Family History Of Type 2 Diabetes Mellitus Research Articles

Role of FOXP3 gene polymorphisms (SNPs rs3761547, rs3761549, and rs2232365) in the development of Type 2 diabetes mellitus

Type 2 diabetes mellitus (T2DM) is a multifactorial disease induced by an intricated interaction of several genetic variants and multiples environmental factors. A total of 281 patients diagnosed with T2DM and 281 non-diabetic control were enrolled in this study. Three SNPs (rs3761547, rs3761549, and rs2232365) in the FOXP3 gene were selected to study their role in the development of T2DM and T2DM-associated hypertension in an Iraqi population. The DNA extraction and genotyping were performed using allele-specific PCR. Our results showed that 212 patients were positive for a family history of T2DM, and 69 patients were negative (P < 0.001). The distribution of the rs3761547 genotypes among the diabetic patients with a positive family history was statistically significant (P < 0.001). Moreover, 205 patients were positive for hypertension, and 76 patients were negative (P < 0.001). The distribution of the rs3761547 genotypes among the diabetic patients with hypertension was statistically significant (P < 0.001). Furthermore, there was a statistical association for the rs3761549 genotype distribution among the diabetic patients without hypertension (P = 0.038). The correlation of the rs3761547 genotypes between the patients and controls was strongly significant for AA, GG, and AG (P < 0.001, P < 0.001, and P < 0.001, respectively). In contrast, there was no statistical significance for the rs3761549 genotypes (CC, TT, and CT; P = 0.362, P = 0.584, and P = 0.140, respectively). The rs2232365 (GG) genotype revealed a significant relationship (P < 0.001), while no statistical significance was displayed for the AA genotype (P = 0.130) and the AG genotype (P = 0.081). We concluded the FOXP3 gene polymorphisms rs3761547 and rs2232365 are linked with T2DM, while rs3761549 is not.

Associations between serum amino acids and incident type 2 diabetes in Chinese rural adults

Background and aimsSome amino acids (AAs) may be associated with type 2 diabetes (T2DM). This study aimed to determine the associations of individual AAs with the development of T2DM in rural Chinese adults. Methods and resultsA cohort study of 1199 individuals aged 18 years or older was conducted from 2006 to 2008 in a rural community of Deqing, China, a repeated survey was done in 2015 and data linkage with the electronic health records system was performed each year for identifying new T2DM cases. A high-performance liquid chromatography approach was used to measure the baseline serum concentrations of 15 AAs. Cox proportional hazards models were used to examine the associations between AAs and the risk of incident T2DM. A total of 98 new T2DM cases were identified during the follow-up of 12 years on average. Among 15 AAs, proline was associated with an increased risk of incident T2DM after adjusted for age, sex, body mass index, fasting plasma glucose, family history of T2DM, smoking status, alcohol use, and history of hypertension, the adjusted hazard ratio for 1-standard deviation increment was 1.20 (95% confidence interval: 1.00, 1.43). The association tended to be more marked in subjects younger than 60 years and overweight/obese subjects. Among participants without hypertension, proline and phenylalanine were associated with an increased risk of incident T2DM, while aspartic acid was associated with a decreased risk. ConclusionSerum proline was associated with the risk of incident T2DM in rural Chinese adults and might be a potential predictor.

Changes in β-Cell Function in Offspring of Type-2 Diabetic Patients, as per Fasting and Two-Hour Plasma Glucose Levels.

BackgroundThe changes in β-cell function in high-risk populations who are apparently in the normal glucose tolerant stage are still under investigation for designing earlier prevention strategies. This study analyzes changes in β-cell function and insulin sensitivity across fasting and two-hour glucose categories spanning normal glucose tolerance (NGT) to impaired glucose tolerance (IGT), in offspring of subjects with type-2 diabetes mellitus (T2DM) compared to the controls without a known family history of T2DM.MethodsOffspring of T2DM patients (cases) and individuals without a family history of T2DM (controls) were the subjects for this cross-sectional study. All participants underwent a 75 g oral glucose tolerance test and blood samples were collected for plasma glucose, insulin, C-peptide and proinsulin, at zero, 30, 60, and 120 minutes. ResultsA total of 358 cases (age 23.0 ± 10.8 years, 54% males) and 287 controls (age 28.4 ± 8.10 years, 65% males) were the subjects of this study. Cases and controls were divided into subgroups based on fasting and two-hour glucose categories spanning NGT to IGT. Compared to the reference category of controls (< 80 mg/dL for fasting glucose and < 84 mg/dL for two-hour glucose), cases with IGT had ~60% decline in both β-cell compensation (as measured as disposition index {0-120}) and insulin sensitivity (as measured as whole-body insulin sensitivity index {0-120}); adjusted for age, gender, and body mass index. From lower to higher fasting and two-hour glucose categories, there was a continuous and significant decline in β-cell compensation in both cases and controls. Significant reduction in first-phase insulin secretion, as measured as insulinogenic (0-30) index, was only observed among two-hour glucose categories, not among the fasting glucose categories. In the transition from late NGT cases to IGT cases, there was a significant decline in β-cell compensation, first-phase insulin secretion (more prominent than a decline in overall β-cell secretion) and the changes in whole-body insulin sensitivity were not statistically significant.ConclusionsThe decline in β-cell compensation was continuous and significant in offspring of subjects with type-2 diabetes and controls without a known family history of diabetes from early normal glucose tolerant ranges to impaired glucose tolerant ranges. Compared to the strictest glucose controlled category of controls, approximately 60% decline was observed in β-cell compensation and insulin sensitivity, in impaired glucose tolerant offspring of subjects with type-2 diabetes mellitus.

