Risk Factor For Development Of Diabetes Research Articles

Excess homocysteine inhibits pancreatic β-cell secretory function by repressing Zbtb20 expression

Homocysteine (Hcy) is a sulfur-containing amino acid. An elevated level of Hcy is a risk factor for diabetes development. However, the mechanism of its effect on pancreatic β-cell function is unclear. In this study, we constructed a hyperhomocysteinemia (HHcy) mouse model by feeding mice a high methionine diet (HMD). The mice suffered impaired glucose tolerance and reduced insulin secretion. Furthermore, at the cellular level, INS1 cells exhibited impaired insulin secretory function after the Hcy intervention. Transcriptomics revealed that Zbtb20 expression was downregulated and the downstream gene Fbp1 was upregulated in HHcy-induced mice compared with mice fed with normal diet. Insulin secretion could be restored by Zbtb20 overexpression or fructose 1,6-bisphosphatase (FBPase) activity inhibition in INS1 cells. In conclusion, our study suggested that Hcy inhibited the insulin secretory function of pancreatic β-cells by suppressing Zbtb20 expression, leading to the development of diabetes. Zbtb20 may be a key target in the development of diabetes associated with elevated Hcy levels.

Changes in Isoleucine, Sarcosine, and Dimethylglycine During OGTT as Risk Factors for Diabetes.

Current metabolomics studies in diabetes have focused on the fasting state, while only a few have addressed the satiated state. We combined the oral glucose tolerance test (OGTT) and metabolomics to examine metabolite-level changes in populations with different glucose tolerance statuses and to evaluate the potential risk of these changes for diabetes. We grouped participants into those with normal glucose tolerance (NGT), impaired glucose regulation (IGR), and newly diagnosed type 2 diabetes (NDM). During the OGTT, serum was collected at 0, 30, 60, 120, and 180 minutes. We evaluated the changes in metabolite levels during the OGTT and compared metabolic profiles among the 3 groups. The relationship between metabolite levels during the OGTT and risk of diabetes and prediabetes was analyzed using a generalized estimating equation (GEE). The regression results were adjusted for sex, body mass index, fasting insulin levels, heart rate, smoking status, and blood pressure. Glucose intake altered metabolic profile and induced an increase in glycolytic intermediates and a decrease in amino acids, glycerol, ketone bodies, and triglycerides. Isoleucine levels differed between the NGT and NDM groups and between the NGT and IGR groups. Changes in sarcosine levels during the OGTT in the diabetes groups were opposite to those in glycine levels. GEE analysis revealed that during OGTT, isoleucine, sarcosine, and acetic acid levels were associated with NDM risks, and isoleucine and acetate levels with IGR risks. Metabolic profiles differ after glucose induction in individuals with different glucose tolerance statuses. Changes in metabolite levels during OGTT are potential risk factors for diabetes development.

Diffuse calcification of pancreas impairs endocrine function and predicts poor outcome in total pancreatectomy with islet autotransplantation

In patients with chronic pancreatitis, pancreatic calcification is a risk factor for diabetes development, poor islet yield, and metabolic outcomes after total pancreatectomy with islet autotransplantation (TPIAT). We investigated whether calcification pattern based on computed tomography is associated with outcomes using our database of 200 consecutive TPIAT procedures. Three groups were compared: noncalcification (NC); focal calcification, limited to the pancreas head, body, or tail; and diffuse calcification (DC), with calcification in >2 sections. Maximum changes in outcomes were seen in the DC vs focal calcification group. In the DC group, preoperative hemoglobin A1c levels were higher (P < .01), and stimulated C-peptide levels were lower (P < .01) than in the NC group. Islet isolation from the DC pancreas resulted in the lowest islet equivalent (IEQ) yield and IEQ/kg among the 3 groups (P < .0001), with no insulin independence 12 months posttransplant (P < .05 vs NC group). Notably, at 12 months, the DC group was 91.7% narcotic-free, significantly higher than the NC group (P < .05). Although DC is a sign of diabetes risk after TPIAT, the DC group showed exceptional pain relief. These findings suggest that TPIAT can be beneficial for patients with chronic pancreatitis with severe calcification.

