Diabetes-related Research Research Articles

Consideration of sex as a biological variable in diabetes research across twenty years

BackgroundSex differences exist in the risk of developing type 1 and type 2 diabetes, and in the risk of developing diabetes-associated complications. Sex differences in glucose homeostasis, islet and β cell biology, and peripheral insulin sensitivity have also been reported. Yet, we lack detailed information on the mechanisms underlying these differences, preventing the development of sex-informed therapeutic strategies for persons living with diabetes. To chart a path toward greater inclusion of biological sex as a variable in diabetes research, we first need a detailed assessment of common practices in the field.MethodsWe developed a scoring system to evaluate the inclusion of biological sex in manuscripts published in Diabetes, a journal published by the American Diabetes Association. We chose Diabetes as this journal focuses solely on diabetes and diabetes-related research, and includes manuscripts that use both clinical and biomedical approaches. We scored papers published across 3 years within a 20-year period (1999, 2009, 2019), a timeframe that spans the introduction of funding agency and journal policies designed to improve the consideration of biological sex as a variable.ResultsOur analysis showed fewer than 15% of papers used sex-based analysis in even one figure across all study years, a trend that was reproduced across journal-defined categories of diabetes research (e.g., islet studies, signal transduction). Single-sex studies accounted for approximately 40% of all manuscripts, of which > 87% used male subjects only. While we observed a modest increase in the overall inclusion of sex as a biological variable during our study period, our data highlight significant opportunities for improvement in diabetes research practices. We also present data supporting a positive role for journal policies in promoting better consideration of biological sex in diabetes research.ConclusionsOur analysis provides significant insight into common practices in diabetes research related to the consideration of biological sex as a variable. Based on our analysis we recommend ways that diabetes researchers can improve inclusion of biological sex as a variable. In the long term, improved practices will reveal sex-specific mechanisms underlying diabetes risk and complications, generating knowledge to enable the development of sex-informed prevention and treatment strategies.

Methodological advancements in organ-specific ectopic lipid quantitative characterization: Effects of high fat diet on muscle and liver intracellular lipids

ObjectiveEctopic lipid accumulation is a hallmark of metabolic diseases, linking obesity to non-alcoholic fatty liver disease, insulin resistance and diabetes. The use of zebrafish as a model of obesity and diabetes is raising due to the conserved properties of fat metabolism between humans and zebrafish, the homologous genes regulating lipid uptake and transport, the implementation of the ‘3R’s principle and their cost-effectiveness. To date, a method allowing the conservation of lipid droplets (LDs) and organs in zebrafish larvae to image ectopic lipids is not available. Our objectives were to develop a novel methodology to quantitatively evaluate organ-specific LDs, in skeletal muscle and liver, in response to a nutritional perturbation. MethodsWe developed a novel embedding and cryosectioning protocol allowing the conservation of LDs and organs in zebrafish larvae. To establish the quantitative measures, we used a three-arm parallel nutritional intervention design. Zebrafish larvae were fed a control diet containing 14% of nutritional fat or two high fat diets (HFDs) containing 25 and 36% of dietary fats. In muscle and liver, LDs were characterized using immunofluorescence confocal microscopy. In liver, intrahepatocellular lipids were discriminated from intrasinusoid lipids. To complete liver characteristics, fibrosis was identified with Masson’s Trichrome staining. Finally, to confirm the conservation and effect of HFD, molecular players of fat metabolism were evaluated by RT-qPCR. ResultsThe cryosections obtained after setting up the embedding and cryopreservation method were of high quality, preserving tissue morphology and allowing the visualization of ectopic lipids. Both HFDs were obesogenic, without modifying larvae survival or development. Neutral lipid content increased with time and augmented dietary fat. Intramuscular LD volume density increased and was explained by an increase in LDs size but not in numbers. Intrahepatocellular LD volume density increased and was explained by an increased number of LDs, not by their increased size. Sinusoid area and lipid content were both increased. Hepatic fibrosis appeared with both HFDs. We observed alterations in the expression of genes associated with LD coating proteins, LD dynamics, lipogenesis, lipolysis and fatty acid oxidation. ConclusionsIn this study, we propose a reproducible and fast method to image zebrafish larvae without losing LD quality and organ morphology. We demonstrate the impact of HFD on LD characteristics in liver and skeletal muscle accompanied by alterations of key players of fat metabolism. Our observations confirm the evolutionarily conserved mechanisms in lipid metabolism and reveal organ specific adaptations. The methodological advancements proposed in this work open the doors to study organelle adaptations in obesity and diabetes related research such as lipotoxicity, organelle contacts and specific lipid depositions.