Progression of Prediabetes to Type 2 Diabetes Mellitus in Thai Population

Background: Pre-diabetes (pre-DM) increases the risk of developing type 2 diabetes mellitus (T2DM). The incidence of progression from pre-DM to T2DM varies in different ethnic populations. Objective: To examine the rate of progression from pre-DM to T2DM in a Thai population. Materials and Methods: This was a cohort study involving participants with pre-DM, diagnosed according to the results of fasting plasma glucose (FPG) and plasma glucose levels two hours after a 75-g oral glucose tolerance test (OGTT) (2-h PG), including IFG+/IGT–, defined by an FPG of 100 to 125 mg/dL (IFG+) and a normal 2-h PG of less than 140 mg/dL (IGT–); IFG–/IGT+, defined by a normal FPG of less than 100 mg/dL (IFG–) and a 2-h PG of 140 to 199 mg/dL (IGT+), and IFG+/IGT+. Each participant was followed-up until diabetes developed or for three years. The incidence of progression to T2DM was calculated every year until the 3-year follow-up period. Results: Three hundred twenty-five pre-DM participants were enrolled and classified into the following categories: IFG+/IGT– (22.5%), IFG–/IGT+ (44.3%), and IFG+/IGT+ (33.2%). During the 3-year follow-up period, 63 of 325 (19.4%) participants developed T2DM. The incidence of progression to T2DM was 3.1%, 5.7%, and 11.8% at 1, 2, and 3 years, respectively. The mean time to progression to T2DM was 25.5 months. When comparing between subgroups of pre-DM, the IFG–/IGT+ or IFG+/IGT+ subgroups had a higher chance of developing T2DM than the IFG+/IGT– subgroup (p&lt;0.05). Some risk factors, which were a family history of T2DM in first-degree relatives, FPG of 110 mg/dL or more, and an HbA1C of 6.0% or greater were significantly associated with the progression of T2DM in univariate analysis (p&lt;0.05). However moderate-intensity exercise and diabetes self-management education (DSME) attainment were the protective factors (p&lt;0.05). Conclusion: Almost one-fifth of the participants with pre-DM progressed to T2DM within three years. The annual incidence of DM development was 3.1%, 5.7%, and 11.8% at 1, 2, and 3 years, respectively. People with FPG of 110 mg/dL or more, and an HbA1C of 6.0% or higher, or IGT or combined IGT&amp;IFG should be screened for DM more frequently, using FPG and HbA1C, perhaps every three to six months, especially in those with a family history of T2DM in first-degree relatives. Otherwise, lifestyle modification should be strongly emphasized to prevent development of T2DM in these people. Keywords: Pre-diabetes, Glucose tolerance test, Diabetes mellitus

Repetitiveness of the oral glucose tolerance test in children and adolescents.