Assessment of Type 2 Diabetes Risk in General Population using Bitter Taste Sensitivity Status to Phenylthiocarbamide - A Pilot Study

Eating habits and genetic factors contribute to diseases such as obesity and Type 2 Diabetes Mellitus (T2DM). Variation in bitter taste perception has been linked with intake of alcohol, coffee, vegetable, and smoking habit as well as with adiposity, a risk factor for diabetes development. Therefore, it was hypothesized that bitter taste perception could lead to differences in eating/drinking behavior among individuals, which may lead T2DM development later in the life. Bitter taste sensitivity was assessed using paper strips having supra-threshold concentration of Phenyl Thio Carbamide (PTC). Lifestyle variables were assessed using standard anthropometry measurements and a questionnaire. T2DM risk was assessed using a point based system developed by Finnish Diabetes Association (FINDRISC score). SPSS software was used for statistical analysis. A total of 498 volunteers from New Delhi region participated in the present study, where the mean age of PTC tasters was 24 ± 12 years and for non-tasters was 29 ± 16 years. PTC taster status was significantly correlated with age (p ≤ 0.01), weight (p ≤ 0.05), BMI (p ≤ 0.05) and waste circumference (p ≤ 0.05). A positive correlation was observed for type of chocolate liking (r = 0.113, p ≤ 0.001) and for T2DM risk (p ≤ 0.012) with PTC non-taster status. Logistic regression analysis showed that PTC non-taster individuals are at a higher risk (OR: 1.558, 95% CI: 1.037-2.342, p=0.033) for developing T2DM in the next ten years. Present results have shown that bitter taste sensitivity modulates liking towards certain food and non-tasters for PTC have a higher BMI, weight and are at a higher risk for T2DM development. PTC tasting could be employed as a method for assessing risk of diabetes in healthy individuals. We recommend large scale screening among young adults to promote awareness and early prevention measures.

The Association between the Low-density Lipoprotein-Cholesterol to High-density Lipoprotein-Cholesterol Ratio and the Incidence of Type 2 Diabetes Mellitus in Korean Adults: A Secondary Data Analysis Using a Community-based Cohort Study in Korea

Purpose: This study investigated the association between the low-density lipoprotein-cholesterol/high-density lipoprotein-cholesterol (LDL-C/HDL-C) ratio and the incidence of diabetes in a Korean community-based cohort.Methods: The participants were 7,653 adults aged 40-69 years without diabetes at baseline from Korean Genome and Epidemiology Study who were followed up for 16 years biennially. These participants were categorized into four groups (Q1-Q4) according to quartiles of LDL-C/HDL-C ratio at baseline. Significant differences in the probability of diabetes-free survival curve were identified using the log-rank test in Kaplan-Meier analysis. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression analysis.Results: In total, 1,833 (24.0%) participants newly developed diabetes. The overall incidence of diabetes was 20.37 per 1,000 person-years (14.94, 17.12, 22.0, and 22.08 per 1,000 person-years for Q1, Q2, Q3, and Q4, respectively). The probability of diabetes-free survival was significantly different among the four groups (log-rank, &lt;i&gt;x&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=117.88, &lt;i&gt;p&lt;/i&gt;&lt;.001). Covariates included age, sex, triglyceride, fasting plasma glucose, homeostatic model assessment for insulin resistance index, hypertension, body mass index, family history of diabetes mellitus, smoking status, and alcohol use. Multivariate Cox proportional hazards regression showed that people with the highest quartile of the LDL-C/HDL-C ratio had a 1.17 times higher (HR=1.17, 95% CI: 1.01~1.35, &lt;i&gt;p&lt;/i&gt;=.038) risk of diabetes development than those in the lowest quartile after adjusting for covariates.Conclusion: The LDL-C/HDL-C ratio is an independent risk factor for diabetes development. Measuring and managing the LDL-C/HDL-C ratio is necessary for detecting individuals at high risk for developing diabetes.

Clinical/biochemical characteristics and related outcomes in people with new‐onset diabetes and COVID‐19: experience from a single centre

