 95% CI: 1.4–8.4), pulmonary (OR: 2.5; 95% CI: 1.1–5.4) and upper GI (OR: 13.6; 95% CI: 5.0–36.9) cancers was associated with increased odds of initiating insulin in the 3months after cancer diagnosis. During all study time windows, the odds of treatment drops were higher for patients with upper GI cancers whereas, for most other cancers, these odds were higher only after a diagnosis of cancer. Conclusion The greater odds of initiating insulin during the 6months prior to diagnosis of upper GI cancers suggest reverse causation. After cancer diagnosis, drops in use of GLDs was commonly seen.

      PubDate: 2017-11-18T15:10:00Z
       
  • Gestational diabetes mellitus screening according to Carpenter–Coustan
           and IADPSG criteria: A 7-year follow-up of prevalence, treatment and
           neonatal complications at a Belgian general hospital
    • Abstract: Publication date: Available online 21 October 2017
      Source:Diabetes & Metabolism
      Author(s): P. Oriot, J. Radikov, U. Gilleman, R. Loumaye, V. Ryckoort, E. Debue, C. Neve, A. Gruber, S. Vermeulen, M. Jacob, G. Herman, M. Buysschaert


      PubDate: 2017-11-18T15:10:00Z
       
  • A synopsis of brown adipose tissue imaging modalities for clinical
           research
    • Abstract: Publication date: October 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 5
      Author(s): L. Sun, J. Yan, L. Sun, S.S. Velan, M.K.S. Leow
      Body weight gain results from a chronic excess of energy intake over energy expenditure. Accentuating endogenous energy expenditure has been accorded considerable attention ever since the presence of brown adipose tissue (BAT) in adult humans was recognized, given that BAT is known to increase energy expenditure via thermogenesis. Besides classic BAT, significant strides in our understanding of inducible brown adipocytes have been made regarding its development and function. While it is ideal to study BAT histologically, its relatively inaccessible anatomical locations and the inherent risks associated with biopsy preclude invasive techniques to evaluate BAT on a routine basis. Thus, there has been a surge in interest to employ non-invasive methods to examine BAT. The gold standard of non-invasive detection of BAT activation is 18F-fluorodeoxyglucose positron emission tomography (PET) with computed tomography (CT). However, a major limitation of PET/CT as a tool for human BAT studies is the clinically significant doses of ionizing radiation. More recently, several other imaging methods, including single-photon emission computed tomography (SPECT), magnetic resonance imaging (MRI), infrared thermography (IRT)/thermal imaging and contrast ultrasonography (US) have been developed in hopes that they would allow non-invasive, quantitative measures of BAT mass and activity with lower costs. This review focuses on such methods to detect human BAT activation and white adipose tissue (WAT) browning to prompt the establishment of BAT-centric strategies for augmenting energy expenditure and combatting obesity. Clinical validation of these methods will most likely expand the scope and flexibility of future BAT studies.

      PubDate: 2017-11-18T15:10:00Z
       
  • Effects of anti-somatostatin agents on glucose metabolism
    • Abstract: Publication date: October 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 5
      Author(s): B. Vergès
      The anti-somatostatin agents used to treat acromegaly, Cushing's disease and neuroendocrine tumours also have hyperglycaemic effects. This is particularly true for pasireotide. Hyperglycaemic events are seen in 57–73% of patients with Cushing's treated with pasireotide, with a need to initiate antidiabetic treatment in about 50% of these patients. In acromegaly, treatment with pasireotide induces hyperglycaemia in 29–61% of patients. Pasireotide-induced hyperglycemia occurs early, within the first 3 months of treatment, due to a decrease in insulin secretion secondary to a fall in secretion of GLP-1 and GIP, and potentially also due to a direct inhibitory effect of pasireotide on beta cells. Close monitoring of blood glucose is mandatory in all patients during the first 3 months of treatment with pasireotide. Where necessary, antidiabetic treatment should be initiated, preferably with a DPP-4 inhibitor or a GLP-1 receptor agonist, both of which have proven efficacy in the control of hyperglycaemia induced by pasireotide.