Diabetes-related research priorities of people with type 1 and type 2 diabetes: a cross-sectional study in Germany

To investigate (i) the importance and priorities of research objectives for people with type 1 (T1DM) and type 2 diabetes (T2DM); (ii) subgroups with specific research priorities; (iii) associated factors (e.g., sociodemographic characteristics) of the subgroups. The cross-sectional survey was conducted in 2018 using data from 869 respondents (29.0% response, 31.2% female, mean age 61.3 years, 62.7% T2DM) from a German statutory health insurance population. Diabetes-related research priorities were assessed with a questionnaire. Subgroups and associated factors were identified using latent class analysis. Three subgroups were found in T1DM: (1) high priority for the research topic ‘healing diabetes’ and moderate priority for the research topic ‘prevention of long-term complications’, (2) priorities for simplifying handling (high) and stress reduction (moderate), (3) priorities for healing diabetes (high) and simplifying handling (high). Three subgroups were found in T2DM: (1) priorities for simplifying handling (moderate), diabetes prevention (moderate) and prevention of long-term complications (moderate), (2) priorities for stress reduction (high) and diabetes prevention (moderate), (3) priorities for simplifying handling (high) and stress reduction (high). Classes differed in age and HbA1c. Knowledge about research priorities enables researchers to align their work with the needs of people with diabetes.

Tetra-Primer Amplification-Refractory Mutation System (ARMS)-PCR for Genotyping Mouse Leptin Gene Mutation.

Simple SummaryWe developed a method to detect a single-point mutation in an obese gene in a mouse research model. The method is quick, easy to conduct, and suitable for obesity and diabetes-related research, especially in settings with constrained resources to identify and differentiate wild-type mice from mice carrying a gene mutation.Due to spontaneous deficiency in leptin, ob/ob mice are one of the most commonly used experimental animal models in diabetes research. In this study, we reported a quick and easy-to-conduct genotyping method using tetra-primer amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) to differentiate mice with a mutated allele from the wild-type genotype. The amplicon patterns of different genotypes are clearly visible and distinguishable on 1.5% agarose gel. This method can serve as a valuable tool to differentiate genotypes for breeding purposes, to maintain animal colonies, control the available space in the animal facility, and identify appropriate individuals for animal experiments.

Diabetes Prevalence, Risk Factors, and Care in Asian American and Pacific Islanders of Texas: Data From the 2015-2019 Behavioral Risk Factors Surveillance System.

The purpose of this study was to investigate the health status and needs of the Asian American/Pacific Islander (AAPI) population with diabetes in Texas. This was a cross-sectional secondary analysis of data collected from the Behavioral Risk Factors Surveillance System in Texas from 2015 to 2019 for non-Hispanic White (NHW) and AAPI adults. Although the overall crude diabetes prevalence was lower in AAPI adults, age-adjusted diabetes prevalence was higher than in NHWs. Significant risk factors associated with diabetes in the AAPI group included being male, marital status, lower education levels, lower income, being overweight/obese, and having a sedentary lifestyle. Engagement in self-management activities (checking blood glucose, checking feet, attending a diabetes management course) was lower in AAPIs than in NHWs. Given stiff barriers to adequate screening and self-management support in diabetes care among ethnic populations such as AAPIs, targeted efforts to improve diabetes screening and effective care are warranted. Because today's AAPI populations are predominantly first-generation immigrant groups who suffer from language barriers, efforts should be made to develop health surveys in multiple languages for wider inclusion of understudied groups like AAPIs in diabetes-related research.

