Incidence Of Type 2 Diabetes Mellitus Research Articles

BMI trajectory and subsequent risk of type 2 diabetes among middle-aged women

Background and aimsLittle is known about how weight trajectories among women during menopausal transition and beyond may be related to risk of type 2 diabetes mellitus (T2DM). The aim of this study was to examine associations between body mass index (BMI) trajectories over 20 years, age of obesity onset, cumulative obese-years and incidence of T2DM among middle-aged women. Methods and results12,302 women enrolled in the Australian Longitudinal Study on Women's Health (ALSWH) were surveyed in 1996 (Survey 1, age 45–50), 1998 and then every three years to 2016. Self-reported weight and height were collected for up to eight time points. Incident diabetes was assessed via validated self-report of physician-diagnosed diabetes. Growth mixture models were used to identify distinct BMI trajectories. A total of 1380 (11.2%) women newly developed T2DM over an average 16 years of follow-up. Seven distinct BMI trajectories were identified with differential risk of developing T2DM. Initial BMI was positively associated with T2DM risk. We also observed that risk of T2DM was positively associated with rapid weight increase, early age of obesity onset and greater obese-years. ConclusionSlowing down weight increases, delaying the onset of obesity, or reducing cumulative exposure to obesity may substantially lower the risk of developing T2DM.

Is the effect of Mediterranean diet on hip fracture mediated through type 2 diabetes mellitus and body mass index?

BackgroundWe examined whether the inverse association between adherence to a Mediterranean diet and hip fracture risk is mediated by incident type 2 diabetes mellitus (T2DM) and body mass index (BMI).MethodsWe included 50 755 men and women from the Cohort of Swedish Men and the Swedish Mammography Cohort who answered lifestyle and medical questionnaires in 1997 and 2008 (used for calculation of the Mediterranean diet score 9mMED; low, medium, high) and BMI in 1997, and incident T2DM in 1997–2008). The cumulative incidence of hip fracture from the National Patient Register (2009–14) was considered as outcome.ResultsWe present conditional odds ratios (OR) 9[95% confidence interval, CI) of hip fracture for medium and high adherence to mMED, compared with low adherence. The total effect ORs were 0.82 (0.71, 0.95) and 0.75 (0.62, 0.91), respectively. The controlled direct effect of mMED on hip fracture (not mediated by T2DM, considering BMI as an exposure-induced confounder), calculated using inverse probability weighting of marginal structural models, rendered ORs of 0.82 (0.72, 0.95) and 0.73 (0.60, 0.88), respectively. The natural direct effect ORs (not mediated by BMI or T2DM, calculated using flexible mediation analysis) were 0.82 (0.71, 0.95) and 0.74(0.61, 0.89), respectively. The path-specific indirect and partial indirect natural effects ORs (through BMI or T2DM) were close to 1.ConclusionsMediterranean diet has a direct effect on hip fracture risk via pathways other than through T2DM and BMI. We cannot exclude mediating effects of T2DM or BMI, or that their effects cancel each other out.

Association of Serum Bile Acids Profile and Pathway Dysregulation With the Risk of Developing Diabetes Among Normoglycemic Chinese Adults: Findings From the 4C Study

Comprehensive assessment of serum bile acids (BAs) aberrations before diabetes onset remains inconclusive. We examined the association of serum BA profile and coregulation with the risk of developing type 2 diabetes mellitus (T2DM) among normoglycemic Chinese adults. We tested 23 serum BA species in subjects with incident diabetes (n = 1,707) and control subjects (n = 1,707) matched by propensity score (including age, sex, BMI, and fasting glucose) from the China Cardiometabolic Disease and Cancer Cohort (4C) Study, which was composed of 54,807 normoglycemic Chinese adults with a median follow-up of 3.03 years. Multivariable-adjusted odds ratios (ORs) for associations of BAs with T2DM were estimated using conditional logistic regression. In multivariable-adjusted logistic regression analysis, per SD increment of unconjugated primary and secondary BAs were inversely associated with incident diabetes, with an OR (95% CI) of 0.89 (0.83-0.96) for cholic acid, 0.90 (0.84-0.97) for chenodeoxycholic acid, and 0.90 (0.83-0.96) for deoxycholic acid (P < 0.05 and false discovery rate <0.05). On the other hand, conjugated primary BAs (glycocholic acid, taurocholic acid, glycochenodeoxycholic acid, taurochenodeoxycholic acid, and sulfated glycochenodeoxycholic acid) and secondary BA (tauroursodeoxycholic acid) were positively related with incident diabetes, with ORs ranging from 1.11 to 1.19 (95% CIs ranging between 1.05 and 1.28). In a fully adjusted model additionally adjusted for liver enzymes, HDL cholesterol, diet, 2-h postload glucose, HOMA-insulin resistance, and waist circumference, the risk estimates were similar. Differential correlation network analysis revealed that perturbations in intraclass (i.e., primary and secondary) and interclass (i.e., unconjugated and conjugated) BA coregulation preexisted before diabetes onset. These findings reveal novel changes in BAs exist before incident T2DM and support a potential role of BA metabolism in the pathogenesis of diabetes.

