Diabetes Mellitus Individuals Research Articles

The association between sleep efficiency and diabetes mellitus in community-dwelling individuals with or without sleep-disordered breathing.

Sleeping habits have been reported to be associated with diabetes mellitus. This study aimed to explore the relationship of sleep efficiency with diabetes mellitus in individuals with or without sleep-disordered breathing based on polysomnography records. We enrolled participants from the Sleep Heart Health Study. Objective indicators of sleep characteristics including sleep efficiency, sleep latency, slow-wave sleep, wake after sleep onset, and total arousal index were monitored via in-home polysomnography. Sleep efficiency was divided into grade 1 (≥85%), grade 2 (80%-84.9%), and grade 3 (<80%). Multivariate logistic regression models were utilized to investigate the association between sleep quality and diabetes mellitus. The present study comprised 4737 participants with a mean age of 63.6 ± 11.0 years. The prevalence of diabetes mellitus was higher in those with grade 3 sleep efficiency than that in those with grade 1 and grade 2 sleep efficiency in participants with (10.9% vs 8.5% vs 8.3%, respectively; P =.134) or without (9.5% vs 5.6% vs 3.5%, respectively; P <.001) sleep-disordered breathing. After adjusting for potential confounding factors, sleep efficiency <80% was associated with the prevalence of diabetes mellitus only in participants without sleep-disordered breathing (odds ratio, 1.894; 95% confidence interval, 1.187-3.022, P =.007). Poor sleep efficiency is associated with diabetes mellitus in those without sleep-disordered breathing. Therefore, the relationship between sleep efficiency and diabetes mellitus is worth further investigation.

Bariatric surgery in individuals with human immunodeficiency virus and type 2 diabetes: a case series

BackgroundThe efficacy and safety of bariatric surgery have not been fully elucidated in patients affected with human immunodeficiency virus. Although adjustable gastric banding and sleeve gastrectomy are starting to be used in patients with human immunodeficiency virus, there are limited descriptions of the outcomes of type 2 diabetes mellitus in individuals who are human immunodeficiency virus positive and undergoing these procedures.Case presentationWe have evaluated retrospectively three patients who underwent adjustable gastric banding or sleeve gastrectomy, the effect in weight reduction and glycemic control as well as its impact on human immunodeficiency virus management. Case 1 (adjustable gastric banding), a 58-year-old Caucasian male, achieved 19% total weight loss, Case 2, a 33-year-old Caucasian male (sleeve gastrectomy) lost 25%, and Case 3, a 48-year-old Caucasian female (sleeve gastrectomy), lost 14% postoperation. In terms of type 2 diabetes mellitus, Case 2 achieved complete remission according to American Diabetes Association criteria, while Case 1 would also have achieved remission were it not for the continuation of metformin postoperatively. Insulin requirements and pill burden were markedly reduced in Case 3 after sleeve gastrectomy, although lack of remission was predictable given the longevity of type 2 diabetes mellitus and preoperative insulin dosage. In all three cases, human immunodeficiency virus status did not appear to be affected by the bariatric surgery which was supported by the postoperative stable CD4 count and undetectable viral load.ConclusionsBariatric surgery is a safe and effective treatment modality in patients who are human immunodeficiency virus positive with obesity and type 2 diabetes mellitus.

The tongue features associated with type 2 diabetes mellitus.