BACKGROUNDData regarding the most suitable diagnostic method for the diagnosis of glucose impairment in asymptomatic children and adolescents are inconclusive. Furthermore, limited data are available on the reproducibility of the oral glucose tolerance test (OGTT) in children and adolescents who are obese (OB).AIMTo investigate the usefulness of the OGTT as a screening method for glucose dysregulation in children and adolescents.METHODSEighty-one children and adolescents, 41 females, either overweight (OW), OB or normal weight (NW) but with a strong positive family history of type 2 diabetes mellitus (T2DM), were enrolled in the present observational study from the Outpatient Clinic of Paediatric Endocrinology of the University Hospital of Patras in Greece. One or two 3-h OGTTs were performed and glucose, insulin and C-peptide concentrations were measured at several time points (t = 0 min, t = 15 min, t = 30 min, t = 60 min, t = 90 min, t = 120 min, t = 180 min).RESULTSGood repetitiveness was observed in the OGTT response with regard to T2DM, while low repetitiveness was noted in the OGTT response with regard to impaired glucose tolerance (IGT) and no repetitiveness with regard to impaired fasting glucose (IFG). In addition, no concordance was observed between IFG and IGT. During the 1st and 2nd OGTTs, no significant difference was found in the glucose concentrations between NW, OW and OB patients, whereas insulin and C-peptide concentrations were higher in OW and OB compared to NW patients at several time points during the OGTTs. Also, OW and OB patients showed a worsening insulin and C-peptide response during the 2nd OGTT as compared to the 1st OGTT.CONCLUSIONIn mild or moderate disorders of glucose metabolism, such as IFG and IGT, a diagnosis may not be reached using only one OGTT, and a second test or additional investigations may be needed. When glucose metabolism is profoundly impaired, as in T2DM, one OGTT is probably more reliable and adequate for establishing the diagnosis. Excessive weight and/or a positive family history of T2DM possibly affect the insulin and C-peptide response in the OGTT from a young age.

Who Should Return for an Oral Glucose Tolerance Test? A Proposed Clinical Pathway Based on Retrospective Analysis of 332 Children

Purpose: Fasting plasma glucose (FPG) or oral glucose tolerance test (OGTT) is the traditional diagnostic tool for type 2 diabetes (T2DM). Primary barrier to performing FPG or OGTT in asymptomatic patients is the requirement of fasting, and thus the need for another scheduled visit. For OGTT, at least 2 blood draws would be needed, making the test inconvenient and labour-intensive. These barriers may lead to lower testing rate and possibly under-diagnosis. In a busy clinic setting with increasing number of referrals for children with obesity, a more practical and simpler clinical pathway to stratify those at higher risk of having abnormal OGTT results from the lower risk ones is needed. This study thus aimed to identify simple non-fasting parameters which can be used to formulate a clinical pahtway to stratify subjects according to their risk of abnormal OGTT. Methods: This retrospective study included subjects with overweight or obesity who had undergone OGTT in tertiary paediatric unit from 2012–2018. The optimal haemoglobin A1c (HbA1c) cutoff that predicts abnormal OGTT was evaluated. Other non-fasting parameters, in combination with this HbA1c cutoff, were also explored as predictors of abnormal OGTT. Results: Three hundred and thirty-two subjects (boys: 54.2%, Chinese: 97.3%) were included for analysis, of which, 272 (81.9%) subjects had normal OGTT while 60 (18.0%) subjects had abnormal OGTT (prediabetes or T2DM). The mean age was 15.4 ± 2.3 years and the mean BMI z-score was 2.7 ± 0.6. The mean HbA1c level was significantly higher in the abnormal OGTT group than normal OGTT group (5.6% vs 5.3%, P<0.001). In our cohort, using the ADA criteria for prediabetes with a HbA1c cutoff of ≥ 5.7% only yielded a sensitivity of 41.7% and a specificity of 86% in identifying abnormal OGTT (prediabetes or T2DM), meaning that a substantial proportion of subjects with prediabetes or diabetes will be missed. From Receivers operating characteristic (ROC) curves analysis, optimal HbA1c predicting abnormal OGTT was 5.5% (AUC 0.71; sensitivity of 66.7% and specificity of 71%). When HbA1c ≥ 5.5% was combined with positive family history and abnormal alanine transaminase (ALT) level, the positive predictive value for abnormal OGTT was increased from 33.6% to 61.6%. Conclusion: In our cohort, over 97% were Chinese and close to 60% had family history of T2DM, thus fulfilling the ‘high-risk’ group criteria as suggested by American Diabetes Association to have FPG or OGTT screening. Nevertheless, only 18% of subjects had prediabetes or diabetes based on OGTT results. Our study showed that HbA1c, family history of T2DM and ALT level could be used to derive a clinical pathway to stratify children who have high risk of abnormal OGTT. These high risk individuals can go for further diagnostic tests, while those at lower risk of prediabetes/T2DM can avoid unnecessary tests and additional clinic visits.