Using Social Media for More Engaged Users and Enhanced Health Communication in Diabetes Care

Background: Recent literature identified social media message features predictive of user engagement. Desired information from a patient perspective and use of social media information from a provider perspective in diabetes care is less clear. Purpose: Our study analyzed diabetes patients’ desired information from social media and how such information could be used in conjunction with doctor–patient communication to enhance compliance with recommended care. Methods: A survey examined diabetic patients’ interests in searching for various diabetes information on social media and assessed the potential impact of social media sourced information on doctor–patient communication. This survey was followed by a content analysis of major US diabetes organizations’ Facebook pages, which were considered for effectiveness in their communication with diabetes patients. Results: Survey participants were most interested in diabetes management recommendations. Diabetes knowledge positively correlated with interests in diabetes management recommendations but negatively correlated with prior use of social media for diabetes information. 70.9% of patients had discussed information from social media with their doctor. The content analysis showed narrative evidence and updates on diabetes-related research findings, and medical policies generated a higher level of user engagement. Conclusion: While survey participants showed greatest interests in health recommendations and tips, only 11.7% of the analyzed social media posts included such information. Posts that included diabetes-related information led to higher engagement than posts that emphasized social values. Patients in general have asked doctors about information received on social media which suggests that social media can be a useful platform for communicating diabetes care information.

Applying CRISPR Screen in Diabetes Research.

The CRISPR/Cas9 genome editing system has been one of the greatest scientific discoveries in the last decade. The highly efficient and precise editing ability of this technology is of great therapeutic value and benefits the basic sciences as an advantageous research tool. In recent years, forward genetic screens using CRISPR technology have been widely adopted, with genome-wide or pathway-focused screens leading to important and novel discoveries. CRISPR screens have been used primarily in cancer biology, virology, and basic cell biology, but they have rarely been applied to diabetes research. A potential reason for this is that diabetes-related research can be more complicated, often involving cross talk between multiple organs or cell types. Nevertheless, many questions can still be reduced to the study of a single cell type if assays are carefully designed. Here we review the application of CRISPR screen technology and provide perspective on how it can be used in diabetes research.

Career Advancement for Women in Diabetes-Related Research: Developing and Retaining Female Talent.

To change the future you need a firm grip on history. Successful implementation of strategies to catalyze evolution of gender parity requires a coherent plan with clear deliverables. The article by Dunne et al. (1,2), simultaneously published in Diabetes and Diabetes Care , provides a much-needed foundation that defines the scope of the problem within the field of diabetes, documents stagnated progress over recent years, and offers suggestions for intervention. We applaud the authors and are encouraged that the American Diabetes Association (ADA) leadership is fully invested in being part of an effective solution. As nationally funded and internationally recognized women leaders in diabetes research, we are compelled to initiate the process of addressing the inequities brought to light by Dunne et al. to enhance the development and retention of female talent in our field. To intiate that process, here we discuss the observations by Dunne et al. and propose a set of concrete measures for achieving gender equity within diabetes-related professions. Dunne et al. observe that almost half (43%) of the attendees of the annual ADA Scientific Sessions national conference are women, demonstrating strong active participation of women. Women are also well represented in education-focused leadership positions comprising 83% of the then Vice Presidents and now Presidents of Health Care and Education over the last five decades and 89% and 49% of the editorial boards for Diabetes Spectrum and Clinical Diabetes , respectively. In striking contrast, in the last 20 years, only 9% of ADA Presidents of Medicine and Science have been women (1,2), and since the inception of the ADA, only 5 of 81 ADA Presidents of Medicine and Science have been women. Further, women represent one-third or fewer of editorial board members for the highest-impact diabetes journals ( Diabetes Care, Diabetes , and Diabetologia …

Career Advancement for Women in Diabetes-Related Research: Developing and Retaining Female Talent.