Increased Risk of Nasal Septal Abscess After Septoplasty in Patients with Type 2 Diabetes Mellitus.

To investigate the risk of nasal septal abscess (NSA) in patients with type 2 diabetes mellitus (T2DM) after septoplasty. Retrospective cohort study through Taiwan National Health Insurance database. The Taiwan National Health Insurance Research Database was used to conduct this retrospective cohort study. A total of 382 patients with T2DM (DM group) diagnosed between 2000 and 2010 and 382 matched patients without a DM diagnosis (non-DM group) were enrolled. Patients were followed up until death or December 31, 2013. NSA incidence was the main outcome. After septoplasty, the cumulative incidence of NSA in the DM group was significantly higher than that in the non-DM group (P< .001). Cox proportional hazards regression indicated a significant association between T2DM and higher NSA incidence (adjusted hazard ratio, 2.62; 95% CI, 1.44-3.61; P< .001). However, subgroup analysis and sensitivity testing demonstrated that the effect of T2DM on NSA risk was stable. In addition, the subgroup with a Diabetes Complications Severity Index (DCSI) of ≥1 had higher NSA risk than that with DCSI=0 (adjusted hazard ratio, 3.58; 95% CI, 2.10-6.09; P< .001). The treatment type for NSA did not differ between the groups. T2DM is an independent risk factor for NSA in patients undergoing nasal septoplasty, and the NSA risk is greater among patients with high DM severity. IV Laryngoscope, 131:E2420-E2425, 2021.

Incidence of childhood type 1 diabetes mellitus in Yamanashi Prefecture, Japan, 1986-2018.

IntroductionSeveral studies have examined the incidence of childhood T1DM in Japan from the 1970s onwards, but none have been long‐term studies using registration data. We estimate the incidence of childhood type 1 diabetes mellitus (T1DM) from 1986 to 2018 in Yamanashi Prefecture, Japan.MethodsWe began a population‐based, long‐term study of childhood T1DM in 1986 involving every hospital paediatrics department in Yamanashi Prefecture. In the Prefecture, every child newly diagnosed with T1DM is referred to a hospital, and therefore, almost 100% of new patients aged <15 years are registered. We calculated the incidence of T1DM among children aged <15 years from 1986 to 2018. All cases met the Japan Diabetes Society diagnostic criteria and were tested for T1DM‐related autoantibodies whenever possible.ResultsNinety‐nine patients (44 boys and 55 girls) were newly diagnosed with T1DM. The annual incidence among 5‐ to 9‐year‐olds increased by 5.35% over the study period (95% confidence interval 2.34%‐8.35%, p = .0005), and there was a trend towards increasing 3‐year incidence (15.52% increase, p = .0516). There were also trends towards increasing annual and 3‐year incidence among 0‐ to 14‐year‐olds. However, there were no changes over time in annual or 3‐year incidence in the 0–4 year or 10–14 year age groups.ConclusionsThe incidence of T1DM in Yamanashi Prefecture increased among children aged 0‐14 years over the study period, with the most significant increase occurring among 5‐ to 9‐year‐olds. These data suggest that the number of children aged <15 years with T1DM is gradually increasing in one of the local prefectures in Japan, Yamanashi Prefecture and that the age of onset is decreasing.

Dietary iron intake and the risk of type 2 diabetes mellitus in middle-aged and older adults in urban China: a prospective cohort study.

