for Journals by Title or ISSN
for Articles by Keywords
help

Publisher: Elsevier   (Total: 3032 journals)

 A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  

We no longer collect new content from this publisher because the publisher has forbidden systematic access to its RSS feeds.
Journal Cover Diabetes & Metabolism
  [SJR: 1.252]   [H-I: 70]   [64 followers]  Follow
    
   Full-text available via subscription Subscription journal  (Not entitled to full-text)
   ISSN (Print) 1262-3636
   Published by Elsevier Homepage  [3032 journals]
  • Metformin is associated with a lower risk of colorectal cancer in
           Taiwanese patients with type 2 diabetes: A retrospective cohort analysis
    • Abstract: Publication date: Available online 21 April 2017
      Source:Diabetes & Metabolism
      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: 2017-04-25T09:45:54Z
       
  • 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: Available online 19 April 2017
      Source:Diabetes & Metabolism
      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: 2017-04-25T09:45:54Z
       
  • GLP-1 receptor agonist confer target organ protection in type 2 diabetes
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Supplement 1
      Author(s): Fabrice Bonnet


      PubDate: 2017-04-25T09:45:54Z
       
  • After the LEADER trial and SUSTAIN-6, how do we explain the cardiovascular
           benefits of some GLP-1 receptor agonists?
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Supplement 1
      Author(s): B. Vergès, B. Charbonnel
      Recent cardiovascular outcome trials – the LEADER with liragutide and SUSTAIN-6 with semaglutide – have shown significant reductions of major cardiovascular (CV) events with these glucagon-like peptide (GLP)-1 receptor agonists. Progressive separation of the treatment and placebo curves, starting clearly between 12 and 18 months of the trial period, and significant reductions in the risk of myocardial infarction and stroke, indicate that the beneficial CV effects observed with GLP-1 receptor agonists could be due to an antiatherogenic effect. So far, the reasons for such an effect of GLP-1 receptor agonists have not been entirely clear, although several hypotheses may be proposed. As the reductions in glycated haemoglobin and systolic blood pressure (SBP) in these trials were modest, and both trials lasted only a short period of time, reductions in hyperglycaemia and SBP are unlikely to be involved in the beneficial CV effects of GLP-1 receptor agonists. On the other hand, their effect on lipids and, in particular, the dramatic decrease in postprandial hypertriglyceridaemia may explain their beneficial CV actions. Reduction of body weight, including a significant decrease in visceral fat in patients using GLP-1 receptor agonists, may also have beneficial CV effects by reducing chronic proatherogenic inflammation. In addition, there are in-vitro data showing a direct anti-inflammatory effect with these agents that could also be involved in their beneficial CV effects. Moreover, studies in humans have shown significant beneficial effects on ischaemic myocardium after a very short treatment period, suggesting a direct effect of GLP-1 receptor agonists on myocardium, although the precise mechanism remains unclear. Finally, as a reduction in insulin resistance has been associated with a decrease in CV risk, it cannot be ruled out that the lowering of insulin resistance induced by GLP-1 receptor agonists might also be involved in their beneficial CV actions.