Diabetes mellitus (DM) is a public problem closely associated with numerous oral complications, such as coated tongue, xerostomia, salivary dysfunction, etc. Tongue diagnosis plays an important role in clinical prognosis and treatment of diabetes in the traditional Chinese medicine (TCM). This study investigated discriminating tongue features to distinguish between type 2 DM and non-DM individuals through non-invasive TCM tongue diagnosis.The tongue features for 199 patients with type 2 DM, and 372 non-DM individuals, serving as control, are extracted by the automatic tongue diagnosis system (ATDS). A total of 9 tongue features, namely, tongue shape, tongue color, fur thickness, fur color, saliva, tongue fissure, ecchymosis, teeth mark, and red dot. The demography, laboratory, physical examination, and tongue manifestation data between 2 groups were compared.Patients with type 2 DM possessed significantly larger covering area of yellow fur (58.5% vs 22.5%, P < .001), thick fur (50.8% vs 29.2%, P < .001), and bluish tongue (P < .001) than those of the control group. Also, a significantly higher portion (72.7% vs 55.2%, P < .05) of patients with long-term diabetics having yellow fur color than the short-term counterparts was observed.The high prevalence of thick fur, yellow fur color, and bluish tongue in patient with type 2 DM revealed that TCM tongue diagnosis can serve as a preliminary screening procedure in the early detection of type 2 DM in light of its simple and non-invasive nature, followed by other more accurate testing process. To the best of our knowledge, this is the first attempt in applying non-invasive TCM tongue diagnosis to the discrimination of type 2 DM patients and non-DM individuals.

Haptoglobin Phenotype Is Associated With High-Density Lipoprotein-Bound Hemoglobin Content and Coronary Endothelial Dysfunction in Patients With Mild Nonobstructive Coronary Artery Disease.

Objective- Coronary endothelial dysfunction (ED) is an early stage of atherosclerosis and is associated with impaired high-density lipoprotein (HDL) function. A functional polymorphism at the haptoglobin (Hp) gene locus (rs72294371) has been associated with marked differences in HDL structure and function. We sought to determine whether Hp phenotype was associated with coronary ED and whether the amount of hemoglobin (Hb) tethered to HDL via Hp was Hp-type dependent and associated with ED. Approach and Results- Microvascular and epicardial coronary endothelial function was assessed in 338 individuals with nonobstructive coronary artery disease. Microvascular ED was defined as <50% change in coronary blood flow and epicardial ED as ≥20% decrease in coronary artery diameter after intracoronary acetylcholine infusion. The amount of Hb bound to HDL was measured by ELISA after HDL purification from plasma samples using immune-affinity chromatography. One hundred and seventy of the individuals in this study (50.3%) were diagnosed with microvascular ED, 143 (42.3%) with epicardial ED, and 67 (19.7%) had diabetes mellitus (DM). Hp phenotype was significantly associated with microvascular ( P=0.01) and epicardial ED ( P=0.04) among DM individuals. There was a significant and inverse correlation between the amount of HDL-bound Hb and change in coronary blood flow (r=-0.40; P<0.0001) and in coronary artery diameter (r=-0.44; P<0.0001) in response to acetylcholine infusion. Hb content of HDL was significantly increased in individuals with Hp 2-2 and DM. In a logistic regression model, Hp 2-2 phenotype was associated with microvascular ED (odds ratio, 1.9; P=0.03) and the amount of HDL-bound Hb was an independent predictor of both microvascular (odds ratio, 4.6 for each 1-SD increase; P<0.0001) and epicardial (odds ratio, 2.2; P<0.0001) ED. Conclusions- Hp phenotype is significantly associated with coronary ED in DM individuals. This association is likely related to increased Hb tethering to HDL via Hp 2-2 in DM.