To change the future you need a firm grip on history. Successful implementation of strategies to catalyze evolution of gender parity requires a coherent plan with clear deliverables. The article by Dunne et al. (1,2), simultaneously published in Diabetes and Diabetes Care , provides a much-needed foundation that defines the scope of the problem within the field of diabetes, documents stagnated progress over recent years, and offers suggestions for intervention. We applaud the authors and are encouraged that the American Diabetes Association (ADA) leadership is fully invested in being part of an effective solution. As nationally funded and internationally recognized women leaders in diabetes research, we are compelled to initiate the process of addressing the inequities brought to light by Dunne et al. to enhance the development and retention of female talent in our field. To intiate that process, here we discuss the observations by Dunne et al. and propose a set of concrete measures for achieving gender equity within diabetes-related professions. Dunne et al. observe that almost half (43%) of the attendees of the annual ADA Scientific Sessions national conference are women, demonstrating strong active participation of women. Women are also well represented in education-focused leadership positions comprising 83% of the then Vice Presidents and now Presidents of Health Care and Education over the last five decades and 89% and 49% of the editorial boards for Diabetes Spectrum and Clinical Diabetes , respectively. In striking contrast, in the last 20 years, only 9% of ADA Presidents of Medicine and Science have been women (1,2), and since the inception of the ADA, only 5 of 81 ADA Presidents of Medicine and Science have been women. Further, women represent one-third or fewer of editorial board members for the highest-impact diabetes journals ( Diabetes Care, Diabetes , and Diabetologia …

Evaluation of the My Diabetes Care Patient Portal Intervention: Protocol for a Pilot Randomized Controlled Trial.

BackgroundMy Diabetes Care (MDC) is a multi-faceted intervention embedded within an established patient portal, My Health at Vanderbilt. MDC is designed to help patients better understand their diabetes health data and support self-care. MDC uses infographics to visualize and summarize patients’ diabetes health data, incorporates motivational strategies, provides literacy-level appropriate educational resources, and links to a diabetes online patient support community and diabetes news feeds.ObjectiveThis study aims to evaluate the effects of MDC on patient activation in adult patients with type 2 diabetes mellitus. Moreover, we plan to assess secondary outcomes, including system use and usability, and the effects of MDC on cognitive and behavioral outcomes (eg, self-care and self-efficacy).MethodsWe are conducting a 6-month, 2-arm, parallel-design, pragmatic pilot randomized controlled trial of the effect of MDC on patient activation. Adult patients with type 2 diabetes mellitus are recruited from primary care clinics affiliated with Vanderbilt University Medical Center. Participants are eligible for the study if they are currently being treated with at least one diabetes medication, are able to speak and read in English, are 21 years or older, and have an existing My Health at Vanderbilt account and reliable access to a desktop or laptop computer with internet access. We exclude patients living in long-term care facilities, patients with known cognitive deficits or severe visual impairment, and patients currently participating in any other diabetes-related research study. Participants are randomly assigned to MDC or usual care. We collect self-reported survey data, including the Patient Activation Measure (R) at baseline, 3 months, and 6 months. We will use mixed-effects regression models to estimate potentially time-varying intervention effects while adjusting for the baseline measure of the outcome. The mixed-effects model will use fixed effects for patient-level characteristics and random effects for health care provider variables (eg, primary care physicians).ResultsThis study is ongoing. Recruitment was closed in May 2020; 270 patients were randomized. Of those randomized, most (214/267, 80.1%) were non-Hispanic White, and 13.1% (35/267) were non-Hispanic Black, 43.7% (118/270) reported being 65 years or older, and 33.6% (90/268) reported limited health literacy. We obtained at least 95.6% (258/270) completion among participants through the 3-month follow-up assessment.ConclusionsThis randomized controlled trial will be one of the first to evaluate a patient-facing diabetes digital health intervention delivered via a patient portal. By embedding MDC into Epic’s MyChart platform with more than 127 million patient records, our intervention is directly integrated into routine care, highly scalable, and sustainable. Our findings and evolving patient portal functionality will inform the continued development of MDC to best meet users’ needs and a larger trial focused on the impact of MDC on clinical end points.Trial RegistrationClinicalTrials.gov NCT03947333; https://clinicaltrials.gov/ct2/show/NCT03947333International Registered Report Identifier (IRRID)DERR1-10.2196/25955

TRAIL induces proliferation in rodent pancreatic beta cells via AKT activation.