The association between dietary Fe intake and diabetes risk remains inconsistent. We aimed to explore the association between dietary Fe intake and type 2 diabetes mellitus (T2DM) risk in middle-aged and older adults in urban China. This study used data from the Guangzhou Nutrition and Health Study, an on-going community-based prospective cohort study. Participants were recruited from 2008 to 2013 in Guangzhou community. A total of 2696 participants aged 40-75 years without T2DM at baseline were included in data analyses, with a median of 5·6 (interquartile range 4·1-5·9) years of follow-up. T2DM was identified by self-reported diagnosis, fasting glucose ≥ 7·0 mmol/l or glycosylated Hb ≥ 6·5 %. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95 % CI. We ascertained 205 incident T2DM cases during 13476 person-years. The adjusted HR for T2DM risk in the fourth quartile of haem Fe intake was 1·92 (95 % CI 1·07, 3·46; Ptrend = 0·010), compared with the first quartile intake. These significant associations were found in haem Fe intake from total meat (HR 2·74; 95 % CI 1·22, 6·15; Ptrend = 0·011) and haem Fe intake from red meat (HR 1·86; 95 % CI 1·01, 3·44; Ptrend = 0·034), but not haem Fe intake from processed meat, poultry or fish/shellfish. The association between dietary intake of total Fe or non-haem Fe with T2DM risk had no significance. Our findings suggested that higher dietary intake of haem Fe (especially from red meat), but not total Fe or non-haem Fe, was associated with greater T2DM risk in middle-aged and older adults.

Association between Triglyceride-Glucose Index and Type 2 Diabetes Mellitus in the Japanese Population: A Secondary Analysis of a Retrospective Cohort Study.

Triglyceride-glucose index (TyG index) is associated with type 2 diabetes mellitus (T2DM), but research on this relationship is limited in Japan. The purpose of this study was to evaluate the correlation between TyG index and the risk of T2DM in the Japanese population. Here, 12732 participants were selected from the NAGALA study (NAfld in the Gifu Area, Longitudinal Analysis) conducted between 2004 and 2015 for a retrospective cohort analysis. The association between TyG index and T2DM was assessed using the Cox proportional-hazard model. Subgroup analyses were conducted according to age, sex, smoking status, alcohol consumption, waist circumference, BMI, and follow-up duration. The formula for TyG index was expressed as ln [fasting triglyceride level (mg/dL) × fasting plasma glucose level (mg/dL)/2]. After follow-up, 150 (1.18%) patients developed T2DM. After adjusting for potential confounders, a linear relationship was observed between TyG and the risk of T2DM. After adjusting for age, sex, BMI, waist circumference, HDL-cholesterol, total cholesterol, systolic blood pressure, regular exercise, smoking status, and alcohol consumption, TyG index, as a continuous variable, was associated with an increased risk of T2DM (adjusted hazard ratio (aHR), 1.79; 95% confidence interval (95% CI), 1.25-2.57). Compared with the first quartile of TyG index, subjects in the fourth quartile were 2.33-fold more likely to develop T2DM (aHR 2.33, 95% CI 1.09-4.96; P for trend 0.0224). Subgroup analyses showed that the association between TyG index and incident T2DM stably existed in different subgroups according to the variables tested. Therefore, TyG index was linearly related to the risk of incident T2DM in the Japanese population and may be used as a monitoring tool.

Leukocyte count, C-reactive protein level and incidence risk of type 2 diabetes among non-smoking adults: A longitudinal finding over 12 years from the Korean Genome and Epidemiology Study

AimsChronic low-grade inflammation is closely linked to the development and progression of type 2 diabetes mellitus (T2DM). Since inflammatory markers tend to be chronically elevated in current smokers, we examined the association of inflammatory markers, including leukocyte counts and C-reactive protein (CRP) levels, with incidence risk of T2DM in non-smoking adults. Methods5568 non-smoking participants aged 40–69 years without diabetes at baseline were selected from the Korean Genome and Epidemiology Study (KoGES), a large prospective cohort study. The hazard ratios (HRs) with 95% confidence intervals (CIs) for incident T2DM according to leukocyte and CRP quartiles, respectively, were calculated using multivariate Cox proportional hazards regression models. ResultsDuring the 12-year follow-up period, T2DM developed in 1030 subjects (18.5%, 1030/5568), with an incidence rate of 3.1–4.9 per 2 years. The cumulative incidence of T2DM increased proportionally with increasing leukocyte and CRP quartiles. Compared with the reference first quartile, the HRs of incident T2DM in the second, third, and fourth quartiles of leukocyte counts and third and fourth quartiles of CRP levels increased in a dose-dependent manner after adjusting for potentially confounding variables. ConclusionsLeukocyte counts and CRP levels are predictors of incident T2DM independent of tobacco smoking.