EFFECT OF LIFESTYLE MODIFICATION IN TYPE II DIABETES MELLITUS INDIVIDUALS

Objectives: The objectives of this study were as follows: (1) To find the effect of conventional physiotherapy along with medications on Type II diabetes mellitus (DM) individuals and (2) to find the effect of lifestyle modification (LSM) and conventional physiotherapy with medications on Type II DM individuals.&#x0D; Methods: Ethical clearance was obtained from the institutional ethical committee. A total of 70 Type II DM individuals were assessed and 64 were included in this study based on inclusion criteria, the individuals were allocated into two groups: Group A (n=32) received conventional physiotherapy along with prescribed diabetic medications and Group B (n=32) received LSM and conventional physiotherapy with prescribed diabetic medications. Pre- and post-test were done for plasma glucose, serum insulin, glycated hemoglobin (HbA1c), total cholesterol, triglycerides, high-density lipoprotein-C, low-density lipoprotein by blood test, exercise tolerance by 6-min walk test, and quality of life (QOL) by SF-36 questionnaire, and the outcome measures were analyzed after 3 months.&#x0D; Results: Intergroup statistical analysis for HbA1c (p&lt;0.0001) and QOL (p&lt;0.0001) revealed extremely significant difference post-intervention. Analysis of HbA1c test for Group A (p=0.0652) was not significant and for Group B (p&lt;0.0001) was extremely significant. Moreover, QOL was significant for Group A (p=0.0004) as well as for Group B (p&lt;0.0001).&#x0D; Conclusion: The study results concluded that LSM was significantly effective in reducing HbA1c levels, exercise tolerance, plasma glucose, serum glycerine, and total cholesterol and improving QOL compared to conventional exercise.

Lipid Testing and Statin Prescriptions Among Medicaid Recipients With Systemic Lupus Erythematosus or Diabetes Mellitus and the General Medicaid Population.

Cardiovascular disease (CVD) risks in systemic lupus erythematosus (SLE) are similar to those in diabetes mellitus (DM). We investigated whether the numbers of lipid tests and statin prescriptions in patients with SLE are comparable with those in patients with DM and those in individuals without either disease. Using Analytic eXtract files from 29 states for 2007-2010, we identified a cohort of US Medicaid beneficiaries, ages 18-65 years, with prevalent SLE. Each SLE patient was matched for age and sex with 2 patients with DM and 4 individuals in the general Medicaid population who did not have either SLE or DM. We compared the proportions of patients in each cohort who received ≥1 lipid test and ≥1 statin prescription during 1-year follow-up. We used multivariable logistic regression to calculate the odds of lipid testing and receiving prescriptions for statins and conditional logistic regression to compare the matched cohorts. We identified 3 Medicaid cohorts: 25,950 patients with SLE, 51,900 patients with DM, and 103,800 Medicaid recipients without either condition. In these cohorts, lipid testing was performed in 24% of patients in the SLE group, 43% of patients in the DM group, and 16% of individuals in the group with neither condition, and statin prescriptions were dispensed in 11%, 33%, and 7% of these groups, respectively. SLE patients were 66% less likely (odds ratio [OR] 0.34, 95% confidence interval [95% CI] 0.34-0.35) to have lipid tests and 82% less likely (OR 0.18, 95% CI 0.18-0.18) to fill a statin prescription compared with DM patients. SLE patients were also less likely (OR 0.89, 95% CI 0.84-0.94) to fill a statin prescription compared with individuals in the general Medicaid population. Despite having an elevated risk of CVD, SLE patients received less lipid testing and received fewer statin prescriptions compared with age- and sex-matched DM patients and individuals in the general Medicaid population; this gap should be a target for improvement.

Longitudinal assessment of coronary plaque volume change related to glycemic status using serial coronary computed tomography angiography: A PARADIGM (Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging) substudy