      PubDate: 2017-04-25T09:45:54Z
       
  • GLP-1 receptor agonists and heart failure in diabetes
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Supplement 1
      Author(s): André J. Scheen
      The prevalence of heart failure (HF) is increasing in patients with type 2 diabetes (T2D), and glucose-lowering agents have distinctive effects on the risk of developing HF that requires hospitalization. Such an increased risk has been consistently reported with thiazolidinediones (glitazones) and perhaps also with the dipeptidyl peptidase (DPP)-4 inhibitor saxagliptin (at least in SAVOR – TIMI 53), whereas a markedly decreased risk was highlighted with the sodium – glucose cotransporter type 2 (SGLT2) inhibitor empagliflozin in EMPA-REG OUTCOME. Yet, the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on myocardial function remain controversial. Whereas some promising observations have been reported in various animal models, the effects of GLP-1RAs on myocardial function in humans are more heterogeneous, while the positive effect on left ventricular ejection fraction (LVEF), if any, appears to be inconsistent and rather modest in most patients with HF. However, no increased risk of hospitalization for HF has been reported with GLP-1RAs in meta-analyses of phase-II/III trials (exenatide, albiglutide, dulaglutide, liraglutide), demonstrating the safety of this pharmacological class, and such findings have been confirmed by three large prospective cardiovascular outcome trials (ELIXA with lixisenatide, LEADER with liraglutide and SUSTAIN-6 with semaglutide). In particular, LEADER reported a trend towards a reduction in HF hospitalization (−13%, P = 0.14), together with a significant reduction in cardiovascular and all-cause mortality in patients with T2D at risk of cardiovascular disease. These results are reassuring in the face of the somewhat negative results of the FIGHT trial, which evaluated the effects of liraglutide in patients with advanced HF and low LVEF, such that further studies and caution are now required when using this agent to treat such patients in clinical practice.

      PubDate: 2017-04-25T09:45:54Z
       
  • The potential and pitfalls of GLP-1 receptor agonists for renal protection
           in type 2 diabetes
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Supplement 1
      Author(s): Merlin C. Thomas
      Glucagon-Like Peptide-1 Receptor agonists (GLP-1 RA) offer substantial benefits for the management of glucose levels in type 2 diabetes. In addition, recent data from clinical trials have demonstrated that treatment with Glucagon-Like Peptide-1 Receptor agonists (GLP-1 RA) are also able to reduce new onset macroalbuminuria. These benefits may be consistent with the known effects of GLP-1 RA on traditional risk factors for progressive kidney disease including glucose lowering, blood pressure lowering, reduced insulin levels and weight reduction. However, emerging evidence suggests that GLP-1 RA can also have direct effects in the kidney, including inhibiting NHE3-dependent sodium reabsorption in the proximal tubule. Additional effects on the intrarenal renin angiotensin system, ischaemia/hypoxia, inflammation, apoptosis and neural signalling may also contribute to renal benefits. The extent to which these effects are mediated by the GLP-1R remains to be established. Recent studies confirm that the metabolic products of GLP-1 retain important antioxidant and anti-apoptotic activities that are GLP-1 R independent. Moreover the divergent peptide sequences of the currently available GLP-1 RA may mean that divergent reno-protective efficacy could be anticipated from different GLP-1 RA on this basis. Kidney disease is an important and deadly clinical outcome, and one worth preventing. Although both experimental and clinical data now support the possibility of renoprotective effects arising from treatment with GLP-1 RA, further work is needed to optimise these effects. A logical synergism with SGLT2 inhibition also exists, and at least in the short term, this combination approach may become the most useful way to protect the kidney in type 2 diabetes.

      PubDate: 2017-04-25T09:45:54Z
       
  • GLP-1 receptor agonists in NAFLD
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Supplement 1
      Author(s): J.-M. Petit, B. Vergès
      Non-alcoholic fatty liver disease (NAFLD) is very common in patients with type 2 diabetes (T2D), with approximately two-thirds having a diagnosis of the disease. Currently, the only validated treatment for NAFLD is weight loss. A number of studies of animal models and human trials have evaluated the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on liver fat content and suggest that the treatment could represent a new alternative for NAFLD management. In this review, our focus is on the main studies regarding the effects of GLP-1RAs on NAFLD. Also, the mechanisms that might explain their beneficial effects on liver diseases are analyzed.