Abstract Aims: It is known that there is a bidirectional relationship between diabetes mellitus (DM) and coronavirus disease (COVID‐19). It has been described that those patients infected with SARS‐CoV‐2 could develop severe metabolic decompensation of pre‐existing or new‐onset DM, although diabetogenic effect of SARS‐CoV‐2 has still not been well consolidated. In fact, the coexistence of SARS‐CoV‐2 infection and new‐onset DM is an infrequent situation.Methods: We describe the clinical and analytical characteristics of 19 patients admitted to a Spanish tertiary hospital – all 19 having COVID‐19 infection and new‐onset DM.Results: 12/19 patients (63.2%) were female; the mean age at diagnosis of DM was 54 (39–65) years. The most frequent ethnic group was Caucasian (n=9), followed by Latin‐American (n=7); 7/19 (36.8%) previously met criteria for prediabetes due to altered basal glycaemia or HbA1c. The mean BMI at diagnosis was 32.26kg/m2 (27.62–35.18kg/m2). Eighteen of 19 patients (94.7%) showed bilateral bronchopneumonia. The mean blood glucose of the first blood was 17.5mmol/L (11.1–21.1mmol/L), and the mean HbA1c was 88mmol/mol (60–115mmol/mol). C‐peptide was requested in eight patients and it was within normal range in 87.5% (n=7) and below the inferior threshold in one case. Autoantibodies were requested in 26.3% (five patients), being negative in 4/5 (80%) and positive in 1/5 (20%). Regarding the type of diabetes diagnosed, 18 were type 2 DM and only one case was diagnosed with type 1 DM. Seventeen had simple hyperglycaemia and two suffered a diabetic ketoacidosis. The mean HbA1c at 8.0 months (5.0–12.0 months) follow‐up was 42mmol/mol (40–49mmol/mol).Conclusion: The majority of those described had type 2 DM that appears to have been unmasked by the COVID‐19 infection, since they had high HbA1c and several risk factors for diabetes development, such as obesity and prediabetes. Most of them had their pancreatic reserve preserved, and this may suggest insulin resistance as the aetiology rather than direct beta‐cell damage. A good evolution of diabetes after hospital discharge was observed in the patients followed up at our centre. Copyright © 2022 John Wiley &amp; Sons.

Time to Diagnosis and Treatment of Diabetes Mellitus among Korean Adults with Hyperglycemia: Using a Community-Based Cohort Study.

Objectives: To identify the time from hyperglycemia to diabetes mellitus (DM) diagnosis and treatment, the risk factors for diabetes development, and the prevalence of comorbidities/complications in patients > 40 years of age. Methods: This secondary data analysis study used data from the Korean Genome and Epidemiology Study. The participants comprised 186 patients who did not have diabetes at baseline, but developed hyperglycemia at the first follow-up. The average and median periods until DM diagnosis and treatment were calculated using Kaplan–Meier survival analysis. Results: Of the 186 participants, 57.0% were men and 35.5% were 40–49 years old. The average time to DM diagnosis and treatment was 10.87 years and 11.34 years, respectively. The risk factors for the duration of DM were current smoking, body mass index (BMI), fasting blood sugar (FBS), and postprandial 2-hour glucose (PP2). The risk factors for the duration of diabetes treatment were current smoking, hypertension, BMI, FBS, and PP2. The development of one or more comorbidities or diabetes complications was identified at the time of DM diagnosis (36.5%) and DM treatment (41.4%). Conclusions: As diabetes complications occur at the time of DM, and early treatment can impact the development of diabetes complications or mortality, it is necessary to establish a referral program so that participants presenting with high blood sugar levels in the screening program can be diagnosed and treated in a timely manner.

Epidemiology and risk factors for diabetes in the suburbs of Beijing: a retrospective cohort study

ObjectiveWe aimed to detect the incidence and risk factors of type 2 diabetes mellitus (T2DM) development in the suburbs of Beijing.DesignCohort study with record linkage to incidence data.SettingWe performed a...

Diabète et corticoïdes : nouveautés et aspects pratiques

Diabetes frequently occurs during corticosteroid treatment, sometimes necessitating urgent therapeutic management, with insulin for example. Corticosteroids induce insulin resistance in the liver, adipocytes and skeletal muscle, and have direct deleterious effects on insulin secretion. The development of insulin resistance during corticosteroid treatment, and the insufficient adaptation of insulin secretion, are key elements in the pathophysiology of corticosteroid-induced diabetes. The capacity of pancreatic β-cells to increase insulin secretion in response to insulin resistance is partly genetically determined. A familial history of type 2 diabetes is, therefore, a major risk factor for diabetes development on corticosteroid treatment. Corticosteroid treatments are usually initiated at a fairly high dose, which is subsequently decreased to the lowest level sufficient to achieve disease control. Pharmacological management of diabetes is needed in patients with blood glucose levels exceeding 2.16g/l (12mmol/l) and insulin therapy can be started when blood glucose levels are higher than 3.6g/l (20mmol/l) with clinical symptoms of diabetes. Insulin can then be replaced with oral hypoglycemic compounds when both blood glucose levels and corticosteroid dose have decreased. Patient education is essential, particularly for the management of hypoglycemia when corticosteroids are withdrawn or their dose tapered.

