Risk Factors For Type 2 Diabetes Mellitus Research Articles

Association of LPAR1 Gene Variants with Type 2 Diabetes in Local Population

Type 2 diabetes mellitus (T2DM) is the most prevailing worldwide health challenge of the 21st century and the 5th leading cause of death worldwide. About 90% of diabetic patients are diagnosed as having T2DM. LPAR1 gene codes LPA protein that is involved in the regulation of many biological processes. In this study, we have investigated the association of single nucleotide polymorphism (SNP) of LPAR1 gene variants rs494605 and rs558347 with T2DM in our local population. This association was analyzed by amplification of the target gene through Tetra ARMS PCR. The study involved 200 participants with equal ration of cases and controls. Both genetic variants of LPAR1 rs494605 and rs558347 have allelic origin T/C. The allelic frequency of LPAR1 was calculated through the Hardy Weinberg Equilibrium. re found that in LPAR1 rs494605 mutant allele, C was 47% in cases compared to controls (39%) and in LPAR1 rs558347, heterozygosity allele (TC) was 46% compared to mutant allele C (13%), while wild T allele was 17% in cases. Many demographic and lifestyle risk factors were significantly associated with LPAR1 gene variants. The heterogeneity of genetic variants with T2DM also showed a strong correlation with obesity, hormonal imbalance, and depression with p-value of 0.001, and 95% confidence interval. Smoking and alcohol consumption are major risk factors of T2DM. Variations in LPAR1 can be used as a biomarker and diagnostic tool for T2DM.

Genetic Association between Different Metabolic Variants in APOA5 and PLIN1 in Type 2 Diabetes Mellitus among the Western Saudi Population: Case-Control Study.

Type 2 diabetes mellitus (T2DM) is a multifactorial disease with a high global incidence. Hypertriglyceridemia is a major risk factor for both cardiovascular disease and T2DM. In this study, we determined the allele and genotype frequencies of apolipoprotein A5 (APOA5) single nucleotide polymorphism (SNP) rs662799 and perilipin 1 (PLIN1) SNPs rs894160, rs6496589, and rs1052700 and evaluated their association with T2DM risk in western Saudis. Only rs6496589 was found to be significantly associated with T2DM risk. We determined the risk allele for each SNP based on relative risk, and found that the G allele of rs662799, T allele of rs894160, G allele of r6496589, and T allele of rs1052700 correlated with T2DM risk. The effect of each SNP on T2DM risk and five of its clinical phenotypes was explored using multiple logistic regression. We found significant correlations between the C/G and G/G genotypes of rs6496589 and T2DM risk in the unadjusted model, whereas G/G was the only genotype that correlated with the risk of T2DM in the adjusted model. There was no significant correlation between rs662799, rs894160, and rs1052700 genotypes and T2DM risk. In conclusion, we have identified novel risk alleles and genotypes that contribute to genetic risk for T2DM in the western Saudi population.

Contributing factors of diabetes mellitus among patients with gout (results of the long-term prospective study)