      PubDate: 2017-04-25T09:45:54Z
       
  • Use of GLP-1 receptor agonists for type 2 diabetes treatment
           intensification after basal insulin failure
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Supplement 1
      Author(s): M. Joubert, Y. Reznik
      Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are part of the armamentarium for the treatment of type 2 diabetes (T2D), although recent guidelines have mainly recommended their use on top of oral treatments when a single or combination of two or three oral hypoglycaemic agents has failed to lower HbA1c levels below the individualized target range. In such situations, the decision to use GLP-1RAs is mostly driven by their high level of efficacy, their effect on body weight balance and their safety considerations, such as low hypoglycaemic risk. According to the current guidelines, GLP-1RAs may also be used in T2D patients in addition to basal insulin, following specialist-care advice, in patients who are more severely obese or who may not have the capacity to handle the complexities of a multiple daily injection (MDI) insulin regimen. The present review looks at the scientific evaluations performed in this context as well as the clinical trials assessing the use of GLP-1RAs in combination with intensive insulin therapy as further step-up therapy.

      PubDate: 2017-04-25T09:45:54Z
       
  • Associations between a fetal imprinted gene allele score and late
           pregnancy maternal glucose concentrations
    • Abstract: Publication date: Available online 6 April 2017
      Source:Diabetes & Metabolism
      Author(s): C.J. Petry, K. Mooslehner, P. Prentice, M.G. Hayes, M. Nodzenski, D.M. Scholtens, I.A. Hughes, C.L. Acerini, K.K. Ong, W.L. Lowe, D.B. Dunger
      Aim We hypothesised that some of the genetic risk for gestational diabetes (GDM) is due to the fetal genome affecting maternal glucose concentrations. Previously, we found associations between fetal IGF2 gene variants and maternal glucose concentrations in late pregnancy. Methods In the present study, we tested associations between SNP alleles from 15 fetal imprinted genes and maternal glucose concentrations in late pregnancy in the Cambridge Baby Growth and Wellbeing cohorts (1160 DNA trios). Results Four fetal SNP alleles with the strongest univariate associations: paternally-transmitted IGF2 rs10770125 (P-value=2×10–4) and INS rs2585 (P-value=7×10–4), and maternally-transmitted KCNQ1(OT1) rs231841 (P-value=1×10–3) and KCNQ1(OT1) rs7929804 (P-value=4×10–3), were used to construct a composite fetal imprinted gene allele score which was associated with maternal glucose concentrations (P-value=4.3×10–6, n =981, r2 =2.0%) and GDM prevalence (odds ratio per allele 1.44 (1.15, 1.80), P-value=1×10–3, n =89 cases and 899 controls). Meta-analysis of the associations including data from 1367 Hyperglycaemia and Adverse Pregnancy Outcome Study participants confirmed the paternally-transmitted fetal IGF2/INS SNP associations (rs10770125, P-value=3.2×10–8, rs2585, P-value=3.6×10–5) and the composite fetal imprinted gene allele score association (P-value=1.3×10–8), but not the maternally-transmitted fetal KCNQ1(OT1) associations (rs231841, P-value=0.4; rs7929804, P-value=0.2). Conclusion This study suggests that polymorphic variation in fetal imprinted genes, particularly in the IGF2/INS region, contribute a small but significant part to the risk of raised late pregnancy maternal glucose concentrations.

