Incidence Of Diabetes Type Research Articles

Distalization of Standard Roux-en-Y Gastric Bypass: Indications, Technique, and Long-Term Results.

Weight loss failure or weight regain after primary Roux-en-Y gastric bypass (RYGB) is a challenge for bariatric surgeons. Failure to achieve a body mass index (BMI) <35 kg/m2 after RYGB occurs in up to 40.0%. The aim of this study was to evaluate long-term results of a novel technique for distalization of Roux-en-Y gastric bypass (DRYGB) as a revisional procedure. Retrospective data were reviewed for 22 patients who had undergone RYGB and failed to achieve an excess weight loss (EWL) >50% or BMI <35 kg/m2 and underwent limb distalization between 2013 and 2022. For this DRYGB procedure, the length of the common channel was 100 cm, and the lengths of the biliopancreatic limb and the alimentary limb were 1/3 and 2/3 of the remaining bowel, respectively. The mean BMI values before and after DRYGB were 43.7 kg/m2 and 33.5 kg/m2, respectively. Five years after DRYGB, mean % EWL was 74.3% and mean % total weight loss (TWL) was 28.8%. Mean % EWL and mean % TWL of the two procedures (RYGB and DRYGB) after 5 years were 80.9% and 44.7%, respectively. Three patients experienced protein calorie malnutrition. One was reproximalized and the others were treated with parenteral nutrition with no recurrence. There was a significant decrease in the incidence of diabetes type 2 and dyslipidemia after DRYGB. The DRYGB procedure results in substantial and sustained long-term weight loss. Due to the risk of malnutrition, patients must be strictly followed for life after the procedure.

Adolescent Obesity and Type Two Diabetes in Young Adults in the Minority Muslim Bedouin Population in Southern Israel.

Minority populations suffer from adolescent obesity at increasing rates and develop diabetes type 2 at a younger age. To assess the prevalence of adolescent obesity in the minority Bedouin population of Israel and its association with obesity and diabetes type 2 during young adulthood. A retrospective cohort study, based on computerized medical records. The study cohort was comprised of Bedouin adolescents, born in 1988-1990, who had BMI measurements at ages 14-19years in their medical records (N = 3310). The prevalence of obesity was 17.3% in middle adolescence, and 9.6% in late adolescence. The ORs for obesity in young adulthood were 30.1 (95% CI 19.1-49.3) and 40.9 (95% CI 25.7-69.1) for the middle and late adolescent groups, respectively. The incidence of diabetes type 2 per 105 person-years was 494.88 (95% CI 263.55-846.27) vs. 23.06 (95% CI 4.76-67.40) and 446.93 (95% CI 223.11-79 9.68) vs. 113.13 (95% CI 74.55-164.59) among adolescents with and without obesity in the middle and late adolescence groups, respectively. Interventions are needed to reduce the prevalence of adolescent obesity in the vulnerable Muslim Bedouin population in southern Israel.

A study of association between presence or absence of GSTT1 and GSTM1 and/or single nucleotide polymorphism in FABP2 and GSTP1 with incidence of diabetes type 2: A case-control study.

To assess the association of single nucleotide polymorphisms in fatty acid binding protein-2 (rs1799883) and glutathione S-transferase pi (rs1695) genes with presence/absence of glutathione S-transferase mu and glutathione S-transferase theta genes in type 2 diabetes. The cross-sectional case-control study was conducted at Institute of Molecular Biology and Biotechnology during March till September 2019 and comprised type 2 diabetes patients and non-diabetic controls from two districts in southern Punjab. Polymerase chain reaction, polymerase chain reaction-restriction fragment length polymorphism and tetra-primer amplification refractory mutation system-polymerase chain reaction were applied to investigate glutathione S-transferase theta, mu and pi genes as well as fatty acid binding protein-2, as appropriate. The association of single nucleotide polymorphisms in all genes with the disease were studied either individually or in various combinations. Data was analysed using Minitab 18. Of the 448 subjects, 248(55.4%) were patients and 200(44.6%) were controls. Overall there were 213(47.5%) males and 235(52.5) were females, and 141(31.5%) were aged 30-46 years. The presence of rs1799883 in fatty acid binding protein-2 (p=0.03) and the absence of glutathione S-transferase mu gene (p<0.001) had significant association with type 2 diabetes, while the presence of glutathione S-transferase theta and rs1695 in glutathione S-transferase pi genes were not associated with the disease. Individuals with glutathione S-transferase mu gene null and Ileu/Ileu or Ileu/Val genotype of rs1695 in glutathione S-transferase pi gene have potential to develop type 2 diabetes in their lifetime (p<0.05). The presence of rs1799883 in fatty acid binding protein-2 and the absence of glutathione S-transferase mu gene were found to play significantly in the development of type 2 diabetes.