Hypertriglyceridemic Waist Phenotype and Lipid Accumulation Product: Two Comprehensive Obese Indicators of Waist Circumference and Triglyceride to Predict Type 2 Diabetes Mellitus in Chinese Population.

Purpose To determine whether hypertriglyceridemic waist (HTGW) and high lipid accumulation product (LAP) preceded the incidence of type 2 diabetes mellitus (T2DM), and to investigate the interactions of HTGW and LAP with other components of metabolic syndrome on the risk of T2DM. Methods A total of 15,717 eligible participants without baseline T2DM and aged 35 and over were included from a Chinese rural cohort. Cox proportional hazards regression models were used to estimate the association of HTGW and LAP with the incidence of T2DM, and the restricted cubic spline model was used to evaluate the dose-response association. Results Overall, 867 new T2DM cases were diagnosed after 7.77 years of follow-up. Participants with HTGW had a higher hazard ratio for T2DM (hazard ratio (HR): 6.249, 95% confidence interval (CI): 5.199-7.511) after adjustment for potential confounders. The risk of incident T2DM was increased with quartiles 3 and 4 versus quartile 1 of LAP, and the adjusted HRs (95% CIs) were 2.903 (2.226-3.784) and 6.298 (4.911-8.077), respectively. There were additive interactions of HTGW (synergy index (SI): 1.678, 95% CI: 1.358-2.072) and high LAP (SI: 1.701, 95% CI: 1.406-2.059) with increased fasting plasma glucose (FPG) on the risk of T2DM. Additionally, a nonlinear (P nonlinear < 0.001) dose-response association was found between LAP and T2DM. Conclusion The subjects with HTGW and high LAP were at high risk of developing T2DM, and the association between LAP and the risk of T2DM may be nonlinear. Our study further demonstrates additive interactions of HTGW and high LAP with increased FPG on the risk of T2DM.

Characterizing the type 2 diabetes mellitus epidemic in Jordan up to 2050

We aimed to characterize the type 2 diabetes mellitus (T2DM) epidemic and the role of key risk factors in Jordan between 1990–2050, and to forecast the T2DM-related costs. A recently-developed population-level T2DM mathematical model was adapted and applied to Jordan. The model was fitted to six population-based survey data collected between 1990 and 2017. T2DM prevalence was 14.0% in 1990, and projected to be 16.0% in 2020, and 20.6% in 2050. The total predicted number of T2DM cases were 218,326 (12,313 were new cases) in 1990, 702,326 (36,941 were new cases) in 2020, and 1.9 million (79,419 were new cases) in 2050. Out of Jordan’s total health expenditure, 19.0% in 1990, 21.1% in 2020, and 25.2% in 2050 was forecasted to be spent on T2DM. The proportion of T2DM incident cases attributed to obesity was 55.6% in 1990, 59.5% in 2020, and 62.6% in 2050. Meanwhile, the combined contribution of smoking and physical inactivity hovered around 5% between 1990 and 2050. Jordan’s T2DM epidemic is predicted to grow sizably in the next three decades, driven by population ageing and high and increasing obesity levels. The national strategy to prevent T2DM needs to be strengthened by focusing it on preventive interventions targeting T2DM and key risk factors.

Factors Related of Diabetes Mellitus Type II in Kebon Jeruk District

Diabetes mellitus is a condition that increases blood sugar levels that are chronic as a result of a disruption of body metabolisms such as fat, carbohydrate, and protein due to a deficiency of the hormone insulin. The main problem in people with DM is the occurrence of complications, especially the complications of chronic DM, which is the main cause of morbidity and mortality in DM patients. This study aims to analyze relationship between family history, age, gender, physical activity, obesity, hypertension to the incidence of Diabetes Mellitus type II. This research is a quantitative research type and uses a cross-sectional design. This research was conducted at the Kebon Jeruk District Health Center in West Jakarta in 2018, with a sample size of 77 samples or respondents. Independent variables included family history, age, gender, physical activity, obesity, and hypertension. The dependent variable is type II diabetes mellitus. Analysis of the relationship between the two variables was measured using the chi-square test. The results showed an association between life history, age, physical activity, and obesity with the incidence of type II DM in Kebon Jeruk District Health Center in 2018. It is recommended that people who have a family history of DM to immediately detect DM disease and apply a healthy lifestyle, carry out physical activities for at least 15-20 minutes every day, health workers are also advised to continue to conduct health education related to DM disease.