      PubDate: 2017-04-11T09:28:07Z
       
  • Evolution of subcutaneous adipose tissue fibrosis after bariatric surgery
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 2
      Author(s): K. Chabot, M.-S. Gauthier, P.Y. Garneau, R. Rabasa-Lhoret
      Aim Obesity is associated with the development of metabolic complications such as insulin resistance (IR). The mechanisms leading to IR remain unclear. This study aimed to investigate the relationship between adipose tissue fibrosis and IR in obese patients before and after bariatric surgery. Methods Thirty-five obese patients awaiting bariatric surgery (12 with type 2 diabetes) were included in the study. Non-diabetic patients were classified as either insulin-sensitive (n =11) or insulin-resistant (n =12), based on the Matsuda insulin sensitivity index (ISIMatsuda). Homoeostasis model assessment (HOMA-IR) was used for longitudinal evaluation of insulin resistance. Fibrosis was quantified by Masson's trichrome staining on microscopy, and mRNA levels of fibrosis-related genes were examined in subcutaneous (SAT) and visceral adipose tissue (VAT) biopsies collected during and 6 months after bariatric surgery (SAT only). Results Despite their similar age, body mass index and fat mass, SAT fibrosis was significantly higher in diabetic vs insulin-sensitive patients (P <0.05), and associated with IR as assessed by both ISIMatsuda (r =−0.417, P =0.038) and HOMA-IR (r =0.464, P =0.007) at baseline, whereas VAT fibrosis was not. Six months after surgery and significant weight loss, fibrosis levels remained unchanged in SAT, although IR was significantly reduced in all groups (P <0.0001). No correlation was found between SAT fibrosis and IR after surgery. Conclusion Overall, these results show a significant but, most likely, transient association between SAT fibrosis and IR in obese humans.

      PubDate: 2017-04-04T08:54:02Z
       
  • Low adiponectin levels at baseline and decreasing adiponectin levels over
           10 years of follow-up predict risk of the metabolic syndrome
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 2
      Author(s): S. Lindberg, J.S. Jensen, M. Bjerre, J. Frystyk, A. Flyvbjerg, J. Jeppesen, R. Mogelvang
      Aim Adiponectin is the most abundant adipokine and may play a key role in the interplay between obesity, inflammation, insulin resistance and the metabolic syndrome (MetS). Thus, this large population-based cohort investigated whether adiponectin at baseline and/or a decrease in adiponectin during follow-up is associated prospectively with the risk of incident MetS. Methods Using a prospective study design, the development of MetS was examined in 1134 healthy participants from the community. Plasma adiponectin was measured at study entry and again after a median follow-up of 9.4 years (IQR: 9.2–9.7). During follow-up, 187 participants developed MetS, and 439 presented with at least two components of MetS. Results During follow-up, adiponectin decreased in participants who developed MetS, whereas adiponectin was increased in those who did not develop MetS (P <0.001). Those with low adiponectin levels (quartile 1) at baseline had an increased risk of developing MetS (OR: 2.92, 2.08–6.97; P <0.001) compared with those with high levels (quartile 4). After adjusting for confounding variables, low adiponectin levels at baseline remained independently associated with MetS (OR: 2.24, 1.11–4.52; P =0.017). Similarly, participants with a decrease in adiponectin during follow-up also had an increased risk of MetS (OR: 2.96, 2.09–4.18; P <0.001). This association persisted after multivariable adjustments, including for baseline adiponectin (OR: 4.37, 2.77–6.97; P <0.001). Finally, adiponectin levels at follow-up were inversely associated with an increase in the number of components of MetS (P <0.001); geometric mean adiponectin levels were 9.5mg/L (95% CI: 9.0–10.0) for participants with no components vs 7.0mg/L (95% CI: 6.3–7.9) for those with four to five components. Conclusions/interpretation Low plasma adiponectin levels at baseline and decreasing adiponectin levels during follow-up are both associated with an increased risk of MetS.