Strategies to increase functional pancreatic beta cell mass is of great interest in diabetes-related research. TNF-related apoptosis-inducing ligand (TRAIL) is well known to promote proliferation and survival in various cell types, including vascular smooth muscle and endothelial cells. Correlation between the protective nature of TRAIL on these cells and its proliferative effect is noteworthy. TRAIL's seemingly protective/therapeutic effect in diabetes prompted us to question whether it may act as an inducer of proliferation in pancreatic beta cells. We used rat primary islet cells and MIN6 mouse beta cell line to investigate TRAIL-induced proliferation. Cell viability and/or death was analyzed by MTT, WST-1, and Annexin-V/PI assays, while proliferation rates and pathways were assessed via immunocytochemical and Western blot analyses. Receptor neutralization antibodies identified the mediator receptors. Recombinant soluble TRAIL (sTRAIL) treatment led to 1.6-fold increased proliferation in insulin-positive cells in dispersed rat islets compared to the untreated group, while adenovirus-mediated overexpression of TRAIL increased the number of proliferating beta cells up to more than six-fold. sTRAIL or adenoviral vector-mediated TRAIL overexpression induced proliferation in MIN6 cells also. TRAIL's proliferative effect was mediated via AKT activation, which was suppressed upon specific inhibition. Neutralization of each TRAIL receptor reversed the proliferative effect to some degree, with the highest level of inhibition in death receptor 5 (DR5) blockage in MIN6 cells and in decoy receptor 1 (DcR1) blockage in primary rat beta cells. Thus, TRAIL induces proliferation in rodent pancreatic beta cells through activation of the AKT pathway.

Trends in diabetes research outputs in South Africa over 30years from 2010 to 2019: A bibliometric analysis.

Diabetes mellitus (DM) is one of the leading causes of mortality in South Africa, which is impelled by people’s consumption of unhealthy diets and lifestyles, negligence about an individual’s health status, and increased urbanization. DM can be linked to several human diseases and thus, making it an important public health issue in the South African health sector. Therefore, it is necessary to assess the level of research that has been conducted in the country on diabetes, in a quest for solutions against the deadly disease. Hence, the present study aimed to map diabetes-related research in South Africa from 2010 to 2019. Data on the subject was retrieved from the Web of Science Core Collection (WoSCC) and bibliometrix package in Rstudio statistical software was used to analyze the data while VOSviewer was explored for data visualization networks. Our analysis revealed that the annual growth rate of publication trends was 23.2%. The authors per document were 23.3 with a collaboration index of 23.4. From the 416 articles analyzed, Islam MS (n = 34) was the most prolific author and the top active institution was University of KwaZulu-Natal (n = 165) and the top journal was Diabetes Research and Clinical Practice (n = 20). Findings from this study reveal that the quantity of research on diabetes has significantly increased over the decade, and the outcomes of this scientific progress can guide future research and substantially provide the basic needs for improving management procedures for diabetes in the country.

An overview of diabetes research achievements during a quarter of a century in Diabetes Research Center

Endocrinology and Metabolism Research Institute (EMRI) is one of the biggest research institutes in Iran that was established to develop research strategies for managing endocrine and metabolic disorders such as diabetes. The aim of this study was to provide an overview of diabetes related research activities and achievements in the EMRI since its foundation. A comprehensive search was conducted in the PubMed, Scopus, and EMBASE to find out diabetes-related research studies performed in the EMRI. After data extraction, articles were categorized based on their document types, levels of evidence, diabetes types, and subject areas and were presented in various charts. After removing duplications and screening, 228 remained documents were categorized. The majority of diabetes investigations performed in the Diabetes Research Center (DRC) was on type 2 diabetes (T2D) (37%). Based on document types, most of these publications were original articles. Moreover, clinical studies constituted the greatest amount of evidence in the literature. According to the subject areas, most of the articles were on basic sciences and diabetes-related associated factors, followed by studies related to the management and prevention of diabetes. As one of the most comprehensive research institute, the EMRI has developed its national and international research activities to improve diabetes management and cure through developing new treatment strategies, improving translational research, and applying new emerging technologies such as regenerative medicine.

Scientometric Evaluation of Research Productivity on Diabetes from the Kingdom of Saudi Arabia over the Last Two Decades (2000-2019).