A Case of Possible SARS-COV-2 Induced Beta-Cell Failure

Background: There are several known viral triggers of ketosis-prone diabetes, including SARS-1 and HHV-81,2. SARS-COV-2 can bind ACE-2 receptors on the beta-cell causing destruction and acute impairment of insulin secretion3. There is accruing evidence to suggest that COVID-19 infection can worsen preexisting diabetes or induce new disease4. Clinical Case: A 40-year-old Hispanic male presented to the ER complaining of fatigue, polyuria, and polydipsia. A screening COVID-19 PCR was positive but he denied URI symptoms. His admission labs were notable for hyperglycemia (434 mg/dL; n 71–99), metabolic acidosis (pH 7.1 [n 7.35–7.45]; HCO3 3 mmoL/L [n 21–32]), increased anion gap (27 mmoL/L; n < 12) and elevated HbA1c (7.9%; n < 5.7%). The patient’s fructosamine was also high (464 umol/L; n 200–285) and discordant from his HbA1c. There was no evidence of pancreatitis, lactic acidosis, renal impairment or hepatic dysfunction. The patient had no known medical problems, did not drink alcohol to excess, and reported good access to nutrition. He had a strong family history of T2DM, but his BMI (23.3 kg/m2) and lipid panel were normal. The DKA was managed in the medical ICU using fluids and IV insulin per protocol. The patient required 180 units of IV insulin/24-hours (2.5 units/kg/day) to maintain blood glucose 180–250 mg/dL. After 48-hours of IV insulin, he was transitioned to subcutaneous insulin and prescribed multiple daily injections at discharge. There were concerns about possible T1DM and/or glucose toxicity leading to further diagnostics. His GAD-65 (<5 [IU]/mL; n 0–5 [IU]/mL) and IA-2 (<5.4 U/mL; n <5.4 U/mL) antibodies were negative but his c-peptide was suppressed (0.64 ng/mL; n 0.8–3.85). The patient was reevaluated at three months post-discharge. His glycemic control and insulin requirements had improved but repeat c-peptide level was undetectable. He was thought to have beta-cell failure and referred to a diabetologist. Conclusion: This is a case of absolute insulin deficiency persisting for at least three months most likely attributable to acute COVID-19 infection.

Endocrinological and metabolic characteristics in patients who are non-obese and have polycystic ovary syndrome and different types of a family history of type 2 diabetes mellitus.

ObjectiveWe aimed to investigate whether patients with polycystic ovary syndrome (PCOS) and a family history (FH) of type 2 diabetes mellitus (T2DM) are at increased risk of endocrinological and metabolic abnormalities, and whether this risk differs between first-degree and second-degree relatives, and between maternal and paternal transmission.MethodsA total of 680 patients with PCOS were enrolled in this retrospective, single-center study. Endocrine and glycolipid metabolism parameters were compared.ResultsThe free androgen index (FAI), and levels of fasting blood glucose (FBG), fasting insulin (FINS), homeostatic model assessment-insulin resistance (HOMA-IR), total cholesterol (TC), and low-density lipoprotein cholesterol were significantly higher, whereas sex hormone binding globulin (SHBG) levels were significantly lower in patients with PCOS and a FH of T2DM. In patients with PCOS with a FH of T2DM in first-degree relatives, age and levels of FBG, FINS, and HOMA-IR were significantly higher than those who had a FH of T2DM in second-degree relatives. A maternal history of T2DM was associated with a higher body mass index, FAI, and TG levels, and lower SHBG levels.ConclusionsPatients with PCOS and a FH of T2DM have more severe hyperandrogenism and metabolic disorders, especially in those with maternal transmission.

Association of the Ratio of Triglycerides to High-Density Lipoprotein Cholesterol Levels with the Risk of Type 2 Diabetes: A Retrospective Cohort Study in Beijing.