      PubDate: 2017-04-04T08:54:02Z
       
  • Sex hormone levels are not associated with progression of renal disease in
           male patients with T2DM
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 2
      Author(s): E. Feigerlová, P.-J. Saulnier, P. Gourdy, R. Roussel, J.-M. Halimi, E. Gand, D. Dardari, B. Guerci, P. Sosner, M. Marre, P. Zaoui, S. Ragot, S. Hadjadj
      Background Greater renal function decline (RFD) in type 2 diabetes (T2DM) has been suggested in men compared with women, and imbalances in estrogen/androgen levels have been associated with cardiovascular disease mortality in elderly men, but it remains unclear whether sex hormone disequilibrium is related to diabetic nephropathy (DN) in men with T2DM. Objective This study examined the relationship between sex steroid concentrations and renal outcomes in male T2DM patients. Population and methods Total testosterone (T), total estradiol (E2), sex hormone-binding globulin (SHBG), and total and calculated free (cf) E2/T ratios were compared in 735 male T2DM patients with (n =513) and without (n =222) DN, using a cross-sectional approach. Also, in a pilot complementary prospective nested case-control cohort, total E2/total T and cfE2/cfT were evaluated according to a hard renal outcome (HRO): end-stage renal disease/doubling of baseline serum creatinine (36 HRO cases, 72 HRO controls) and rate of eGFR decline (68 rapid vs 68 slow RFD). Result With the cross-sectional approach, E2 and cfE2 were higher in DN cases vs DN controls (95.5 vs 86.8pmol/L [P =0.0246] and 2.59 vs 2.36pmol/L [P =0.005], respectively). The difference in E2 persisted on multivariate analysis. In the prospective approach, E2 and T concentrations, and total E2/total T and cfE2/cfT2 ratios did not differ in HRO cases vs controls or in patients with rapid vs slow RFD. Conclusion Although positively related to DN in the cross-sectional analysis, progression of renal disease in male patients with T2DM was not related to either sex hormone levels or aromatase index as reflected by E2/T ratio.

      PubDate: 2017-04-04T08:54:02Z
       
  • Increased serum ferritin levels are independently related to incidence of
           prediabetes in adult populations
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 2
      Author(s): G. Meng, H. Yang, X. Bao, Q. Zhang, L. Liu, H. Wu, H. Du, Y. Xia, H. Shi, X. Guo, X. Liu, C. Li, Q. Su, Y. Gu, L. Fang, F. Yu, S. Sun, X. Wang, M. Zhou, Q. Jia, Q. Guo, K. Song, G. Huang, G. Wang, Y. Wu, K. Niu
      Aim To comprehensively and exhaustively assess the relationship between serum ferritin levels and incidence of prediabetes in a prospective study. Methods This prospective cohort study (n =7380) with a mean follow-up of 3.07 years (range: 1–7, 95% CI: 3.03–3.12) was conducted in Tianjin, China. Blood fasting glucose, oral glucose tolerance test, serum ferritin levels and other potentially confounding factors were measured at baseline and at each year of follow-up. Adjusted Cox proportional hazards regression models were used to assess the gender-specific relationship between baseline and mean serum ferritin quintiles and prediabetes. Results The incidence of prediabetes was 85 per 1000 person-years among men and 44 per 1000 person-years among women during follow-up (from 2007 to 2014). After adjusting for potential confounders, hazard ratios (95% CI) for prediabetes across baseline ferritin quintiles were: for men, 1.00, 1.13 (0.90–1.40), 1.20 (0.97–1.48), 1.41 (1.14–1.73) and 1.73 (1.41–2.11); and for women, 1.00, 1.01 (0.74–1.38), 0.68 (0.48–0.96), 0.84 (0.61–1.15) and 1.07 (0.80–1.45), respectively. Similar results were also observed for mean ferritin levels. Conclusion Both baseline and mean serum ferritin levels were significantly and linearly related to prediabetes in men, whereas U-shaped relationships were observed between baseline and mean serum ferritin and prediabetes in women. The relationship between prediabetes risk and mean serum ferritin levels may be more stable than one with baseline serum ferritin levels.