      PubDate: 2017-11-18T15:10:00Z
       
  • Moderate intensity sports and exercise is associated with glycaemic
           control in women with gestational diabetes
    • Abstract: Publication date: October 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 5
      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: 2017-11-18T15:10:00Z
       
  • Metformin is associated with a lower risk of colorectal cancer in
           Taiwanese patients with type 2 diabetes: A retrospective cohort analysis
    • Abstract: Publication date: October 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 5
      Author(s): C.-H. Tseng
      Background The association between metformin and colorectal cancer (CRC) has rarely been investigated in Asian populations. Methods This retrospective cohort study included patients with newly diagnosed type 2 diabetes during 1999–2005, recruited from Taiwan's National Health Insurance database. A total of 169,601 patients (original cohort: 153,270 ever-users and 16,331 never-users of metformin) and a subgroup of 1:1 propensity-score-matched pairs of 16,331 ever-users and 16,331 never-users (matched cohort) were followed up to 31 December 2011. Cox regression was constructed with the inverse probability of treatment-weighting, using propensity scores, and was used to estimate hazard ratios (HRs). Results In the original cohort, the incidence of CRC was 242.9 and 480.9 per 100,000 person-years, respectively, in ever- and never-users. The overall HR [0.50, 95% confidence interval (CI): 0.45–0.56] suggested a significantly lower risk in metformin users, while compared with never-users, the HR (95% CI) for the first (<27.1 months), second (27.1–58.1 months) and third (>58.1 months) tertiles of cumulative duration of metformin therapy was 0.86 (0.76–0.98), 0.51 (0.45–0.59) and 0.26 (0.23–0.30), respectively. Analyses in the matched cohort showed similar findings with an overall HR of 0.62 (0.53–0.74), and a tertile analysis HR of 1.02 (0.81–1.28), 0.70 (0.56–0.89) and 0.32 (0.23–0.43), respectively. Re-analyses using more stringent diagnoses of CRC and cumulative duration as a continuous variable have consistently supported a protective effect with metformin use. Conclusion Metformin is associated with a lower frequency of CRC.

      PubDate: 2017-11-18T15:10:00Z
       
  • Glycaemic control and hypoglycaemia with insulin glargine 300 U/mL
           compared with glargine 100 U/mL in Japanese adults with type 2 diabetes
           using basal insulin plus oral anti-hyperglycaemic drugs (EDITION JP 2
           randomised 12-month trial including 6-month extension)
    • Abstract: Publication date: October 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 5
      Author(s): Y. Terauchi, M. Koyama, X. Cheng, M. Sumi, M.C. Riddle, G.B. Bolli, T. Hirose
      Aims To compare insulin glargine 300 U/mL (Gla-300) with glargine 100 U/mL (Gla-100) in Japanese adults with uncontrolled type 2 diabetes on basal insulin and oral anti-hyperglycaemic drugs over 12 months. Methods EDITION JP 2 was a randomised, open-label, phase 3 study. Following a 6-month treatment period, participants continued receiving previously assigned once daily Gla-300 or Gla-100, plus oral anti-hyperglycaemic drugs, in a 6-month extension period. Glycaemic control, hypoglycaemia and adverse events were assessed. Results The 12-month completion rate was 88% for Gla-300 and 96% for Gla-100, with comparable reasons for discontinuation. Mean HbA1c decrease from baseline to month 12 was 0.3% in both groups. Annualised rates of confirmed (≤3.9mmol/L [≤70mg/dL]) or severe hypoglycaemia were lower with Gla-300 than Gla-100 (nocturnal [00:00–05:59h]: rate ratio 0.41; 95% confidence interval: 0.18 to 0.92; anytime [24h]: rate ratio 0.64; 95% confidence interval: 0.44 to 0.94). Cumulative number of hypoglycaemic events was lower with Gla-300 than Gla-100. Adverse event profiles were comparable between treatments. Conclusion Over 12 months, Gla-300-treated participants achieved sustained glycaemic control and experienced less hypoglycaemia, particularly at night, versus Gla-100, supporting 6-month results.