Background Previous studies have shown that the ratio of triglyceride to high-density lipoprotein cholesterol level (TG/HDL-C) is a risk factor for type 2 diabetes mellitus (T2DM). The aim of this study was to investigate the nonlinear relationship between TG/HDL-C and the incidence of T2DM in a Chinese population. Methods We used logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the incidence of T2DM among 7,791 participants from the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) cohort study at baseline. Results After adjusting for age, sex, body mass index, smoking status, alcohol intake, low-density lipoprotein cholesterol level, strenuous activity, education level, family histories of T2DM and tumors, and the presence of hypertension, tumor, stroke, and coronary heart disease, we showed that TG/HDL-C was positively associated with the incidence of T2DM at the 4-year follow-up (OR = 1.49, 95%CI = 1.26–1.78). TG/HDL-C and incidence of T2DM showed a nonlinear relationship; the inflection point of TG/HDL-C was 1.50. The ORs (95% CI) on the left and right sides of the inflection point were 2.50 (1.70–3.67) and 0.96 (0.67–1.37), respectively. After adjusting for age, sex, and body mass index (BMI) in the linear relationship, the OR of the incidence of T2DM was 1.60 (95%CI = 1.37–1.87). When the TG/HDL-C was less than 1.50 or greater than 1.76, the ORs (95% CI) were 2.41 (1.82–3.18) or 0.81 (0.53–1.25), respectively. Subgroup analysis showed no relationships of T2DM incidence with sex, BMI, family history of T2DM, or TG/HDL-C. Conclusion TG/HDL-C is positively associated with diabetes risk. In our study, with each increasing quintile, the risk of T2DM after 4 years was 1.60 or 1.49 depending on the variables adjusted. In addition, our cohort study showed a nonlinear relationship between TG/HDL-C and T2DM incidence, with an inflection point of 1.76 or 1.50, depending on the variables adjusted. When the TG/HDL was less than 1.50, the ORs (95% CI) were 2.41 (1.82–3.18) and 2.50 (1.70–3.67). When the TG/HDL-C was greater than 1.76 or 1.50, there was no significant difference in the change in OR.

Bidirectional Association between Metabolic Control in Type-2 Diabetes Mellitus and Periodontitis Inflammatory Burden: A Cross-Sectional Study in an Italian Population.

This study assessed the periodontal conditions of type 2 diabetes (T2DM) patients attending an Outpatient Center in North Italy and explored the associations between metabolic control and periodontitis. Periodontal health of 104 T2DM patients (61 men and 43 women, mean age of 65.3 ± 10.1 years) was assessed according to CDC/AAP periodontitis case definitions and Periodontal Inflamed Surface Area (PISA) Index. Data on sociodemographic factors, lifestyle behaviors, laboratory tests, and glycated hemoglobin (HbA1c) levels were collected by interview and medical records. Poor glycemic control (HbA1c ≥ 7%), family history of T2DM, and C-reactive protein levels were predictors of severe periodontitis. An increase in HbA1c of 1% was associated with a rise in PISA of 89.6 mm2. On the other hand, predictors of poor glycemic control were severe periodontitis, waist circumference, unbalanced diet, and sedentary lifestyle. A rise in PISA of 10 mm2 increased the odds of having HbA1c ≥ 7% by 2%. There is a strong bidirectional connection between periodontitis and poor glycemic control. The inflammatory burden posed by periodontitis represents the strongest predictor of poor glycemic control.

Who should return for an oral glucose tolerance test? A proposed clinical pathway based on retrospective analysis of 332 children.

Fasting plasma glucose or oral glucose tolerance test (OGTT) is the traditional diagnostic tool for type 2 diabetes (T2DM). However, fasting is required and implementation in all overweight/obese subjects is not practical. This study aimed to formulate a clinical pathway to stratify subjects according to their risk of abnormal OGTT. This retrospective study included patients with overweight or obesity who had undergone OGTT in a tertiary paediatric unit from 2012 to 2018. The optimal haemoglobin A1c (HbA1c) cutoff that predicts abnormal OGTT was evaluated. Other non-fasting parameters, in combination with this HbA1c cutoff, were also explored as predictors of abnormal OGTT. Three hundred and thirty-two patients (boys: 54.2%, Chinese: 97.3%) were included for analysis, of which, 272 (81.9%) patients had normal OGTT while 60 (18.0%) patients had abnormal OGTT (prediabetes or T2DM). Optimal HbA1c predicting abnormal OGTT was 5.5% (AUC 0.71; sensitivity of 66.7% and specificity of 71%). When HbA1c≥5.5% was combined with positive family history and abnormal alanine transaminase (ALT) level, the positive predictive value for abnormal OGTT was increased from 33.6 to 61.6%. HbA1c, family history of T2DM and ALT level could be used to derive a clinical pathway to stratify children who have high risk of abnormal OGTT.

Relationship between family history of type 2 diabetes mellitus and knowledge, attitude, and practice regarding type 2 diabetes mellitus among medical students