Coffee in the diet and prevention of diabetes

The impact of coffee consumption on health deserves an attention, especially in the context of patients’ ongoing concerns about its adverse health effects. Knowledge on this subject may also inform the clinical practice. Objective — to present the current state of knowledge about the relationship between coffee consumption and the incidence of diabetes type 2. Epidemiological studies indicate that the habit of coffee consumption reduces the risk of non-insulin-dependent diabetes. Drinking at least 3 cups of coffee a day reduces the risk of this disease by 20–25%, and higher consumption may portend even more protection. The beneficial effect of coffee is most likely due to polyphenols present in the infusion, which have an anti-inflammatory effect and may improve insulin sensitivity. The content of bioactive ingredients in a cup of coffee is variable, depending on both the natural variation in coffee beans and the brewing method. The issue of sweetening coffee is a particularly important one as the addition of sugar can reduce its beneficial effects. Moderate consumption of coffee brewed using filters (3–5 cups per day) is recommended. Current scientific research indicates that coffee not only has no negative impact on health but may even reduce the incidence of diabetes.

THE ROLE OF POLLUTANTS OF ATMOSPHERIC AIR AND PESTICIDES IN THE DEVELOPMENT OF DIABETES MELLITUS TYPE 2

Introduction. Primary and secondary review of epidemiological studies on the importance of atmospheric air pollutants and chemical pesticides for the development of diabetes mellitus is presented. Material and methods. The article includes reviews using the ISI-Web of Science, EMBASE and PubMed database for systematic review and meta-analysis, and original studies from PubMed and RISC until March 2018 to assess the cause-effect relationships of non-insulin-dependent diabetes mellitus with air pollutants and chemical pesticides. Results. Chemical pollution is considered as a new risk factor for insulin resistance and development of CD2, although the number of publications is limited, and the degree of validity of the findings is very wide. The evidence base for the effect on the incidence of diabetes type 2 is the most complete for organochlorine pesticides (DDT, DDE, HCH) and persistent organic pollutants, which are impurities of the commodity forms of individual preparations. It is supported by systematic reviews, meta-analysis, survey results, the content of active ingredients in biomaterial, risk calculations. Data for assessing the interrelationships of diabetes and glyphosates, chlorophenoxyacetates, pyrethroids and other pesticides widely used in the last two decades are insufficient for statistical generalizations. Intermediate position on the degree of evidence of diabetogenic properties occupies air pollutants (PM2,5, PM10, NO2). The role of the genetic component, obesity, metabolic disorders for the incidence of diabetes in conditions of technogenic pollution is discussed. Conclusion. Targeted epidemiological studies are needed on the environmental risks associated with the development of type 2 diabetes mellitus caused by air pollutants and pesticides used at this stage for the organization of preventive measures.

Association between allele 12Pro of rs1801282 polymorphism gene PPAR and diabetes mellitus type 2

Aim – to investigate the presence of polymorphisms and alleles in patients with type 2 diabetes mellitus (DM) and analyze the link of polymorphism Pro12Ala (rs1801282) in PPARG gene and incidence of diabetes type 2 in the Ukrainian population. Materials and methods. The study was conducted in 88 patients with DM type 2, the control group consisted of 50 patients. For molecular genetic research PCR in real time was used. For the analysis of polymorphic DNA loci standardized test system TaqMan Mutation Detection Assays Life-Technology (USA) was used. Results and discussion. In type 2 DM genotype Pro12Pro was found in 84% of patients versus 72% in the control group; genotype Pro12Ala - 16% vs. 24%; Ala12Ala genotype in patients was not recorded in any patient (in control - 4%). 12Pro allele was found in 92% of patients versus 84% in the control, allele 12Ala — 8% vs. 16% in control. These differences were statistically significant for alleles (p(χ2)=0,04), but not for genotypes (p(χ2)=0,075). Any link between genotypes and DM type 2 was not recorded (p=0,07). Instead, such an association (p=0,04) was found for alleles: 12Pro (OR=2,20; CI=1,03-4,73) and 12Ala (OR=0,45; CI=0,21-0,97). Conclusions. In this study the probable association of gene polymorphism Pro12Ala (rs1801282) gene PPARG with the DM type 2 morbidity in the Ukrainian population was not found, but statistically significant association for allele 12Pro was evident, the presence of which increases more than 2 times the risk of disease, whereas the presence of the allele 12Ala reduced this risk.

Purinergic signalling and diabetes.

The pancreas is an organ with a central role in nutrient breakdown, nutrient sensing and release of hormones regulating whole body nutrient homeostasis. In diabetes mellitus, the balance is broken—cells can be starving in the midst of plenty. There are indications that the incidence of diabetes type 1 and 2, and possibly pancreatogenic diabetes, is rising globally. Events leading to insulin secretion and action are complex, but there is emerging evidence that intracellular nucleotides and nucleotides are not only important as intracellular energy molecules but also as extracellular signalling molecules in purinergic signalling cascades. This signalling takes place at the level of the pancreas, where the close apposition of various cells—endocrine, exocrine, stromal and immune cells—contributes to the integrated function. Following an introduction to diabetes, the pancreas and purinergic signalling, we will focus on the role of purinergic signalling and its changes associated with diabetes in the pancreas and selected tissues/organ systems affected by hyperglycaemia and other stress molecules of diabetes. Since this is the first review of this kind, a comprehensive historical angle is taken, and common and divergent roles of receptors for nucleotides and nucleosides in different organ systems will be given. This integrated picture will aid our understanding of the challenges of the potential and currently used drugs targeted to specific organ/cells or disorders associated with diabetes.