It is assumed that the risk of developing type 2 diabetes mellitus (T2DM) in patients with gout is influenced by both generally accepted risk factors and factors related to gout.Objective. To evaluate the impact of various risk factors for T2DM in patients with gout.Material and methods. 444 patients (49 women, 395 men) ≥18 years old with gout and without DM were included. Duration of observation was 5.66 [2.69; 7.64] g. To identify factors associated with the risk of developing T2DM, multivariate logistic regression was used, which included: sex; T2DM in relatives; insufficient physical activity; unbalanced diet; age ≥45 years; ≥4 attacks per year; presence of tophi; BMI≥30 kg/m2 ; allopurinol, febuxostat, glucocorticoids, diuretics, metformin, colchicine; GFR<60 ml/min/1.73 m2 ; serum uric acid level (sUA) ≥420 μmol/l and ≥480 μmol/l. Results. T2DM developed in 108 (24.3%) patients. According to the multivariate model, the presence of ≥4 attacks of arthritis per year increased the risk of T2DM (OR=5.23; 95% CI: 2.98–9.19; p=0.0001); presence of tophi (OR=2.61; 95% CI: 1.50–4.54; p=0.001); sUA≥480 μmol/l (OR=2.26; 95% CI: 1.02–5.00; p=0.144), diuretics (OR=2.35; 95% CI: 1.19–4.64; p=0.014). Febuxostat (OR=0.31; 95% CI: 0.11–0.84; p=0.022) and metformin (OR=0.49; 95% CI: 0.21–1.16; p=0.107) reduced the risk of developing T2DM. Conclusion. Risk of T2DM in patients with gout is associated with high incidence of arthritis attacks, MK≥480 μmol/l, hypertension, diuretic use, and febuxostat and metformin reduces risk. Key words: gout, type 2 diabetes mellitus, uric acid>˂ 60 ml/min/1.73 m2 ; serum uric acid level (sUA) ≥420 μmol/l and ≥480 μmol/l.Results. T2DM developed in 108 (24.3%) patients. According to the multivariate model, the presence of ≥4 attacks of arthritis per year increased the risk of T2DM (OR=5.23; 95% CI: 2.98–9.19; p=0.0001); presence of tophi (OR=2.61; 95% CI: 1.50–4.54; p=0.001); sUA≥480 μmol/l (OR=2.26; 95% CI: 1.02–5.00; p=0.144), diuretics (OR=2.35; 95% CI: 1.19–4.64; p=0.014). Febuxostat (OR=0.31; 95% CI: 0.11–0.84; p=0.022) and metformin (OR=0.49; 95% CI: 0.21–1.16; p=0.107) reduced the risk of developing T2DM.Conclusion. Risk of T2DM in patients with gout is associated with high incidence of arthritis attacks, MK≥480 μmol/l, hypertension, diuretic use, and febuxostat and metformin reduces risk.

Association of angiotensin-converting enzyme gene polymorphism (rs1799752) with type 2 diabetes mellitus, hypertension and chronic kidney disease and, its clinical relevance

Background: The renin–angiotensin–aldosterone system (RAAS) is important in regulating blood pressure and electrolyte balance. The main effector hormone of the RAAS is angiotensin II, which is generated from angiotensin I in the circulation and in the tissues, mostly as a result of the action of angiotensin-converting enzyme (ACE). The ACE gene has received substantial attention in recent years as a candidate gene for a variety of diseases. Objective: This study was conducted to determine the association of insertion/deletion (I/D) polymorphism of ACE gene in type 2 diabetes mellitus (T2DM), hypertension (HT), and chronic kidney disease (CKD) subjects among South Indian regional population. Methods: A total of 105 subjects participated in this study including 30 T2DM (Group 1), 30 HT (Group 2), 35 CKD (Group 3) patients and 10 controls (Group 4). Blood samples were collected and biochemical investigations were done. Polymerase chain reaction amplification was performed to genotype the DNA. The distribution and allelic frequency of I/D (rs1799752) polymorphism at the 287-base pair Alu repeat sequence in the intron 16 of ACE gene were analyzed using specific primers. Results: The ACE genotypes were distributed as II, 17%; DD, 47%; and ID, 37% in the T2DM group; II, 10%; DD, 50%; and ID, 40% in the HT group; II, 17%; DD, 54%; and ID, 29% in the CKD group; and II, 50%; DD, 20%, and ID, 30% in the control group. The frequency of DD genotype was significantly higher in HT (P = 0.05) and CKD patients (P = 0.05) compared to controls. In codominant model analysis, DD genotype versus II genotype was associated with increased risk of T2DM (odds ratio [OR] = 4.37; 95% confidence interval [CI] = 1.31–14.504), HT (OR = 9.0; 95% CI = 2.23–36.17), and/or CKD (OR = 5.73; 95% CI = 1.906–17.282), respectively. The D allele was more frequent in T2DM (65%), HT (70%), and CKD patients (69%) compared to controls (35%) (P = 0.018, P = 0.005, and P = 0.006, respectively). The D allele was associated with increased risk of T2DM (OR = 3.44; 95% CI = 1.19–9.96), HT (OR = 4.33; 95% CI = 1.48–12.65), and CKD (OR = 4.05; 95% CI = 1.42–11.55). Conclusion: The DD genotype and the D allele of the ACE I/D gene polymorphism can be a risk factor for T2DM, HT, and CKD in South Indian regional population. This result suggests that T2DM and HT patients should be offered analysis to identify defects in ACE I/D polymorphism, which might help to determine the course of CKD disease and aid to choose appropriate antihypertensive therapy with ACE inhibitor/angiotensin receptor blockers.