      PubDate: 2017-04-04T08:54:02Z
       
  • Impaired development and dysfunction of endothelial progenitor cells in
           type 2 diabetic mice
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 2
      Author(s): S. Tsukada, H. Masuda, S.Y. Jung, J. Yun, S. Kang, D.Y. Kim, J.H. Park, S.T. Ji, S.-M. Kwon, T. Asahara
      Aim Dysfunction of circulating endothelial progenitor cells (EPCs) has been shown to affect the development of microvascular diseases in diabetes patients. The aim of this study was to elucidate the development and mechanical dysfunction of EPCs in type 2 diabetes (T2D). Methods The colony-forming capacity of EPCs and differentiation potential of bone marrow (BM) c-Kit(+)/Sca-I(+) lineage-negative mononuclear cells (KSL) were examined in T2D mice, db/db mice and KKAy mice, using EPC colony-forming assay (EPC-CFA). Results T2D mice had fewer BM stem/progenitor cells, and proliferation of KSL was lowest in the BM of db/db mice. In T2D mice, the frequency of large colony-forming units (CFUs) derived from BM-KSL was highly reduced, indicating dysfunction of differentiation into mature EPCs. Only a small number of BM-derived progenitors [CD34(+) KSL cells], which contribute to the supply of EPCs for postnatal neovascularization, was also found. Furthermore, in terms of their plasticity to transdifferentiate into various cell types, BM-KSL exhibited a greater potential to differentiate into granulocyte macrophages (GMs) than into other cell types. Conclusion T2D affected EPC colony formation and differentiation of stem cells to mature EPCs or haematopoietic cells. These data suggest opposing regulatory mechanisms for differentiation into mature EPCs and GMs in T2D mice.

      PubDate: 2017-04-04T08:54:02Z
       
  • Increased intestinal permeability as a risk factor for type 2 diabetes
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 2
      Author(s): A.J. Cox, P. Zhang, D.W. Bowden, B. Devereaux, P.M. Davoren, A.W. Cripps, N.P. West
      Aim Relationships between the intestinal microbiota, intestinal permeability and inflammation in the context of risk for obesity-associated disease continue to be of interest. The aim of the study was to examine the associations between intestinal permeability and type 2 diabetes (T2D). Methods A total of 130 individuals with T2D (age: 57.5±6.2 years (mean±SD); BMI: 30.4±3.2; 45% female) and 161 individuals without T2D (age: 37.4±12.5 years; BMI: 25.1±3.9; 65% female) were included in the study. Assessment of intestinal permeability included measurement of circulating lipopolysaccharide (LPS), LPS-binding protein (LBP) and intestinal fatty acid binding protein (iFABP) concentrations, which were used for calculation of a derived permeability risk score (PRS). Associations between permeability measures and T2D status were assessed using logistic regression models. Results LBP (∼34%, P <0.001), iFABP (∼46%, P <0.001) and the PRS (∼24% P <0.001) were all significantly higher in the T2D affected individuals. Individuals with a PRS in the upper tertile were 5.07 times more likely (CI: 1.72–14.95; P =0.003) to have T2D when models were adjusted for age, sex and BMI. There was a trend towards improved prediction when including the PRS in models containing age, sex and BMI (AUC: 0.954 versus 0.962; P =0.06). Conclusion These data demonstrate differences in measures of intestinal permeability between individuals with and without T2D. The utility of using intestinal permeability measures as a tool for predicting T2D risk in at risk individuals should be further investigated.

      PubDate: 2017-04-04T08:54:02Z
       
  • Link between nasal carriage of Staphylococcus aureus and infected
           diabetic foot ulcers
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 2
      Author(s): C. Dunyach-Remy, C. Courtais-Coulon, C. DeMattei, N. Jourdan, S. Schuldiner, A. Sultan, C. Carrière, S. Alonso, A. Sotto, J.-P. Lavigne
      Aims Nasal carriage of Staphylococcus aureus in diabetic patients may be a risk factor for diabetic foot lesion infections. The aims of this study were to compare the genotypic profiles of S. aureus strains isolated from nares and diabetic foot ulcers (DFUs) using microarray technology. Methods Patients were included if they were admitted for diabetic foot infection (DFI) at any of three diabetology departments of Montpellier and Nîmes University Hospitals between 1 September 2010 to 30 June 2012. All S. aureus isolates were analyzed using oligonucleotides arrays; S. aureus resistance and virulence genes were determined and each isolate was affiliated to a clonal complex. Results The prevalence of S. aureus nasal carriage among the 276 included patients was 39.5% (n =109), while 36.6% (n =101) had S. aureus at both sites (nares and foot wounds) and, of these patients, 65.3% of patients harboured the same strain at both sites. In addition, the spread of the methicillin-resistant S. aureus (MRSA) ST398 clone in DFI and its tropism for bone were also further confirmed. Conclusion These findings appear to provide new arguments in favour of the systematic detection of nasal S. aureus carriage to anticipate the management of DFI.