Materials and Methods Data was extracted from the Web of Science (WoS) platform and later bibliometric analysis performed using the “R-Bibliometrix” package. A wide range of indicators was explored to measure the quantity and quality of the publications related to diabetes from KSA. Results Saudi Arabia was 28th in rank with 2600 documents (0.83% of global share). Articles were the main document type (76%). The total number of authors was 9715 from 104 countries. Three authors showed >50 publications and >100 total citations while 2 authors showed an H-index of ≥20. The USA, UK, and Egypt were other leading contributive countries in terms of corresponding authors and total citations per country. King Saud University was the major contributing affiliation followed by King Abdulaziz University. Among 865 sources, Saudi Medical Journal was the leading and consistent source over the years. Diabetes, Diabetes Mellitus, and Type 2 Diabetes were the most frequently used keywords. Conclusion This study provides a macroscopic overview of diabetes-related research output from KSA. Overall, similar identifications and trends of top authors were observed in terms of productivity, impact, international collaborations, and organizational affiliations. Generally, an increasing productivity trend was observed with the majority published in the last 5 to 10 years. Study findings can benefit relevant stakeholders to better understand the trends and performance of diabetes-related regional research.

Genetic variant of SPARC gene and its association with growth traits in Chinese cattle.

SPARC is a cysteine-rich acidic secreted protein. It is a non-collagen component of bone, which is widely distributed in humans and animals and plays an important role. SPARC has been found in a variety of human cancers (breast cancer, stomach cancer, ovarian cancer, etc.) and diabetes-related research. Especially the muscle and fat metabolism are closely related. In this study, we used a DNA pool to detect a new SNP site (g.12454T C). A total of 616 samples of four breeds of Qinchuan cattle (QC, ), Xianan cattle (XN, ), Pinan cattle (PN, ) and Jiaxian cattle (JX, ) were analyzed and identified with ARMS-PCR. In addition, we correlated SNP with growth traits and showed significant correlation with growth traits such as rump length, hip width, and body length (). Moreover, we tested the SPARC gene expression level in different tissues belonging to XN adult cattle () and found its high expression in muscle tissues (relative to the kidney). Further, we found the SNP is able to increase the SPARC expression level in skeletal muscle (). According to statistical data, this SNP site may be applied to a molecular marker of an early marker-assisted selection for early growth of beef cattle.

Recent trends in diabetes-related consumer health information technology research.

Diabetes-related consumer health information technology (CHIT) has been designed to facilitate self-management practices, and its use has improved health outcomes for many consumers. This analysis sought to identify tendencies in diabetes-related CHIT research from 2010-2015 to help researchers find novel research topics, periodicals, collaborators, and funding agencies and experts and lay consumers to find scholarly information. Six search engines encompassing computer science, engineering, and medicine yielded potential diabetes-related CHIT publications. Abstracts and full texts were screened based on inclusion and exclusion criteria. Information on year, periodical, periodical domain, keywords, author location, author institutions, authors, and funding agencies were collected from included publications. The screening process yielded 1551 publications. Studies were published in a core of twenty periodicals, commonly comprising medicine or technology domains. "Telemedicine" was the most frequently used keyword. Harvard University, Dr. Eirik Årsand, and the National Institute of Diabetes and Digestive Kidney Diseases were the most frequent author institution, author, and funding agency, respectively, associated with publications. This analysis revealed potential for novel research on the sociology and economics of diabetes-related CHIT, among other topics. A lack of collaboration between top authors in the field indicates potential for new, impactful collaborations. Ongoing bibliometric research will be necessary to assess changes in this field. The opportunity exists to inform lay consumers and researchers through bibliometric analyses of other consumer health informatics topics.