BackgroundData on the impact of glycemic status on coronary plaque progression have been limited. This study evaluated the association between glycemic status and coronary plaque volume change (PVC) using coronary computed tomography angiography (CCTA). MethodsA total of 1296 subjects (61 ± 9, 56.9% male) who underwent serial CCTA with available glycemic status were enrolled and analyzed from the Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography IMaging (PARADIGM) registry. The median inter-scan period was 3.2 (2.6–4.4) years. Quantitative assessment of coronary plaques was performed at both scans. All participants were categorized into the following groups according to glycemic status: normal, pre-diabetes (pre-DM), and diabetes mellitus (DM). ResultsDuring the follow-up, significant differences in PVC (normal: 51.3 ± 83.3 mm3 vs. pre-DM: 51.0 ± 84.3 mm3 vs. DM: 72.6 ± 95.0 mm3; p < 0.001) and annualized PVC (normal: 14.9 ± 24.9 mm3 vs. pre-DM: 15.7 ± 23.8 mm3 vs. DM: 21.0 ± 27.7 mm3; p = 0.001) were observed among the 3 groups. Compared with normal individuals, individuals with pre-DM showed no significant differences in the adjusted odds ratio (OR) for plaque progression (PP) (1.338, 95% confidence interval [CI] 0.967–1.853; p = 0.079). However, the adjusted OR for PP was higher in DM individuals than in normal individuals (1.635, 95% CI 1.126–2.375; p = 0.010). ConclusionDM had an incremental impact on coronary PP, but pre-DM appeared to have no significant association with an increased risk of coronary PP after adjusting for confounding factors. Clinical trial registrationClinicalTrials.govNCT02803411.

Impact of Prior Coronary Artery Disease (CAD) and Glucose Tolerance Status (GTS) on Incident CAD in Japanese Men

Despite a decade of historical debate and the recent rebuttal regarding “diabetes mellitus (DM) as a CAD risk equivalent”, few studies have evaluated the impact of prediabetes (preDM) separately. Thus, it is still possible that the impact of DM has been underestimated unless preDM is excluded from the nondiabetic category and independently assessed along with normal glucose tolerance (NGT) and DM. To clarify the independent risk of NGT, preDM and DM with and without prior CAD for incident CAD, we analyzed data using a nationwide claim-based database that included 138,162 men (NGT 78,230; preDM 45,610; DM 14,322) aged 18-72 y in Japan. Multivariate Cox analysis showed that the impact of preDM on CAD was modest compared to DM even with prior CAD (Model 1, Table) whereas prior CAD confers a 5-8-fold excess risk for CAD regardless of GTS (Model 2, Table). The hazard ratio (HR) of CAD in NGT individuals with prior CAD was much higher than in DM individuals without prior CAD (HR 3.08(95% CI 2.08-4.54)). The HR in those with both DM and prior CAD was 15.7(11.8-21.0) compared to NGT without prior CAD. In conclusion, DM alone is not prior CAD risk-equivalent even if the influence of preDM is eliminated. Prior CAD confers a far higher risk for subsequent CAD regardless of GTS. Necessity of intense intervention for the secondary prevention of CAD is implied considering the enormously high risk in those with both DM and prior CAD. Disclosure M. Kitazawa: None. K. Fujihara: None. M. Harada: None. M. Ishizawa: None. M. Yamamoto: None. M. Kaneko: None. T. Osawa: None. T. Yamada: None. Y. Matsubayashi: None. H. Sone: Research Support; Self; Novo Nordisk Inc., Eli Lilly and Company, MSD K.K., Chugai Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Development Center Asia, Pte. Ltd., Daiichi Sankyo Company, Limited, Ono Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Sanofi, Kowa Pharmaceuticals America, Inc., Eisai Inc..

Haptoglobin Genotype Is a Determinant of Hemoglobin Adducts and Vitamin E Content in HDL.

Haptoglobin (Hp) is an abundant hemoglobin- (Hb-) binding serum protein and a constituent of the HDL proteome. In man, there exists a common polymorphism at the Hp locus with two common alleles defined by the presence (Hp 2 allele) or absence (Hp 1 allele) of a 1.7 kb in-frame partial duplication of exons 3 and 4 of the Hp gene. Numerous studies have demonstrated that the Hp 2-2 genotype is associated with a 3–5-fold increase in vascular disease among individuals with diabetes mellitus (DM). Increased Hp-Hb complex has been shown to be associated with the HDL of Hp 2-2 DM individuals. Hb-associated HDL has been proposed to result in the oxidation of HDL and the consumption of antioxidants in HDL, such as vitamin E, rendering the HDL further susceptible to oxidation. In this study, we set out to identify proteins which become cross-linked to Hb in HDL and to measure vitamin E in HDL as a function of the Hp genotype. We report on the identification of a novel 72 kd Hb reactive species which is cross-linked to HDL and demonstrate that vitamin E in HDL is decreased in Hp 2-2 DM individuals.