Rates and Correlates of Incident Type 2 Diabetes Mellitus Among Persons Living With HIV-1 Infection.

The prevalence of various comorbidities continue to rise in aging persons living with HIV-1 infection (PLWH), and our study here aimed to assess the rates and correlates of incident type 2 diabetes mellitus (T2DM) in PLWH from a retrospective, southeastern U.S. cohort. Based on electronic health records, we examined patient demographics, body mass index (BMI), HIV-1-related outcomes, hepatitis C virus co-infection, common comorbidities (e.g. shingles and asthma), usage of protease inhibitors, and usage of statins as potential correlates for T2DM occurrence. Among 3,975 PLWH with ≥12 months of follow-up between January 1999 and March 2018, the overall rate of incident T2DM was 135 per 10,000 person-years, almost 2-fold higher than the rate reported for the general U.S. population. In multivariable models (354 T2DM patients and 3,617 control subjects), sex, BMI, nadir CD4+ T-cell count, HIV-1 viral load (VL) and duration of statin use were independent correlates of incident T2DM (adjusted P <0.05 for all), with clear consistency in several sensitivity analyses. The strongest associations (adjusted odds ratio/OR >2.0 and P <0.0001) were noted for: i) statin use for ≥6 months (OR = 10.2), ii) BMI ≥30 kg/m2 (OR = 3.4), and iii) plasma VL ≥200 copies/ml (OR = 2.2). Their collective predictive value was substantial: the C-statistic for area under the receiver operating characteristics curve was 0.87 (95% CI = 0.84-0.91), showing close similarity between two major racial groups (C-statistic = 0.87 for African Americans and 0.91 for European Americans). Overall, these findings not only establish a promising algorithm for predicting incident T2DM in PLWH but also suggest that patients who are obese and use statins should require special consideration for T2DM diagnosis and prevention.

The Finnish Diabetes Risk Score (FINDRISC), incident diabetes and low-grade inflammation

AimsThe FINDRISC was created to predict the development of type 2 diabetes mellitus (T2DM). Since T2DM associates with inflammation we evaluated if the FINDRISC could predict either current or incident T2DM, and elevated high sensitivity C-reactive protein (hs-CRP). Methods41,880 people (age 41.9 ± 9.7 years; 31% female) evaluated between 2008 and 2016 were included. First, the cross-sectional association between the FINDRISC with presence of either T2DM or hs-CRP ≥ 2.0 mg/L was tested. After a 5 ± 3 years follow-up we tested the score predictive value for incident T2DM and inflammation in respectively 10,559 individuals without diabetes and in a subset of 2,816 individuals having no elevated hs-CRP at baseline. ResultsIn the cross sectional analysis the FINDRISC was associated with both T2DM (OR 1.24, 95% CI: 1.23–1.26, P < 0.001) and inflammation (OR 1.10, 95% CI: 1.09–1.11, P < 0.001) per FINDRISC unit, as well as in longitudinal analyses (OR 1.17, 95% CI: 1.14–1.20, P < 0.001; and OR 1.04, 95% CI: 1.02–1.07, P < 0.001; respectively, per FINDRISC unit). The C-statistic for incident T2DM and inflammation was 0.79 (95% CI 0.77–0.82) and 0.55 (95% CI 0.53–0.58), respectively. ConclusionThe FINDRISC shows good discrimination for incident T2DM but less for inflammation.