      PubDate: 2017-11-18T15:10:00Z
       
  • Efficacy and safety of alirocumab in insulin-treated patients with type 1
           or type 2 diabetes and high cardiovascular risk: Rationale and design of
           the ODYSSEY DM–INSULIN trial
    • Abstract: Publication date: October 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 5
      Author(s): B. Cariou, L.A. Leiter, D. Müller-Wieland, G. Bigot, H.M. Colhoun, S. Del Prato, R.R. Henry, F.J. Tinahones, A. Letierce, L. Aurand, J. Maroni, K.K. Ray, M. Bujas-Bobanovic
      Aims The coadministration of alirocumab, a PCSK9 inhibitor for treatment of hypercholesterolaemia, and insulin in diabetes mellitus (DM) requires further study. Described here is the rationale behind a phase-IIIb study designed to characterize the efficacy and safety of alirocumab in insulin-treated patients with type 1 (T1) or type 2 (T2) DM with hypercholesterolaemia and high cardiovascular (CV) risk. Methods ODYSSEY DM–INSULIN (NCT02585778) is a randomized, double-blind, placebo-controlled, multicentre study that planned to enrol around 400 T2 and up to 100 T1 insulin-treated DM patients. Participants had low-density lipoprotein cholesterol (LDL-C) levels at screening≥70mg/dL (1.81mmol/L) with stable maximum tolerated statin therapy or were statin-intolerant, and taking (or not) other lipid-lowering therapy; they also had established CV disease or at least one additional CV risk factor. Eligible patients were randomized 2:1 to 24weeks of alirocumab 75mg every 2weeks (Q2W) or a placebo. Alirocumab-treated patients with LDL-C≥70mg/dL at week 8 underwent a blinded dose increase to 150mg Q2W at week 12. Primary endpoints were the difference between treatment arms in percentage change of calculated LDL-C from baseline to week 24, and alirocumab safety. Results This is an ongoing clinical trial, with 76 T1 and 441 T2 DM patients enrolled; results are expected in mid-2017. Conclusion The ODYSSEY DM–INSULIN study will provide information on the efficacy and safety of alirocumab in insulin-treated individuals with T1 or T2 DM who are at high CV risk and have hypercholesterolaemia not adequately controlled by the maximum tolerated statin therapy.

      PubDate: 2017-11-18T15:10:00Z
       
  • Low serum creatinine is a type 2 diabetes risk factor in men and women:
           The Yuport Health Checkup Center cohort study
    • Abstract: Publication date: October 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 5
      Author(s): S. Kashima, K. Inoue, M. Matsumoto, K. Akimoto
      Aim Type 2 diabetes (T2D) is a risk factor for muscle loss and subsequent frailty. The reverse association, however, may also happen. This study examined whether serum creatinine level, an indicator of muscle mass, predicted diabetes development. In addition, a role for body mass index (BMI) as an effect modifier of creatinine levels was evaluated. Methods This cohort study included 9667 subjects without diabetes or hypertension and with normal creatinine levels at baseline. Multiple-adjusted hazard ratios (HRs) for associations between baseline creatinine and diabetes development were estimated using the Cox proportional-hazards model. Stratified analyses based on BMI were also performed. Results During the follow-up period (mean: 5.6 years), 287 (5.5%) men and 115 (2.3%) women developed T2D. HR in men with serum creatinine≤0.7mg/dL compared with 0.9–1.2mg/dL was 1.40 (95% CI: 1.05–1.87) after adjusting for age, BMI, blood pressure and fasting plasma glucose at baseline, whereas the adjusted HR in women with creatinine≤0.5mg/dL compared with 0.7–1.1mg/dL was 1.69 (95% CI: 1.04–2.76). In a subgroup analysis stratified by BMI, interactions between BMI and baseline creatinine levels for T2D were statistically significant in women with the lowest creatinine levels (P =0.08 for interaction). Conclusion Low serum creatinine levels, a surrogate marker of muscle mass, predict T2D development in both genders, even after excluding the effect of diabetic and prediabetic glomerular hyperfiltration. BMI modified the association between creatinine and diabetes development in women.