Non-invasive marker-independent high content analysis of a microphysiological human pancreas-on-a-chip model

The increasing prevalence of diabetes, its heterogeneity, and the limited number of treatment options drive the need for physiologically relevant assay platforms with human genetic background that have the potential to improve mechanistic understanding and e\\xpedite diabetes-related research and treatment. In this study, we developed an endocrine pancreas-on-a-chip model based on a tailored microfluidic platform, which enables self-guided trapping of single human pseudo-islets. Continuous, low-shear perfusion provides a physiologically relevant microenvironment especially important for modeling and monitoring of the endocrine function as well as sufficient supply with nutrients and oxygen. Human pseudo-islets, generated from the conditionally immortalized EndoC-βH3 cell line, were successfully injected by hydrostatic pressure-driven flow without altered viability. To track insulin secretion kinetics in response to glucose stimulation in a time-resolved manner, dynamic sampling of the supernatant as well as non-invasive real-time monitoring using Raman microspectroscopy was established on-chip. Dynamic sampling indicated a biphasic glucose-stimulated insulin response. Raman microspectroscopy allowed to trace glucose responsiveness in situ and to visualize different molecular structures such as lipids, mitochondria and nuclei. In-depth spectral analyses demonstrated a glucose stimulation-dependent, increased mitochondrial activity, and a switch in lipid composition of insulin secreting vesicles, supporting the high performance of our pancreas-on-a-chip model.

“Cardiovascular Outcomes Trials in Diabetes: A Necessity or Wastage of Time and Money?”

The last decade can be branded as the decade of cardiovascular outcomes trials (CVOTs) as far as diabetes-related research is concerned. With the publication of several CVOTs we have seen changes creeping into guidelines as well as package inserts of diabetes-related medications. This has become a bit challenging for the physicians as it has now become a norm to have a good grasp over CVOTs to choose an anti-hyperglycemic agent. However, CVOTs have also been exposed to a variety of criticisms. For example, they do not help answer the mechanistic basis for understanding of diabetes or its related complications. Moreover, can we justify such a large expenditure of funds on CVOTs? This mini review investigates certain core issues related to CVOTs and addresses these concerns accordingly.

RhoA/mDia-1/profilin-1 signaling targets microvascular endothelial dysfunction in diabetic retinopathy.

Diabetic retinopathy (DR) is a major cause of blindness in the working-age populations of developed countries, and effective treatments and prevention measures have long been the foci of study. Patients with DR invariably demonstrate impairments of the retinal microvascular endothelium. Many observational and preclinical studies have shown that angiogenesis and apoptosis play crucial roles in the pathogenesis of DR. Increasing evidence suggests that in DR, the small guanosine-5'-triphosphate-binding protein RhoA activates its downstream targets mammalian Diaphanous homolog 1 (mDia-1) and profilin-1, thus affecting important cellular functions, including cell morphology, motility, secretion, proliferation, and gene expression. However, the specific underlying mechanism of disease remains unclear. This review focuses on the RhoA/mDia-1/profilin-1 signaling pathway that specifically triggers endothelial dysfunction in diabetic patients. Recently, RhoA and profilin-1 signaling has attracted a great deal of attention in the context of diabetes-related research. However, the precise molecular mechanism by which the RhoA/mDia-1/profilin-1 pathway is involved in progression of microvascular endothelial dysfunction (MVED) during DR has not been determined. This review briefly describes each feature of the cascade before exploring the most recent findings on how the pathway may trigger endothelial dysfunction in DR. When the underlying mechanisms are understood, novel therapies seeking to restore the endothelial homeostasis comprised in DR will become possible.

Gender Dissimilarity in Type 2 Diabetes Risk Factors: a Chinese Study.

Gender has been identified as a significant factor that contributes to variations on unhealthy behavior engagement and disparity in health outcomes; however, gender dissimilarity in type 2 diabetes-related behavioral risks has not been fully understood in a non-Western social setting. Recognizing gender-specific behavioral risks of type 2 diabetes is important in improving the disease associated health outcomes and healthcare service. This study identifies gender-specific behavioral factors associated with type 2 diabetes diagnoses among middle-aged and older adults in a Chinese context. Data are selected from the China Health and Nutrition Survey (CHNS) 2009. There are 259 male cases and 280 female cases individually matched with their nondiabetic controls on age. Higher level of total carbohydrate intake and physical inactivity is associated with a higher risk of type 2 diabetes diagnoses in both genders (p < .001). Odds ratios of type 2 diabetes diagnoses are higher only among male cigarette smokers and heavy alcohol drinkers. This study provides evidence regarding gender-specific behavioral risks of type 2 diabetes suggesting the need for improving type 2 diabetes related research, prevention, education, and healthcare services for middle-aged and older adults in China.