Associations of changes in fat free mass with risk for type 2 diabetes: Hispanic Community Health Study/Study of Latinos

AimsTo determine whether loss of muscle mass (approximated using fat free mass [FFM]) is associated with risk for type 2 diabetes mellitus (T2DM) in Hispanic/Latino adults in the United States. MethodsParticipants were Hispanic/Latino adults (18–74-year-olds) who completed Visit 2 of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL; multi-site, prospective cohort study; 6.1-year follow-up) and did not have T2DM at baseline (n = 6264). At baseline and Visit 2, FFM was measured using bioelectrical impedance analysis and fasting glucose, HbA1c, and fasting insulin were measured by examiners. Diabetes was defined according to American Diabetes Association criteria. Survey-weighted Poisson regression models examined the association of percent change in relative FFM (%ΔFFM) with incident prediabetes and T2DM. Survey-weighted multivariable regression models examined associations of %ΔFFM with changes in glucose and insulin measures. ResultsRelative FFM declined by 2.1% between visits. %ΔFFM was inversely associated with incident prediabetes (p-for-trend = 0.001) and with changes in glucose and insulin measures (p-for-trend <0.0001). Findings were null, except for HOMA-IR, after adjustment for changes in adiposity measures. Associations were generally stronger for individuals with baseline overweight/obesity. ConclusionsReducing loss of FFM during adulthood may reduce prediabetes risk (primarily insulin resistance), particularly among individuals with overweight/obesity.

Pioglitazone for prevention or delay of type 2 diabetes mellitus and its associated complications in people at risk for the development of type 2 diabetes mellitus.

Pioglitazone for prevention or delay of type 2 diabetes mellitus and its associated complications in people at risk for the development of type 2 diabetes mellitus.

Adverse effects of metabolic disorders in childhood on adult reproductive function and fertility in the male.

Over the last 50 years, there has been a steady decline in fertility rates in humans, which has occurred in parallel with an increasing incidence of obesity and metabolic disorders. The potential impact of these disorders and plausible mechanisms by which they negatively influence male reproduction are only partly understood and published data are often controversial. Obesity is one of the most important health challenges worldwide and is becoming more prevalent in children and adolescents. Obesity, the metabolic syndrome and related co-morbidities can lead to impaired male reproductive function, including adverse effects on spermatogenesis and steroidogenesis as illustrated by reduced sperm number and quality, decreased testosterone levels and elevated inflammatory markers. The incidence of diabetes mellitus type I is also dramatically increasing and may negatively impact spermatogenesis and testicular function, resulting in decreased serum testosterone and epididymal weight. In this review, we summarize and discuss the effects of metabolic diseases that typically develop during childhood and adolescence on later reproductive function and fertility. While impact on reproductive health is likely observed in both sexes, we have chosen to focus on the male in the current review. Specifically, we illustrate adverse effects of obesity, type 1 diabetes, the metabolic syndrome and insulin resistance on sperm function and testosterone metabolism. Identification of pathophysiological mechanisms during childhood may open up new avenues for early prevention and treatment resulting in better reproductive outcomes and improved fertility rates during adulthood.

The combined associations of walking pace and obesity with diabetes incidence: Findings from the UK biobank prospective cohort study

Rationale: Both obesity and walking pace are associated with health outcomes. However, evidence regarding their combined association on type 2 diabetes mellitus (T2DM) risk is limited. Therefore, this study aimed to investigate the joint association of walking pace and obesity with incident T2DM.

The Effects of Altered Endometrial Glucose Homeostasis on Embryo Implantation in Type 2 Diabetic Mice.

Type 2 diabetes mellitus (T2DM) is a disease characterized by hyperglycemia resulting from insulin resistance. In recent years, the incidence of T2DM has been increasing. Women with T2DM often suffer from infertility and early miscarriage; however, the underlying mechanisms remain unclear. Insulin is the most important regulatory hormone of glycogen metabolism. In addition, 5' adenosine monophosphate-activated protein kinase (AMPK) is an important regulator of glycogen metabolism. Patients with T2DM have inhibited AMPK expression in the liver, which leads to impaired glucose metabolism. However, the role of AMPK in endometrial glycogen metabolism has not been reported. In this study, a mouse model of T2DM was established to investigate whether altered endometrial glucose metabolism affects early embryo implantation. Metformin and insulin were used for therapy; the resulting changes to glycogen metabolism and embryo implantation were examined. The results indicate that the concentrations of glycogen decreased significantly in T2DM mice, resulting in insufficient energy supplies for proper endometrial function, and thereby impeding embryonic implantation. Interestingly, endometrial AMPK was not found to be overactivated. Insulin treatment was found to partially resolve the embryo implantation defects in T2DM mice. Metformin improved blood glucose but did not have a significant effect on local endometrial glucose metabolism. This study explored the changes in endometrial glucose metabolism in T2DM mouse, and the effects of these changes on embryo implantation. We found that insulin, but not metformin, significantly resolved embryo implantation problems. These findings will help to increase our understanding of the pathomechanisms of infertility and early miscarriage in women with T2DM.