Prevalence of diabetes mellitus in individuals with airflow obstruction in a Japanese general population: The Yamagata-Takahata Study.

Diabetes has been reported as a comorbidity of chronic obstructive pulmonary disease (COPD) in Western countries, but it has not been demonstrated in epidemiological reports in Japan. The purpose of this study was to clarify whether the relationship between airflow obstruction and diabetes can be confirmed in a Japanese general population. From 2004 to 2006, blood sampling and pulmonary function tests were performed on 3045 people over the age of 40 years in annual health check-ups held in Takahata, Yamagata Prefecture, Japan. Pulmonary function was re-evaluated in 2009 and 2011. The prevalence of diabetes did not differ between subjects with and without airflow obstruction. Furthermore, although body mass index decreased, no increase in the prevalence of diabetes was observed with the progression of airflow obstruction. The annual changes in forced expiration volume in 1s (FEV1) did not differ depending on the presence or absence of diabetes in the study population. There was no difference in the prevalence of diabetes between subjects with airflow obstruction and those without. As patients with COPD in Japan are thinner than in the West, diabetes may not be a common comorbidity in Japanese patients with COPD.

Type 2 diabetes mellitus in individuals with obstructive sleep apnea: should screening be conducted?

Type 2 diabetes mellitus in individuals with obstructive sleep apnea: should screening be conducted?

Modulation of iron status biomarkers in tuberculosis-diabetes co-morbidity

Tuberculosis (TB) and diabetes mellitus (DM) remain vital disease burdens in developing countries and the dual burden of DM and TB clearly signifies a growing global public health concern. While modulation of iron status biomarkers in TB is well described, very little is known about the association of these markers with TB-DM. To examine the association of circulating iron status biomarkers in TB disease, we examined the systemic levels of ferritin, hepcidin, soluble transferrin receptor (sTfR), transferrin, apotransferrin and hemopexin in pulmonary TB (PTB) individuals with DM (PTB-DM), without DM (PTB) and those with diabetes only (DM). Circulating levels of ferritin and hepcidin were significantly enhanced in PTB-DM and PTB compared to the DM group. On the other hand, the circulating levels of transferrin and apotransferrin were significantly diminished in PTB–DM and PTB compared to the DM group. The levels of ferritin and hepcidin exhibited a significant positive relationship with HbA1c, whereas apotransferrin exhibited negative relationship with HbA1c in PTB-DM and PTB. ROC analysis revealed that ferritin, hepcidin and transferrin are markers that can distinguish PTB-DM from DM individuals. Our results suggest that some of these circulating iron status markers could prove useful as biomarkers to monitor disease severity.

Modern views on diabetes mellitus in individuals after cholecystectomy as a prerequisite for the substantiation and development of a physical rehabilitation program

Modern views on diabetes mellitus in individuals after cholecystectomy as a prerequisite for the substantiation and development of a physical rehabilitation program

Análise de tendência da taxa de mortalidade prematura por doenças crônicas não transmissíveis no estado do Paraná entre 2000 e 2013

Objetivo: Analisar a tendência da taxa de mortalidade prematura por doenças crônicas não transmissíveis (DCNT), no estado do Paraná, entre os anos 2000 a 2013.Método: Trata-se de um estudo de séries temporais, de taxa de mortalidade por DCNT, que considerou a mortalidade por Doenças do Aparelho Circulatório (DAC), Doenças do Aparelho Respiratório (DAR), Neoplasias e Diabetes Mellitus em indivíduos de 30 a 69 anos.Resultados: Identificaram-se maiores taxas de mortalidade prematura em indivíduos do sexo masculino. Entre os grupos de causas, as DAC foram as que apresentaram maiores taxas de mortalidade, seguidas pelas Neoplasias, Diabetes Mellitus e DAR. Os Coeficientes de Regressão (CR), tanto do estado, quanto das 22 Regionais de Saúde, foram negativos, com tendência decrescente, apenas para as Neoplasias e para o Diabetes Mellitus o CR foi crescente.Conclusão: A mortalidade prematura por DCNT no estado do Paraná é decrescente, isto indica um cenário de redução na mortalidade por DCNT para os próximos anos.