Risk factors analysis for developing diabetes based on its 3-year outcome in an elderly population with impaired fasting glucose

To examine the risk factors for developing diabetes on its 3-year outcome in an elderly population with impaired fasting glucose (IFG). We selected the 328 elderly with impaired fasting glucose in Binhai new area of Tianjin as the research object. All subjects participated in objective examinations such as physical activity ability tests, blood tests and anthropometric examinations, and completed the questionnaire survey. Between baseline and 3-year outcome, 56 of the subjects with IFG at baseline have developed diabetes. After multivariate adjustments, we found that higher incidence of diabetes was associated with higher fasting plasma glucose (OR=9.30, 95%CI 2.84-30.48, P<0.01) and reduced grip strength/weight (OR=0.88, 95%CI 0.82-0.94, P<0.01). Moreover, the combination of higher fasting plasma glucose and lower grip strength/weight would lead to higher incidence of diabetes compared with higher fasting plasma glucose or lower grip strength/weight alone (P<0.05). In this study, high fasting plasma glucose and low muscle strength were associated with blood glucose worsening in three years in IFG patients. In addition to blood glucose levels, physical activity is also a risk factor for diabetes in older adults. Key words: Impaired fasting glycaemia; Muscle strength; Elderly

Poor clinical response in rheumatoid arthritis is the main risk factor for diabetes development in the short-term: A 1-year, single-centre, longitudinal study.

ObjectivesDespite of the European League Against Rheumatism (EULAR) provided different sets of recommendations for the management of cardiovascular risk in inflammatory arthritis patients, it must be pointed out that cardiometabolic comorbidity, such as type 2 diabetes (T2D), remains still underdiagnosed and undertreated in patients affected by rheumatoid arthritis (RA).MethodsIn this work, we designed a single centre, prospective study in order to better investigate the occurrence of T2D during the course of 1 year of follow-up. Furthermore, we evaluated the role of both traditional cardiovascular and RA-specific related risk factors to predict the occurrence of new T2D.ResultsIn this study, we evaluated 439 consecutive RA patients and we observed that 7.1% of our patients (31/439) developed T2D, after 12 month of prospective follow-up. The regression analysis showed that the presence of high blood pressure, the impaired fasting glucose (IFG) at the first observation and the poor EULAR-DAS28 response, after 12 months of follow–up, were significantly associated with an increased likelihood of being classified as T2D. Similarly, we observed that 7.7% of our patients (34/439) showed IFG after 12 months of prospective follow-up. The regression analysis showed that the presence of high blood pressure and the poor EULAR-DAS28 response after 12 months of follow-up, were significantly associated with an increased likelihood of showing IFG.ConclusionsOur study supports the hypothesis of a significant short-term risk of T2D in RA patients and of a close associations between uncontrolled disease activity and glucose metabolism derangement. Further multicentre, randomised-controlled studies are surely needed in order to elucidate these findings and to better ascertain the possible contribution of different therapeutic regimens to reduce this risk.

The Effect of OSA Therapy on Glucose Metabolism: It's All about CPAP Adherence!

The Effect of OSA Therapy on Glucose Metabolism: It's All about CPAP Adherence!

Is waist circumference ≥102/88cm better than body mass index ≥30 to predict hypertension and diabetes development regardless of gender, age group, and race/ethnicity? Meta-analysis.

Between body mass index (BMI) ≥30 and waist circumference (WC) ≥102/88cm, we investigated which of the two measures is a better predictor of two of the most common chronic diseases - diabetes mellitus and hypertension while also examining differential association by gender, age group, and race/ethnicity. Meta-analysis was conducted for all longitudinal studies with at least 12months of follow-up published up to April 2015. Ratio of relative risk (rRR) and relative risk of diseases were computed and compared by baseline obesity measurement. The final sample included 23 longitudinal observation studies involving 62 study arms with 259,200 individuals. WC≥102/88cm was a better predictor than BMI≥30 for development of diabetes (rRR=0.81, 95% CI=0.68-0.96), but not for hypertension (rRR=0.92, 95% CI=0.80-1.06). Subgroup analyses showed WC≥102/88cm was a better predictor for diabetes in women than men, and for ages 60 and older than other ages. Only WC≥102/88cm, not BMI≥30, predicted development of hypertension among Hispanic/Latinos. Neither BMI≥30 nor WC≥102/88cm were significant predictors of hypertension when age group was controlled. Central obesity may be a more serious risk factor for diabetes development in women and for older ages. The predictive power of BMI≥30 or WC≥102/88cm in hypertension development should not be emphasized as either could mask the effect of age.