      PubDate: 2017-11-18T15:10:00Z
       
  • The novel adipokine/hepatokine fetuin B in severe human and murine
           diabetic kidney disease
    • Abstract: Publication date: October 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 5
      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: 2017-11-18T15:10:00Z
       
  • Increased odds of metabolic syndrome with consumption of high dietary
           advanced glycation end products in adolescents
    • Abstract: Publication date: October 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 5
      Author(s): A. Saha, P. Poojary, L. Chan, K. Chauhan, G. Nadkarni, S. Coca, J. Uribarri


      PubDate: 2017-11-18T15:10:00Z
       
  • Brain-derived neurotrophic factor and insulin resistance during
           hyperinsulinaemic–euglycaemic clamp in type 1 diabetes patients in the
           PoProStu
    • Abstract: Publication date: October 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 5
      Author(s): A. Uruska, P. Niedzwiecki, A. Araszkiewicz, D. Zozulinska-Ziolkiewicz


      PubDate: 2017-11-18T15:10:00Z
       
  • Branched-chain amino acids are associated with odd-chain fatty acids in
           normoglycaemic individuals
    • Abstract: Publication date: October 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 5
      Author(s): M. Al-Majdoub, N. Geidenstam, A. Ali, M. Ridderstråle, P. Storm, L. Groop, L. Bennet, P. Spégel


      PubDate: 2017-11-18T15:10:00Z
       
  • Inhibition or deletion of 11β-HSD1 does not increase angiogenesis in
           ischemic retinopathy
    • Abstract: Publication date: October 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 5
      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: 2017-11-18T15:10:00Z
       
  • Reproducibility and least significant differences of oral glucose
           tolerance test-derived parameters in a postmenopausal population without
           diabetes
    • Abstract: Publication date: October 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 5
      Author(s): F.P. Van de Velde, A. Dierickx, H. Depypere, J.R. Delanghe, J.-M. Kaufman, B. Lapauw


      PubDate: 2017-11-18T15:10:00Z
       
  • Septic ketoacidosis: Evidence from patient autopsies
    • Abstract: Publication date: October 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 5
      Author(s): C. Palmiere, M.P. Scarpelli


      PubDate: 2017-11-18T15:10:00Z
       
  • Importance of alternative-site blood glucose testing in the diagnosis of
           artifactual hypoglycaemia in systemic scleroderma
    • Abstract: Publication date: October 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 5
      Author(s): V. Dubourdieu, H. Mosbah, C. Amouyal, A. Hartemann, F. Andreelli


      PubDate: 2017-11-18T15:10:00Z
       
  • Trajectories of fasting plasma glucose variability and mortality in type 2
           diabetes
    • Abstract: Publication date: Available online 9 October 2017
      Source:Diabetes & Metabolism
      Author(s): Chia-Lin Lee, Wayne Huey-Herng Sheu, I-Te Lee, Shih-Yi Lin, Wen-Miin Liang, Jun-Sing Wang, Yu-Fen Li
      Aim To investigate the effect of changes in fasting plasma glucose (FPG) variability, as assessed by 2-year trajectories of FPG variability, on mortality risk in patients with type 2 diabetes (T2D). Methods From 2009 to 2012, outpatients with T2D, aged>18 years, were enrolled from a medical centre. FPG was measured every 3 months for 2 years in 3569 people. For each of the eight 3-month intervals, FPG variability and means were calculated, with variability defined as the coefficient of variation of FPG. Also, trajectories of FPG variability and means were determined separately, using group-based trajectory analysis with latent class growth models. These models were fitted using the SAS Proc Traj procedure. The primary outcome was all-cause mortality, which was followed-up to the end of 2014. Results Five distinct trajectories of FPG variability (low, increasing, fluctuating, decreasing and high) and means (well controlled, stable control, worsening control, improving control and poor control) were established. The five trajectories of mean FPG were all associated with the same mortality risk. In contrast, in comparison to the low FPG variability trajectory, the fluctuating, decreasing and high variability trajectories all had significantly higher risks of mortality, with respective hazards ratios of 2.63 (95% CI: 1.40–4.93; P = 0.003), 2.78 (95% CI: 1.33–5.80; P = 0.007) and 4.44 (95% CI: 1.78–11.06; P = 0.001) after multivariable adjustment. Conclusion Changes in FPG variability were independently associated with increased mortality risk in patients with T2D.