Abstract&#x0D; BACKGROUND: Diabetes mellitus (DM) is a condition of increase in blood glucose levels, due to impaired synthesis and/or secretion of insulin. Family history of DM is one of the non-modifiable risk factors for someone to suffering DM. Individual knowledge, attitude, and practice towards DM also affects a person to suffering DM.&#x0D; AIM: This study aims to determine the relationship between family history of type 2 diabetes mellitus (T2DM) and knowledge, attitude, and practice regarding T2DM among medical students at the Universitas Sumatera Utara.&#x0D; METHODS: This study was an online questionnaire-based observational study. It was involved 370 medical students from batches of 2017, 2018, and 2019 at the Universitas Sumatera Utara during the period from April-October 2020. Data was collected using a questionnaire containing questions and statements regarding knowledge, attitude, and practice of respondents towards T2DM. The questionnaire also contains questions about respondents' family history of T2DM. The relationship between family history of T2DM and knowledge, attitude, and practice toward T2DM among medical students in the Universitas Sumatera Utara were analyzed using the Chi Square test, with SPSS version 24.&#x0D; RESULTS: From the 370 Universitas Sumatera Utara medical students were being respondents in this study, it was shown that good and poor knowledge scores toward T2DM were 50.8% and 49.2% respectively. The attitude scores were 53.5% and 46.5% respectively. The practice scores were 47.8% and 52.2% respectively. There were 197 students (53.2%) who have a family history of suffering from T2DM and 173 students (46.8%) did not have. The results of the analysis test between data showed that there was a significant relationship between a family history of T2DM with knowledge of T2DM (p = 0.002, RP = 1.921, 95% CI = 1.270-2.906), attitudes (p = 0.005, RP = 1.815, 95% CI = 1.200-2.745) and practice (p = 0.001, RP = 2.092, 95% CI = 1.380-3.173).&#x0D; CONCLUSION: In this study it is shown that the medical students have good knowledge and attitudes towards T2DM but it’s not in line with practice. A family history of T2DM is a factor that influences behavior, attitude, and practice towards T2DM in medical students at the Universitas Sumatera Utara.&#x0D;

Signs of Deregulated Gene Expression Are Present in Both CD14+ and CD14- PBMC From Non-Obese Men With Family History of T2DM.

AimDevelopment of type 2 diabetes (T2DM) is associated with disturbances in immune and metabolic status that may be reflected by an altered gene expression profile of peripheral blood mononuclear cells (PBMC). To reveal a potential family predisposition to these alterations, we investigated the regulation of gene expression profiles in circulating CD14+ and CD14- PBMC in fasting conditions and in response to oral glucose tolerance test (OGTT) in glucose tolerant first-degree relatives (FDR) of T2DM patients and in control subjects.Materials and MethodsThis work is based on the clinical study LIMEX (NCT03155412). Non-obese 12 non-diabetic (FDR), and 12 control men without family history of diabetes matched for age and BMI underwent OGTT. Blood samples taken before and at the end of OGTT were used for isolation of circulating CD14+ and CD14- PBMC. In these cells, mRNA levels of 94 genes related to lipid and carbohydrate metabolism, immunity, and inflammation were assessed by qPCR.ResultsIrrespectively of the group, the majority of analyzed genes had different mRNA expression in CD14+ PBMC compared to CD14- PBMC in the basal (fasting) condition. Seven genes (IRS1, TLR2, TNFα in CD14+ PBMC; ABCA1, ACOX1, ATGL, IL6 in CD14- PBMC) had different expression in control vs. FDR groups. OGTT regulated mRNA levels of nine genes selectively in CD14+ PBMC and of two genes (ABCA1, PFKL) selectively in CD14-PBMC. Differences in OGTT-induced response between FDR and controls were observed for EGR2, CCL2 in CD14+ PBMC and for ABCA1, ACOX1, DGAT2, MLCYD, and PTGS2 in CD14- PBMC.ConclusionThis study revealed a different impact of glucose challenge on gene expression in CD14+ when compared with CD14- PBMC fractions and suggested possible impact of family predisposition to T2DM on basal and OGTT-induced gene expression in these PBMC fractions. Future studies on these putative alterations of inflammation and lipid metabolism in fractionated PBMC in larger groups of subjects are warranted.

The Risk of Type 2 Diabetes Mellitus in a Russian Population Cohort According to Data from the HAPIEE Project.