Sex- and gender-aspects in regard to clinical practice recommendations for pre-diabetes and diabetes

Metabolic diseases dramatically affect life of men and women from infancy up to old age and are a major challenge for clinicians. Health professionals are confronted with different needs of women and men. This article aims at an increase of gender awareness and the implementation of current knowledge of gender medicine in daily clinical practice with regard to pre-diabetes and diabetes. Sex and gender affect screening and diagnosis of metabolic diseases as well as treatment strategies and outcome. Impaired glucose and lipid metabolism, regulation of energy balance and body fat distribution are related to steroid hormones and therefore impose their influence on cardiovascular health in both men and women. Furthermore, education, income and psychosocial factors relate to development of obesity and diabetes differently in men and women. Males appear to be at greater risk of diabetes at younger age and at lower BMI compared to women, but women feature a dramatic increase of their cardiometabolic risk after menopause. The estimated future years of life lost owing to diabetes is somewhat higher in women than men, with higher increase of vascular death in women, but higher increase of cancer death in men. In women pre-diabetes or diabetes are more distinctly associated with a higher number of vascular risk factors, such as inflammatory parameters, unfavourable changes of coagulation and blood pressure. Pre-diabetic and diabetic women are at much higher relative risk for vascular disease. Women are more often obese and less physically active, but may even have greater benefit from increased physical activity than males. Whereas men predominantly feature impaired fasting glucose, women often show impaired glucose tolerance. A history of gestational diabetes or the presence of a PCOS or increased androgen levels in women, on the other hand the presence of erectile dysfunction (ED) or decreased testosterone levels in men are sex specific risk factors for diabetes development. ED is a common feature of obese men with the Metabolic Syndrome and an important predictor of cardiovascular disease. Diabetic women also feature sexual dysfunctions much more frequently than non-diabetic women which should be addressed in clinical care. Several studies showed that diabetic women reach their targets of metabolic control (HbA1c), blood pressure and LDL-cholesterol less often than their male counterparts, although the reasons for worse treatment outcome in diabetic females are not clear. Furthermore, sex differences in action, pharmacokinetics, and side effects of pharmacological therapy have to be taken into account.

Bone turnover biomarkers in obese postmenopausal Saudi women with type-II diabetes mellitus.

There is a high prevalence of diabetes mellitus type-2 (T2DM) and osteoporosis are problems worldwide. In this study, we evaluated the correlation between T2DM and bone turnover in diabetic obese postmenopausal Saudi women. The present study included total of 65 T2-DM obese postmenopausal Saudi women, (36 uncontrolled, 29 controlled). The following serum biochemical parameters were evaluated [fasting blood glucose (FBG), total calcium (Ca), phosphorus (Pi), parathyroid hormone (PTH), 1,25-(OH)2 Vitamin D3, osteocalcin (OC), procollagen (PICP) and cathepsin k (Cath K)]. Serum OC levels were significantly decreased in diabetic obese postmenopausal group compared to their respective healthy group (P < 0.004). PICP and Cath K were significantly elevated in diabetic postmenopausal group compared to the healthy group (P < 0.024 & 0.001). A significant elevation in 1,25(OH)2 Vitamin D3, Ca and Pi levels in diabetic obese postmenopausal patients group compared to the healthy group. However, a non-significant changes was observed in serum PTH level between different groups. In this study, the changes in the biochemical parameters and bone turnover markers in obese women are strong risk factors for diabetes development that may contribute to osteopenia and osteoporosis. The study showed the strong effect of T2DM on biochemical markers of bone turnover in obese postmenopausal Saudi women.