      PubDate: 2017-10-13T21:43:34Z
       
  • Continuous positive airway pressure improves sleep quality, but not
           glycaemic control, in patients with poorly controlled long-standing type 2
           diabetes
    • Abstract: Publication date: Available online 10 October 2017
      Source:Diabetes & Metabolism
      Author(s): M. Torrella, I. Castells, G. Gimenez-Perez, A. Recasens, M. Miquel, O. Simó, E. Barbeta, G. Sampol


      PubDate: 2017-10-10T23:47:25Z
       
  • Hypoglycaemia causes both daytime and nighttime QTc interval prolongation
           in patients with type 2 diabetes receiving insulin treatment
    • Abstract: Publication date: Available online 10 October 2017
      Source:Diabetes & Metabolism
      Author(s): K. Makrilakis, C. Stathi, I. Vlahodimitris, S. Kalopita, P. Thomakos, P. Konstantopoulos, D. Perrea, N. Katsilambros, S. Liatis


      PubDate: 2017-10-10T23:47:25Z
       
  • Glycated albumin predicts the development of early diabetic nephropathy in
           patients with type 2 diabetes
    • Abstract: Publication date: Available online 3 October 2017
      Source:Diabetes & Metabolism
      Author(s): J.E. Jun, K.Y. Hur, Y.-B. Lee, S.-E. Lee, S.-M. Jin, M.-K. Lee, J.H. Kim


      PubDate: 2017-10-03T18:43:36Z
       
  • Effects of linagliptin vs. voglibose on daily glucose excursions during
           continuous glucose monitoring of Japanese type 2 diabetes patients
           (L-CGM): A randomized, open-label, two-arm, parallel comparative trial
    • Abstract: Publication date: Available online 22 September 2017
      Source:Diabetes & Metabolism
      Author(s): H. Satoh, T. Ohira, C. Moriya, I. Inoue, S. Kuribayashi, H. Seino, H. Hirai, T. Hiyoshi, H. Watada


      PubDate: 2017-09-27T12:43:15Z
       
  • Impact of body mass index and metabolic phenotypes on coronary artery
           disease according to glucose tolerance status
    • Abstract: Publication date: Available online 14 September 2017
      Source:Diabetes & Metabolism
      Author(s): K. Fujihara, Y. Matsubayashi, M. Yamamoto, T. Osawa, M. Ishizawa, M. Kaneko, S. Matsunaga, K. Kato, H. Seida, N. Yamanaka, S. Kodama, H. Sone
      Objective This study aimed to examine the impact of obesity, as defined by body mass index (BMI), and a metabolically unhealthy phenotype on the development of coronary artery disease (CAD) according to glucose tolerance status. Methods This population-based retrospective cohort study included 123,746 Japanese men aged 18–72years (normal glucose tolerance: 72,047; prediabetes: 39,633; diabetes: 12,066). Obesity was defined as a BMI≥25kg/m2. Metabolically unhealthy individuals were defined as those with one or more of the following conditions: hypertension, hypertriglyceridaemia and/or low HDL cholesterol. A Cox proportional hazards regression model identified variables related to CAD incidence. Results The prevalences of obese subjects with normal glucose tolerance, prediabetes and diabetes were 21%, 34% and 53%, whereas those for metabolically unhealthy people were 43%, 60% and 79%, respectively. Multivariate analysis showed that a metabolically unhealthy phenotype increases hazard ratios (HRs) for CAD compared with a metabolically healthy phenotype, regardless of glucose tolerance status (normal glucose tolerance: 1.98, 95% CI: 1.32–2.95; prediabetes: 2.91, 95% CI: 1.85–4.55; diabetes: 1.90, 95% CI: 1.18–3.06). HRs for CAD among metabolically unhealthy non-obese diabetes patients and obese diabetes patients with a metabolically unhealthy status were 6.14 (95% CI: 3.94–9.56) and 7.86 (95% CI: 5.21–11.9), respectively, compared with non-obese subjects with normal glucose tolerance and without a metabolically unhealthy status. Conclusion A metabolically unhealthy state can associate with CAD independently of obesity across all glucose tolerance stages. Clinicians may need to consider those with at least one or more conditions indicating a metabolically unhealthy state as being at high risk for CAD regardless of glucose tolerance status.