The aim of this study is to investigate the 14-year risk of type 2 diabetes mellitus (T2DM) and develop a risk score for T2DM in the Siberian cohort. A random population sample (males/females, 45–69 years old) was examined at baseline in 2003–2005 (Health, Alcohol, and Psychosocial Factors in Eastern Europe (HAPIEE) project, n = 9360, Novosibirsk) and re-examined in 2006–2008 and 2015–2017. After excluding those with baseline T2DM, the final analysis included 7739 participants. The risk of incident T2DM during a 14-year follow-up was analysed using Cox regression. In age-adjusted models, male and female hazard ratios (HR) of incident T2DM were 5.02 (95% CI 3.62; 6.96) and 5.13 (95% CI 3.56; 7.37) for BMI ≥ 25 kg/m2; 4.38 (3.37; 5.69) and 4.70 (0.27; 6.75) for abdominal obesity (AO); 3.31 (2.65; 4.14) and 3.61 (3.06; 4.27) for fasting hyperglycaemia (FHG); 2.34 (1.58; 3.49) and 3.27 (2.50; 4.26) for high triglyceride (TG); 2.25 (1.74; 2.91) and 2.82 (2.27; 3.49) for hypertension (HT); and 1.57 (1.14; 2.16) and 1.69 (1.38; 2.07) for family history of diabetes mellitus (DM). In addition, secondary education, low physical activity (PA), and history of cardiovascular disease (CVD) were also significantly associated with T2DM in females. A simple T2DM risk calculator was generated based on non-laboratory parameters. A scale with the best quality included waist circumference >95 cm, HT history, and family history of T2DM (area under the curve (AUC) = 0.71). The proposed 10-year risk score of T2DM represents a simple, non-invasive, and reliable tool for identifying individuals at a high risk of future T2DM.

Are the factors associated with overweight/general obesity and abdominal obesity different depending on menopausal status?

Rapid modernization in China has impacted the daily lives and health of women, including a rise in obesity. However, little is known about the impact of menopausal status, behavior, and psychosocial factors on the risk of obesity for rural women in China. The aim of this study is to identify risk factors, including demographic information (education, family history of T2DM, menopausal status), obesity-related behavior, and psychosocial factors associated with overweight/general obesity and abdominal obesity. In a cross-sectional study design, participants had their weight, height, and waist circumference measured and completed questionnaires regarding family demographics, obesity-related health behaviors (physical activity, diet, sleep), and psychosocial information (stress, social support, and self-efficacy related to physical activity and healthy diet). A total of 646 women were included in this study; 46.6% were overweight/generally obese, and 48% had abdominal obesity. Postmenopausal women had a higher prevalence of general and central obesity. Regular physical activity decreased the risk for overweight/general obesity and abdominal obesity (OR = .41 and .31, respectively, p = .04) in premenopausal women. Postmenopausal women who had not breastfed their infants and reported moderate/high-stress had a higher risk for overweight/general obesity (OR = 3.93, and 2, respectively) and those who reported less than 6 hours of sleep per day increased their risk for abdominal obesity (OR = 2.08). Different factors associated with obesity were found in Chinese women, depending on menopausal status. Future studies should examine the impact of menopause on a woman’s risk for obesity, as well as develop tailored interventions to improve health, well-being and reduce the risk of obesity.

Risk of type 2 diabetes is increased in nonobese women with polycystic ovary syndrome: the National Health Insurance Service-National Sample Cohort Study

To investigate the relationship between polycystic ovary syndrome (PCOS) and type 2 diabetes mellitus (T2DM) in Korean women. Longitudinal case-control study. Not applicable. PCOS patients aged 15 to 44 years (n = 1,136) and control individuals (n = 5,675), matched 1:5 by age group, income, and region of residence. Not applicable. The occurrence of T2DM. In the PCOS and control groups, 15.7% and 14.4%, respectively, were obese (body mass index ≥25 kg/m2). The incidence rate of T2DM was 15.84/1,000 and 5.80/1,000 person-years in the PCOS and control groups, respectively. The unadjusted hazard ratio (HR) of T2DM in women with PCOS was 2.6-fold higher than that in control individuals. Women with PCOS still had a higher HR of T2DM than did control individuals after adjustment for body mass index, family history of T2DM, physical exercise level, and total cholesterol. PCOS was significantly associated with T2DM in women both with and without obesity. PCOS is independently associated with an increased incidence of T2DM in both obese and nonobese women. Screening for T2DM should be considered for both obese and nonobese women with PCOS in Korea.

Is job strain associated with a higher risk of type 2 diabetes mellitus? A systematic review and meta-analysis of prospective cohort studies.

Objectives:Epidemiological studies have explored the relationship between work-related stress and the risk of type 2 diabetes mellitus (T2DM), but it remains unclear on whether work-related stress could increase the risk of T2DM. We aimed to evaluate the association between job strain and the risk of T2DM.Methods:We searched PubMed and Web of Science up to April 2019. Summary risk estimates were calculated by random-effect models. And the analysis was also conducted stratifying by gender, study location, smoking, drinking, body mass index, physical activity, family history of T2DM, education and T2DM ascertainment. Studies with binary job strain and quadrants based on the job strain model were analyzed separately.Results:A total of nine studies with 210 939 participants free of T2DM were included in this analysis. High job strain (high job demands and low control) was associated with the overall risk of T2DM compared with no job strain (all other combinations) [relative risk (RR) 1.16, 95% confidence interval (CI) 1.03–1.31], and the association was more evident in women (RR 1.48, 95% CI 1.02–2.14). A statistically significant association was also observed when using high strain as a category (job strain quadrants) rather than binary variable (RR 1.62, 95% CI 1.04–2.55) in women but not men.Conclusions:Our study suggests that job strain is an important risk factor for T2DM, especially among women. Appropriate preventive interventions in populations with high job strain would contribute to a reduction in T2DM risk.