Atrial Natriuretic Peptide and Type 2 Diabetes Development – Biomarker and Genotype Association Study

BackgroundWe have recently shown that low plasma levels of mid-regional atrial natriuretic peptide (MR-ANP) predict development of diabetes and glucose progression over time, independently of known risk factors for diabetes development. However, since MR-ANP levels might be influenced by unknown factors causing diabetes, we cannot rule out that such relationship might be confounded. Previous studies have shown an association of a single nucleotide polymorphism rs5068 on the natriuretic peptide precursor A (NPPA) locus gene with higher levels of circulating ANP. Since gene variants are inherited randomly and not subject to confounding, we aimed to investigate whether the variant rs5068 within the NPPA locus is associated with incident type 2 diabetes.MethodsWe genotyped the variant rs5068 within the NPPA locus in 27,307 individuals without known diabetes from the Malmö Diet Cancer Study. Incident diabetes was retrieved through national and regional registers (median follow-up time of 14 years, 2,823 incident diabetes cases).ResultsIn Cox regression analysis adjusted for age, sex and BMI, we found that the carriers of at least one copy of the G allele of rs5068 had lower likelihood of incident diabetes within 14 years (HR = 0.88, 95% CI 0.78–0.99, p = 0.037).ConclusionOur results indicate a role of the ANP system in the etiology of type 2 diabetes and might help provide insight in the metabolic actions of natriuretic peptides and the pathophysiology of type 2 diabetes.

Atrial natriuretic peptide and type 2 diabetes development, evidence of causal association from the prospective Malmo diet and cancer study

Purpose: We have recently shown that low plasma levels of mid-regional atrial natriuretic peptide (MR-ANP) predict development of future diabetes and glucose progression over time, independently of known risk factors for diabetes development. However since MR-ANP levels might be influenced by other unknown factors causing diabetes, we cannot rule out that such relationship might be confounded. Previous studies have shown an association of a single nucleotide polymorphism rs5068 on the natriuretic peptide precursor A (NPPA) locus gene with higher levels of circulating MR-ANP. Since gene variants are inherited randomly and not subject to confounding, we aimed to investigate whether the variant rs5068 within the NPPA locus is associated with incident type 2 diabetes in order to prove a causal link between the ANP metabolism and type 2 diabetes. Methods: We genotyped the variant rs5068 within the NPPA locus in 27 308 individuals without known diabetes (mean age 58 years; 60% women). Incident diabetes was retrieved through five national registers (median follow-up time of 14 years, 2823 incident diabetes cases). Results: In Cox regression analysis adjusted for age, sex and BMI, we found that the minor allele of rs5068 was inversely associated with incident diabetes (HR=0.88, 95% CI 0.78-0.99). View this table: Association of rs5068 and incid Conclusion: Our results offer an indication for a potential causal role of the ANP system in the etiology of type 2 diabetes.

Environmental pollutants and type 2 diabetes: a review of mechanisms that can disrupt beta cell function

The prevalence of diabetes mellitus is currently at epidemic proportions and it is estimated that it will increase even further over the next decades. Although genetic predisposition and lifestyle choices are commonly accepted reasons for the occurrence of type 2 diabetes, it has recently been suggested that environmental pollutants are additional risk factors for diabetes development and this review aims to give an overview of the current evidence for this. More specifically, because of the crucial role of pancreatic beta cells in the development and progression of type 2 diabetes, the present work summarises the known effects of several compounds on beta cell function with reference to mechanistic studies that have elucidated how these compounds interfere with the insulin secreting capacity of beta cells. Oestrogenic compounds, organophosphorus compounds, persistent organic pollutants and heavy metals are discussed, and a critical reflection on the relevance of the concentrations used in mechanistic studies relative to the levels found in the human population is given. It is clear that some environmental pollutants affect pancreatic beta cell function, as both epidemiological and experimental research is accumulating. This supports the need to develop a solid and structured platform to fully explore the diabetes-inducing potential of pollutants.

Obesity Raises Risk for Diabetes in Older People

Obesity and excess body fat are risk factors for developing diabetes, but in mid- and late-life the association of various measures of adiposity with

Effects on insulin sensitivity and hepatic safety of Atazanavir in HCV/HIV coinfected patients versus HIV monoinfected: A prostective 48-week study

Background Protease inhibitors based antiretroviral therapy has been associated with elevated plasma insulin levels and insulin resistance. HCV infections are an independent risk factor for diabetes development. In vitro Atazanavir (ATV) has shown minimal inhibitory effect on the insulin-regulated glucose transporter GLUT4. Studies in healthy HIV-negative demonstrated a favorable metabolic profile. Clinical studies in HIV and HCV/HIV coinfected pretreated patients with underlying real conditions are needed.