      PubDate: 2017-09-14T11:43:21Z
       
  • IL-33 receptor ST2 deficiency attenuates renal ischaemia–reperfusion
           
    • Abstract: Publication date: Available online 12 September 2017
      Source:Diabetes & Metabolism
      Author(s): M. Sehnine, M. Ferhat, S. Sena, J.M. Gombert, J.M. Goujon, A. Thierry, G. Touchard, T. Hauet, A. Herbelin, S. Hadjadj
      Aim Kidney hypoxia can predispose to the development of acute and chronic renal failure in diabetes. Ischaemia–reperfusion injury (IRI) causes inflammation, and diabetes is known to exacerbate this inflammatory response in the kidney, whereas alarmin IL-33 could act as an innate immune mediator during kidney IRI. Thus, the present study examined the impact of genetic IL-33 receptor ST2 deficiency (ST2−/−) on renal IRI in euglycaemic and hyperglycaemic mice. Methods Hyperglycaemia was induced with streptozotocin (STZ) in adult male C57BL/6JRj wild-type (WT) mice and ST2−/− mice. Unilateral renal IRI was achieved 3months after STZ treatment by left kidney nephrectomy (non-ischaemic control kidney) and clamping of the right renal artery for 32min in STZ- and vehicle-treated animals. At 24h after reperfusion, renal function and injury were determined by levels of plasma creatinine, blood urea nitrogen (BUN) and histological tubule scores. Also, in a complementary pilot clinical study, soluble ST2 concentrations were compared in diabetics and non-diabetics. Results Urinary albumin was significantly increased in STZ-induced hyperglycaemic mice, regardless of genotypic background. At 24h post-ischaemia, plasma creatinine, BUN and tubular injury were significantly reduced in ST2−/− mice compared with vehicle-treated WT mice, but this protective effect was lost in the STZ-induced hyperglycaemic ST2−/− animals. Plasma concentrations of soluble ST2 were significantly greater in type 2 diabetes patients vs non-diabetics. Conclusion Our data suggest that the IL-33/ST2 pathway exerts differential effects depending on the glucose environment, opening-up new avenues for future research on alarmins and diabetes in ischaemia-related diseases.

      PubDate: 2017-09-14T11:43:21Z
       
  • Vitamin D receptor-targeted treatment to prevent pathological
           dedifferentiation of pancreatic β cells under hyperglycaemic stress
    • Abstract: Publication date: Available online 12 September 2017
      Source:Diabetes & Metabolism
      Author(s): A. Neelankal John, Z. Iqbal, S. Colley, G. Morahan, M. Makishima, F.-X. Jiang
      Dedifferentiation has been identified as one of the causes of β-cell failure resulting in type 2 diabetes (T2D). This study tested whether increasing vitamin D receptor (VDR) expression prevents dedifferentiation of β cells in a high-glucose state in vitro. Culturing a mouse insulinoma cell line (MIN6) in a high-glucose environment decreased VDR expression. However, increased VDR following vitamin D3 (VD3) treatment improved insulin release of early-passage MIN6 and insulin index of db/- (heterozygous) islets to levels seen in normal functional islets. Treatment with VD3, its analogues and derivatives also increased the expression of essential transcription factors, such as Pdx1, MafA and VDR itself, ultimately increasing expression of Ins1 and Ins2, which might protect β cells against dedifferentiation. VD3 agonist lithocholic acid (LCA) propionate was the most potent candidate molecule for protecting against dedifferentiation, and an e-pharmacophore mapping model confirmed that LCA propionate exhibits a stabilizing conformation within the VDR binding site. This study concluded that treating db/+ islets with a VD3 analogue and/or derivatives can increase VDR activity, preventing the pathological dedifferentiation of β cells and the onset of T2D.