Prevention of Diabetes in Family Medicine

Conflict of interest: none declared.IntroductionThe incidence of diabetes type 2 (diabetes mellitus type 2 – DM 2) is rapidly increasing worldwide. Physical inactivity and obesity are the major determinants of the disease. Primary prevention of DM 2 entails health monitoring of people at risk category. People with impaired glycemic control are at high risk for development of DM 2 and enter the intensive supervision program for primary and secondary prevention.Objective of the researchTo evaluate the impact of metformin and lifestyle modification on glycemia and obesity in patients with prediabetes.Patients and MethodsThe study was conducted on three groups of 20 patients each (total of 60 patients) aged from 45 to 80, with an abnormal glycoregulation and prediabetes. The study did not include patients who already met the diagnostic criteria for the diagnosis of diabetes. During the study period of 6 months, one group was extensively educated on changing lifestyle (healthy nutrition and increased physical activity), the second group was treated with 500 mg metformin twice a day, while the control group was advised about diet and physical activities but different from the first two groups. At beginning of the study, all patients were measured initial levels of blood glucose, HbA1C, BMI (Body Mass Index), body weight and height and waist size. Also the same measurements were taken at the end of the conducted research, 6 months later. For the assessment of diabetes control was conducted fasting plasma glucose (FPG) test and 2 hours after a glucose load, and HbA1C.ResultsAt the beginning of the study the average HbA1C (%) values in three different groups according to the type of intervention (lifestyle changes, metformin, control group) were as follows: (6.4 ± 0.5 mmol / l), (6.5 ± 1.2 mmol / l), (6.7 ± 0.5 mmol / l). At the end of the research, the average HbA1C values were: 6.2 ± 0.3 mmol / l, 6.33 ± 0.5 mmol / l and 6.7 ± 1.4 mmol / l. In the group of patients who received intensive training on changing lifestyle or group that was treated with metformin, the average reduction in blood glucose and HbA1C remained within the reference range and there were no criteria for the diagnosis of diabetes. Unlike the control group, a group that was well educated on changing habits decreased average body weight by 4.25 kg, BMI by 1.3 and waist size by 2.5 cm. Metformin therapy led to a reduction in the average weight of 3.83 kg, BMI of 1.33 and 3.27 for waist size. Changing lifestyle (healthy diet and increased physical activity) has led to a reduction in total body weight in 60% of patients, BMI in 65% of patients, whereas metformin therapy led to a reduction of the total body weight in 50%, BMI in 45% of patients. In the control group, the overall reduction in body weight was observed in 25%, and BMI in 15% of patients.ConclusionModification of lifestyle, such as diet and increased physical activity or use of metformin may improve glycemic regulation, reduce obesity and prevent or delay the onset of developing DM 2.

Parents’ discursive resources: Analysis of discourses in Swedish, Danish and Norwegian health care guidelines for children with diabetes type 1

The incidence of diabetes type 1 in children, the most common metabolic disorder in childhood, increases worldwide, with highest incidence in Scandinavia. Having diabetes means demands in everyday life, and the outcome of the child's treatment highly depends on parents' engagement and involvement. The aim of this study was to explore and describe discourses in health care guidelines for children with diabetes type 1, in Sweden, Norway and Denmark during 2007-2010, with a focus on how parents were positioned. As method a Foucauldian approach to discourse analysis was applied, and a six-stage model was used to perform the analysis. The findings shows a Medical, a Pedagogic and a Public Health discourse embedded in the hegemonic Expert discourse. The Expert discourse positioned parents as dependent on expert knowledge, as recipients of education, as valuable and responsible for their child's health through practicing medical skills. This positioning may place parents on a continuum from being deprived of their own initiatives to being invited to take an active part and could result in feelings of guilt and uncertainty, but also of security and significance. From this study we conclude that guidelines rooted in the Expert discourse may reduce opportunities for parents' voices to be heard and may overlook their knowledge. By broadening the selection of authors of the guidelines to include patients and all professionals in the team, new discourses could emerge and the parents' voice might be more prominent.

Mothers' Experiences of Maze Path of Type 1 Diabetes Diagnosis in Children.

Incidence of diabetes Type 1 in children with non-classic symptoms is one of the reasons for the delay in their follow-up. Failure in its diagnosis by the health professional exposes the mothers to many challenges. This study was conducted to explore mothers' experiences in the diagnosis pathway of diabetes Type 1 in children. Semi-structured qualitative interviews were conducted with fifteen mothers of children with Type 1 diabetes. they were selected by the purposefull sampling method. Their child had a medical file in diabetes centers in Kerman, Iran, at least one year has passed of diabetes diagnosis in their child and the maximum age of the child is 14 years. Data were analyzed using content analysis. Three themes and nine sub-themes emerged during data analysis. The extracted themes included "presence in the maze path to the child's disease", "facing the reality of the child's disease", and "to grin and bear with new conditions". According to the finding, these mothers experienced various challenges. Therefore, identification of these challenges by health professionals to prevent and decrease of Them, is necessary.