The kynurenine:tryptophan ratio as a predictor of incident type 2 diabetes mellitus in individuals with coronary artery disease

Aims/hypothesisThe tryptophan metabolite kynurenine has potent immune modulatory and vasoactive properties. Experimental data implicate kynurenine in obesity-related morbidities. Epidemiological studies are, however, sparse. We evaluated associations of the plasma and urine kynurenine:tryptophan ratio (KTR) to incident type 2 diabetes.MethodsWe followed 2519 individuals with coronary artery disease (CAD; 73.1% men) without diabetes at baseline for a median of 7.6 years, during which 173 (6.9%) new incidences of type 2 diabetes were identified. Multivariate Cox regression analyses were applied to investigate the prospective relationships of plasma and urine KTR with new onset type 2 diabetes.ResultsAt inclusion, mean (SD) age was 61.3 (10.4) years, BMI was 25.9 (3.71) kg/m2 and median (interquartile range) HbA1c was 5.6% (5.0%–6.0%) (38 [31–42] mmol/mol). Plasma KTR was not significantly related to type 2 diabetes risk. By contrast, urine KTR showed a strong positive association. Comparing quartile 4 with quartile 1, the HRs (95% CIs) were 2.59 (1.56, 4.30) and 2.35 (1.39, 3.96) in the age- and sex-adjusted and multivariate models, respectively.Conclusions/interpretationUrine KTR is a strong predictor of incident type 2 diabetes in individuals with CAD. Potential clinical implications and possible pathogenic roles of renal kynurenine excretion in type 2 diabetes development should be further elucidated.

Abstract 192: Intra-Individual Temporal Variation of Lipid and Apolipoprotein Levels in Patients With Type II Diabetes Mellitus and Normolipidemic Individuals

Hypertriglyceridemia is frequently observed with diabetes mellitus (DM) and is associated with increased cardiovascular disease (CVD) risk. In conditions of insulin deficiency or resistance, increased levels of free fatty acids are seen by the liver, which trigger increased lipogenesis and secretion of triglyceride (TG) rich lipoprotein (TRL) particles. However, a high number of specific ApoC-III on TRL particles suppress their return to the liver leading to a continuous circulation of highly atherogenic TRL remnants. To better understand the effect of intra-individual temporal variations on the differentiation of lipid and apolipoprotein profiles in DM vs. normal individuals, a small time course study over a 4 week period was performed on 3 normolipidemic, and 3 type II DM patients. Our laboratory has developed a method to separate lipoproteins based on hydrodynamic size coupled with mass spectrometry based analysis. Whole serum and lipoprotein size fractions were analyzed for 8 apolipoproteins (ApoA-I, ApoA-II, ApoA-IV, B-100, ApoC-I, ApoC-II, ApoC-III and E) and non-polar lipids (FC, CE, TG) while monitoring other proteins (ApoD, ApoM, CETP, LCAT, PLTP, PON1 and SAA4). In whole serum over the course of 4 weeks, ApoA-IV levels of DM vs. normal subjects differed the most, 3.2 (0.7) vs. 1.8 (0.4) μM, respectively, more significantly than intra-group or intra-individual variations. On the contrary, significantly lower whole serum levels were found for FC, CE, ApoM and PON1 (Prob&lt;0.01). HDL-ApoC-III/LDL-ApoC-III was also lower in DM vs. normal subjects, 3.0 (1.9) vs. 7.2 (4.1). By metrics of molar ratio measured in 20-35 nm LDL fractions, the most significant difference was found between DM vs. normal subjects in ApoC-III/ApoB-100 (1.8 (0.6) vs. 0.9 (0.3)), C-II/ApoB-100 (0.8 (0.4) vs. 0.4 (0.2)) and ApoE/ApoC-III (0.11 (0.09) vs. 0.24 (0.15)). These LDL composition differences indicate lower lipase activity and inhibition of LDL uptake. However, no significant differences were observed in these molar ratios as function of LDL particle size. In conclusion, due to less significant temporal deviations, apolipoprotein molar ratios are a more useful and informative measure of CVD risk in DM subjects than LDL size distribution characteristics.