      PubDate: 2017-04-04T08:54:02Z
       
  • Dopaminergic Effects on Brown Adipose Tissue (DEBAT): A prospective
           physiological study
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 2
      Author(s): L. Bahler, H.J. Verberne, M.R. Soeters, J. Booij, J.B. Hoekstra, F. Holleman


      PubDate: 2017-04-04T08:54:02Z
       
  • Type A personality is not associated with poor glycaemic control: Data
           from cross-sectional and longitudinal surveys of people with type 1 or
           type 2 diabetes
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 2
      Author(s): J.-C. Chauvet-Gélinier, B. Trojak, C. Lemogne, A. Louprou, B. Bouillet, I. Simoneau, K. Chahraoui, J.-M. Petit, S.M. Consoli, B. Bonin, B. Vergès


      PubDate: 2017-04-04T08:54:02Z
       
  • Family history of diabetes and the risk of coronary heart disease in
           people with or without type 2 diabetes
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 2
      Author(s): M. Afarideh, S. Noshad, A. Ghajar, Z. Aryan, E. Khajeh, S. Hosseini Shirvani, F. Bonnet, A. Esteghamati


      PubDate: 2017-04-04T08:54:02Z
       
  • Relationship between skeletal muscle mass and hepatic fibrosis in patients
           with type 2 diabetes
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 2
      Author(s): T. Osaka, Y. Hashimoto, T. Fukuda, M. Tanaka, M. Yamazaki, M. Fukui


      PubDate: 2017-04-04T08:54:02Z
       
  • Short-term effect of severe hypoglycaemia on glycaemic control in the
           Diabetes Control and Complications Trial
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 2
      Author(s): A. Moutairou, R. Roussel, B. Charbonnel, R. El Boustany, A. Nicolas, A. Leye, K. Mohammedi, M. Marre, B. Detournay, L. Potier


      PubDate: 2017-04-04T08:54:02Z
       
  • Clinical parameters affecting dapagliflozin response in patients with type
           2 diabetes
    • Abstract: Publication date: April 2017
      Source:Diabetes & Metabolism, Volume 43, Issue 2
      Author(s): J.-Y. Lee, G. Kim, S.R. Kim, Y.-H. Lee, B.-W. Lee, B.-S. Cha, E.S. Kang


      PubDate: 2017-04-04T08:54:02Z
       
  • A parental history of diabetes is associated with a high risk of
           retinopathy in patients with type 2 diabetes
    • Abstract: Publication date: Available online 30 March 2017
      Source:Diabetes & Metabolism
      Author(s): G. Lapeyre, A. Cougnard-Grégoire, M.-N. Delyfer, C. Delcourt, S. Hadjadj, L. Blanco, E. Pupier, M.-B. Rougier, K. Rajaobelina, K. Mohammedi, M. Hugo, J.F. Korobelnik, V. Rigalleau


      PubDate: 2017-04-04T08:54:02Z
       
  • 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: Available online 24 March 2017
      Source:Diabetes & Metabolism
      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: 2017-03-28T08:21:01Z
       
  • 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
       
  • 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
       
  • 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
       
 
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
Fax: +00 44 (0)131 4513327
 
Home (Search)
Subjects A-Z
Publishers A-Z
Customise
APIs
Your IP address: 54.198.190.185
 
About JournalTOCs
API
Help
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-2016