Incidence and Prevalence of Type 1 Diabetes Mellitus among Korean Children and Adolescents between 2007 and 2017: An Epidemiologic Study Based on a National Database.

BackgroundThe incidence of type 1 diabetes mellitus (T1DM) among children is high in Europe and the USA and relatively low in Asia, including Korea. The present study aimed to investigate the incidence and prevalence of childhood-onset T1DM in Korea and examine trends in incidence.MethodsThis study was conducted using the national registry data provided by the Health Insurance Review and Assessment Service in Korea from 2007 to 2017. We included children aged 0 to 14 years who were newly registered with a T1DM diagnosis each year (code E10).ResultsA total of 29,013 children were registered. The overall incidence of T1DM was 4.45 per 100,000 persons (girls, 4.93; boys, 4.01). The overall incidence of childhood-onset T1DM in Korea increased from 3.70 in 2008 to 4.77 in 2016 (P=0.002). The incidence of T1DM increased from 3.07 in 2008 to 4.89 in 2016 (P<0.001) among boys. Although the incidence of the disease increased significantly among boys aged 5–9 and 10–14 years, it remained constant among girls (4.39 in 2008, 4.64 in 2016). The overall prevalence of childhood-onset T1DM in Korea increased from 32.85 in 2007 to 41.03 per 100,000 persons in 2017 (girls, 35.54 to 43.88; boys, 32.85 to 41.03).ConclusionWe calculated relatively accurate incidence and prevalence of childhood-onset T1DM from a nation-based registry. The incidence increased by 3% to 4% every year from 2007 to 2017. The increasing trend is noteworthy compared with previous reports.

Increased particle size of triglyceride remnant lipoproteins, but not their plasma concentration or lipid content, augment risk prediction of incident diabetes: prospective results from ELSA-Brasil

Abstract Importance Predicting risk of Type 2 Diabetes Mellitus (T2DM) accurately allows allocation of resources to prevent its development. Fasting blood triglycerides are highly predictive for T2DM. Triglyceride remnant lipoproteins (TRL) more accurately reflect pathophysiological changes that underlie progression to T2DM, such as pancreatic steatosis and inflammation. We hypothesized TRL-related factors could improve risk prediction for development of T2DM. Methods We included individuals aged 35–74 years from the ELSA-Brasil cohort who had HbA1c and an oral glucose tolerance test at baseline. Regression models were used to predict incident T2DM, starting with medical history, metabolic syndrome traits (age, sex, hypertension, waist circumference [WC], HbA1c, triglycerides) and hsCRP, adding TRL-related measurements, including plasma concentration, particle size, as well as cholesterol and triglyceride content. TRL features were measured by NMR spectroscopy. Discrimination was assessed with area under receiver operator curves (AUROCs). Results Among 4,466 individuals at-risk, there were 353 new cases of T2DM after 3.7 (SD=0.6) years follow-up. We derived an 8-variable model with AUROC 0.891 (95% CI: 0.870–0.913). Overall TRL-related markers did not improve predictive capacity for T2DM. However, TRL particle diameter (TRLZ) increased AUROC, particularly in individuals without glucose abnormalities at baseline (Hba1c &amp;lt;5.7%). In this subgroup, AUROC increased from 0.761 (95% CI: 0.739–0.798 – Baseline-model) to 0.823 (95% CI: 0.783–0.862 – TRLZ model) (p-value=0.00006). Consistently, the net reclassification improvent (NRI) of the model with TRLZ improved by 10.27% (95% CI: 1.0–24.1, p=0.00041). In subjects with pre-diabetes at baseline, TRLZ is highly correlated with obesity, insulin resistance and inflammation (sum of z-scores for WC + HOMA-IR + hsPCR: R2=0.25), but this was less important in individuals with Hba1c &amp;lt;5.7% (R2=0.15). Sensitivity analyzes confirmed the results with different inclusion criteria (pre-diabetes defined with TTGO only) and excluding patients diagnosed with DM2 incident based only on fasting blood glucose. Conclusions TRL particle diameter improves prediction of T2DM, particularly in subjects with no glycemic abnormalities at baseline. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Brazilian Ministry of Health (Department of Science and Technology), Ministry of Science, Technology and Innovation, and the National Council for Scientific and Technological Development (CNPq)