Unstable bodyweight and incident type 2 diabetes mellitus: A meta-analysis.

Aims/IntroductionThe present meta‐analysis aimed to clarify the association of unstable bodyweight with the risk of type 2 diabetes mellitus, an association that has been controversial among longitudinal studies.Materials and MethodsAn electronic literature search using EMBASE and MEDLINE was followed up to 31 August 2016. The relative risks (RRs) of type 2 diabetes mellitus in individuals with unstable bodyweight were pooled using the inverse variance method.ResultsEight studies were eligible for the meta‐analysis. The median duration of measurements of weight change and follow‐up years for ascertaining type 2 diabetes mellitus were 13.5 and 9.4 years, respectively. The pooled RR for the least vs most stable category was 1.33 (95% confidence interval 1.12–1.57). Between‐study heterogeneity was statistically significant (P = 0.048). Whether type 2 diabetes mellitus was ascertained by blood testing explained 66.0% of the variance in the logarithm of RR (P = 0.02). In three studies in which blood testing was carried out, type 2 diabetes mellitus risk was not significant (RR 1.06, 95% confidence interval 0.91–1.25). Furthermore, publication bias that inflated type 2 diabetes mellitus risk was statistically detected by Egger's test (P = 0.09).ConclusionsUnstable bodyweight might be modestly associated with the elevated risk of type 2 diabetes mellitus; although serious biases, such as diagnostic suspicion bias and publication bias, made it difficult to assess this association.

Abstract P075: Diversity in Diabetes Status and Cardiovascular Disease in the Longitudinal Hispanic Community Health Study

Introduction: The HCHS/SOL demonstrated that diabetes mellitus (DM) was associated with elevated risk for CVD in a diverse Hispanic/Latino (H/L) cohort. However, the nature of these relationships as a function of H/L background, sex and other relevant variables is still unknown. Objective: We examined across approximately 6 years, the prevalence and incidence of DM and CVD and the CVD-DM relationship in diverse H/L. Methods: Participants at Visit 1:V1 (2008-2011) were 16,386 individuals with DM relevant data, whereas participants at Visit 2:V2 (2014-2016) were 8,401 individuals with similar data who attended the ongoing examination, constituting approximately 60% of the cohort to be studied. Descriptive characteristics were age-standardized to the 2010 U.S. population, and stratified by sex and H/L background. Prevalence estimates were weighted to the known population distribution, adjusting for sampling probability and nonresponse, and trimmed to handle extreme values of weights. Age-adjusted incidence rates /100 person years were estimated across Visit 1, based upon Poisson regression with robust variance taking into account the complex survey design. Both prevalence and incidence values are presented as % (95% CI). Prevalence and incidence of DM were examined by sex, age, H/L background, field center and BMI. We also examined the prevalence and incidence of CVD in those with and without DM by sex, H/L background, age and BMI. Results: Overall prevalence of DM was 17.8 (17.0, 18.6) at V1 and 19.4 (18.3, 20.5) at V2. The prevalence of DM at V2 was lowest, 11.2 (8.2, 15.3) for those of South American and highest for those of Puerto Rican, 22.5 (19.5, 25.8) background. While the prevalence of DM did not differ between women and men, the overall incidence rate for DM was significantly higher for men, 1.53 (1.32, 1.76) than for women, 1.06 (0.94, 1.18). The overall prevalence of CVD was significantly higher for DM than for non-DM individuals at V2: 9.2 (7.9, 10.7) vs. 4.5 (3.9, 5.2). The incidence rate across Visits, 0.71 (0.55, 0.92) vs. 0.20 (0.15, 0.27) was also higher for DM individuals. At V2 the CVD prevalence for DM men, 12.0 (9.7, 14.6) was greater than for DM women, 7.2 (5.6, 9.2). The relationship of CVD prevalence to DM status revealed different patterns among H/L background groups. At V2, for example, those of South American background showed relatively low CVD prevalence: 5.3 (2.6, 10.4) with DM vs. 4.2 (2.3, 7.5) without DM. In contrast, those of Puerto Rican background showed relatively high CVD prevalence: 15.6 (11.0, 21.6) with DM vs. 5.7 (4.1, 8.0) without DM. Conclusions: Overall prevalence and incidence of CVD was significantly higher for DM than for non-DM individuals and these CVD-DM relationships varied markedly across H/L background groups.