      PubDate: 2017-09-14T11:43:21Z
       
  • Severe hypoglycaemia is a major predictor of incident diabetic retinopathy
           in Japanese patients with type 2 diabetes
    • Abstract: Publication date: Available online 15 July 2017
      Source:Diabetes & Metabolism
      Author(s): S. Tanaka, R. Kawasaki, S. Tanaka-Mizuno, S. Iimuro, S. Matsunaga, T. Moriya, S. Ishibashi, S. Katayama, Y. Ohashi, Y. Akanuma, H. Sone, H. Yamashita
      Aim Hypoglycaemia is a common complication in diabetes patients. However, its relationship with retinopathy has not been well documented in patients with type 2 diabetes (T2D). This study aimed to investigate the associations between hypoglycaemia and the incidence and progression of diabetic retinopathy (DR). Methods In this longitudinal cohort study, which was part of the Japan Diabetes Complications Study (JDCS), adult patients with T2D were recruited at 59 diabetes clinics across Japan. Their history of hypoglycaemia was assessed by standardized self-reported questionnaires. Severe hypoglycaemia was defined as having at least one episode with coma requiring an outpatients visit or hospitalization. Adjusted hazard ratios (HRs) for incidence and progression of DR over 8 years of follow-up were determined. Results Of 1221 patients without DR, 127 (10.4%) had experienced non-severe hypoglycaemia within the previous year, whereas 10 (0.8%) reported severe hypoglycaemia episodes. During the 8-year follow-up involving 8492 person-years, 329 patients developed DR. In 410 patients with prevalent DR, the adjusted HRs for incident DR were 4.35 (95% CI: 1.98–9.56; P <0.01) and, for progression of DR, 2.29 (95% CI: 0.45–11.78; P =0.32) with severe hypoglycaemia. Conclusion Having a history of severe hypoglycaemia was one of the strongest predictors of incident DR in patients with T2D, with a fourfold increased risk. Identifying patients with greater risks of DR based on their history of hypoglycaemia may help to personalize risk evaluation in patients with diabetes.

      PubDate: 2017-07-19T02:11:28Z
       
  • Effect of GLP-1 receptor agonist on gastrointestinal tract motility and
           residue rates as evaluated by capsule endoscopy
    • Abstract: Publication date: Available online 23 June 2017
      Source:Diabetes & Metabolism
      Author(s): Y. Nakatani, M. Maeda, M. Matsumura, R. Shimizu, N. Banba, Y. Aso, T. Yasu, H. Harasawa
      Aim This study evaluated the effects of a glucagon-like peptide-1 receptor agonist on gastrointestinal (GI) tract motility and residue rates by examining GI transit time and lumen using capsule endoscopy. Material and methods GI motility and lumen were assessed by capsule endoscopy before and after liraglutide administration in 14 patients with type 2 diabetes mellitus (T2DM). Results Gastric transit time in the group with diabetic neuropathy (DN) was 1:12:36±1:04:30h before liraglutide administration and 0:48:40±0:32:52h after administration (nonsignificant difference, P =0.19). Gastric transit time in the non-DN group was 1:01:30±0:52:59h before administration and 2:33:29±1:37:24h after administration (significant increase, P =0.03). Duodenal and small intestine transit time in the DN group was 4:10:34±0:25:54h before and 6:38:42±3:52:42h after administration (not significant, P =0.09) and, in the non-DN group, 3:51:03±0:53:47h before and 6:45:31±2:41:36h after administration (significant increase, P =0.03). The GI residue rate in the DN group was 32.1±24% before administration and 90.0±9.1% after administration (significant increase, P <0.001), and increased in all patients; in the non-DN group, it was 32.1±35.3% before and 78.3±23.9% after administration (significant increase, P <0.001), and also increased in all patients. Conclusion Liraglutide causes delayed gastric emptying and inhibits duodenal and small intestine motility. However, these GI movement-inhibiting effects may be decreased or absent in patients with DN-associated dysautonomia.

      PubDate: 2017-07-01T02:24:07Z
       
 
 
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