Adolescent metabolic syndrome and its components associations with incidence of type 2 diabetes in early adulthood: Tehran lipid and glucose study

AimTo investigate the association of youth metabolic syndrome (MetS) and its components, individually and in combination with early adulthood incident type 2 diabetes (T2DM).MethodsA total of 2798 adolescents aged 11–19 years enrolled in the study. At baseline, MetS, its components including blood pressure (BP), waist circumference (WC), triglycerides (TGs), fasting plasma glucose, and low HDL-C, and different combinations of MetS components were defined. After a mean 11.3 years of follow-up, T2DM was determined. Multivariable Cox proportional hazard regression analysis adjusted for age, sex, family history of T2DM, and adult BMI was used for data analysis. The hazard ratio (HR) and 95% confidence interval (CI) were reported.ResultsDuring the follow-up, 44 incidents T2DM were developed. Among different individual components, only high WC [HR = 2.63, 95% CI (1.39–4.97)] and high TGs [HR = 1.82, 95% CI (1.00–3.34)] remained as significant predictors only in the age and sex adjusted model. Regarding combinations of MetS components, ‘high TGs and high WC’ [HR = 2.70, 95% CI (1.27–5.77)], ‘high BP and high WC’ [HR = 2.52, 95% CI (1.00–6.33)], ‘high TGs and high BP’ [HR = 2.27, 95% CI (1.02–5.05)] as well as MetS per se [HR = 2.82, 95% CI (1.41–5.64)] had a significant relationship with incident T2DM in the multivariable adjusted model. Among different confounders, being female and having family history of T2DM were consistently associated with higher risk of T2DM, in different combinations of MetS components.ConclusionsAdolescence MetS and some combinations of MetS components predicted early adulthood T2DM. Thus, adolescents, particularly female ones, with combinations of MetS components as well as those with family history of T2DM could be targeted for lifestyle intervention.

REAL-world evidence of risk factors and comorbidities in YOUNG Indian adults with type 2 diabetes mellitus: A REAL YOUNG (diabetes) study.

Objective:To assess the clinical characteristics, risk factors, and comorbidities associated with type 2 diabetes mellitus (T2DM) in young adult patients.Methods:This is a retrospective, multicentric real-world study that included young adults (18–45 years) with T2DM. Primary information including demographics, medical and family history, biochemical measures (pre-and post-prandial blood glucose levels, glycosylated hemoglobin [HbA1c] and blood pressure, and lipid parameters) smoking and drinking habits were collected retrospectively from the medical records of the respective hospitals/clinics. Data were analyzed using descriptive and appropriate comparative statistics.Results:A total of 22,921 patients from 623 sites were included. The median age was 37.0 years and the majority were men (61.6%). The proportion of patients from the age group >35–≤45 years was 62.7%. Among all patients, 46.9% had only T2DM; however, 53.1% of patients had T2DM with other comorbidities (T2DM with hypertension, dyslipidemia, and both). The majority of patients had elevated body mass index (BMI) (overweight, 46.6%; and obese, 22.9%). Family history of T2DM (68.1%) was most common in overall population. Sedentary lifestyle (63.1%), alcohol consumption (38.9%), and regular smoking (23.1%) were the most common associations in patients with T2DM with dyslipidemia and hypertension. Uncontrolled HbA1c level (≥7%) were observed in 79.2% of patients. The level of HbA1c was significantly increased with the duration of T2DM and sedentary lifestyle (p < 0.001).Conclusion:Higher BMI, family history of T2DM, sedentary lifestyle, alcohol consumption, and smoking were the most common risk facors, while hypertension and dyslipidemia were the most prevalent comorbidities associated with T2DM in young Indian adults.

Clusters of people with type 2 diabetes in the general population: unsupervised machine learning approach using national surveys in Latin America and the Caribbean

IntroductionWe aimed to identify clusters of people with type 2 diabetes mellitus (T2DM) and to assess whether the frequency of these clusters was consistent across selected countries in Latin America...