Sensitivity, Specificity and Predictive Value of Heart Rate Variability Indices in Type 1 Diabetes Mellitus.

BackgroundHeart rate variability (HRV) indices may detect autonomic changes with good diagnostic accuracy. Type diabetes mellitus (DM) individuals may have changes in autonomic modulation; however, studies of this nature in this population are still scarce.ObjectiveTo compare HRV indices between and assess their prognostic value by measurements of sensitivity, specificity and predictive values in young individuals with type 1 DM and healthy volunteers.MethodsIn this cross-sectional study, physical and clinical assessment was performed in 39 young patients with type 1 DM and 43 young healthy controls. For HRV analysis, beat-to-beat heart rate variability was measured in dorsal decubitus, using a Polar S810i heart rate monitor, for 30 minutes. The following indices were calculated: SDNN, RMSSD, PNN50, TINN, RRTri, LF ms2, HF ms2, LF un, HF un, LF/HF, SD1, SD2, SD1/SD2, and ApEn.ResultsType 1 DM subjects showed a decrease in sympathetic and parasympathetic activities, and overall variability of autonomic nervous system. The RMSSD, SDNN, PNN50, LF ms2, HF ms2, RRTri, SD1 and SD2 indices showed greater diagnostic accuracy in discriminating diabetic from healthy individuals.ConclusionType 1 DM individuals have changes in autonomic modulation. The SDNN, RMSSD, PNN50, RRtri, LF ms2, HF ms2, SD1 and SD2 indices may be alternative tools to discriminate individuals with type 1 DM.

Helicobacter pylori Infection Is Associated with Type 2 Diabetes, Not Type 1 Diabetes: An Updated Meta-Analysis.

Background Extragastric manifestations of Helicobacter pylori (H. pylori) infection have been reported in many diseases. However, there are still controversies about whether H. pylori infection is associated with diabetes mellitus (DM). This study was aimed at answering the question. Methods A systematic search of the literature from January 1996 to January 2016 was conducted in PubMed, Embase databases, Cochrane Library, Google Scholar, Wanfang Data, China national knowledge database, and SinoMed. Published studies reporting H. pylori infection in both DM and non-DM individuals were recruited. Results 79 studies with 57,397 individuals were included in this meta-analysis. The prevalence of H. pylori infection in DM group (54.9%) was significantly higher than that (47.5%) in non-DM group (OR = 1.69, P < 0.001). The difference was significant in comparison between type 2 DM group and non-DM group (OR = 2.05), but not in that between type 1 DM group and non-DM group (OR = 1.23, 95% CI: 0.77–1.96, P = 0.38). Conclusion Our meta-analysis suggested that there is significantly higher prevalence of H. pylori infection in DM patients as compared to non-DM individuals. And the difference is associated with type 2 DM but not type 1 DM.