Whey Protein Supplementation and Type 2 Diabetes Mellitus Risk Factors: A Scoping Review of Systematic Reviews and/or Meta–Analyses of Randomized Controlled Trials

ObjectivesEmerging research on whey protein supplementation WPS suggests it may be a potential modifier of type 2 diabetes mellitus (T2DM) risk factors, including glycemic regulation. As systematic reviews and/or meta-analyses of RCTS are gaining importance in nutrition literature, we conducted a scoping review to systematically search and chronicle published systematic reviews and/or meta-analyses of RCTs pertinent to WPS and T2DM modifiable risk factors. MethodsThe protocol was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines. Potentially eligible articles were identified via a systematic search of five electronic health research databases (PubMed, Cochrane Library, CINAHL (EBSCO), Scopus, and SPORTDiscus). Included articles were assessed for quality using the AMSTAR-2 critical appraisal tool. ResultsEight of the 1,692 identified articles met the inclusion criteria. Of the 8 included articles, the outcomes related to T2DM risk factors reported in articles were as follows; 4 included HDL-cholesterol and triglycerides; 3 included fasting blood glucose, total cholesterol, LDL-cholesterol, and body weight; 1 included fasting insulin, HbA1c, blood pressures BMI, and CRP. The results of AMSTAR 2 critical appraisal tool showed that of the 8 included articles, 5 were deemed high quality, 2 were deemed moderate quality, and 1 article was deemed low quality. ConclusionsResults of the scoping review identified no published systematic reviews and/or meta-analyses of RCTs that provide a comprehensive assessment specifically pertaining to the effects of WPS on T2DM modifiable risk factors. Future systematic reviews and/or meta-analyses of RCTs specifically investigating the effects of WPS on modifiable T2DM risk factors in a comprehensive manner are warranted. Funding SourcesThe Whey Protein Research Consortium

Relationships between Glycemic and Lipid Control and TSH in Euthyroid Latinx Adults- a Community-Based Study

ObjectivesThyroid hormone abnormalities are among the most common endocrine disorders comorbidly suffered alongside metabolic syndrome and type 2 diabetes mellitus (T2DM). Thyroid hormones and their regulating hormone, thyroid-stimulating hormone (TSH), play a role in metabolism, obesity, insulin resistance and other disorders that share similar mechanisms. The aim of this study was to examine the associations between TSH and clinical measures of chronic disease markers in a Latinx population receiving free health care services at a community clinic. MethodsA needs assessment was conducted on euthyroid Latinx adult patients from a community clinic in south Florida. The medical records of 93 randomly selected patients were cross-sectionally reviewed to collect data on demographics, diagnoses of health conditions, and biomedical laboratory information. The cut-off point for high TSH was ≥2 mU/L and low TSH as <2 mU/L. Statistical analyses included descriptive statistics, independent t-test, chi-squared test, logistic regressions. ResultsThe mean age was 51.9 ± 11.8 years and 82.8% were female. There were no differences between low and high TSH groups on age, gender, BMI, hypertension, T2DM, CVD, or CVD risk factors. The low TSH group had significantly higher fasting glucose (194.0 mg/dL ± 86.2 vs 140 mg/dL ± 52.8, P = 0.046), hemoglobin A1c (9.6% ±2.8 vs 7.5% ±1.5, P = 0.018), and total cholesterol (200.5 mg/dL ± 32.8 vs 171.5 mg/dL ± 39.7, P = 0.034) compared with the high TSH group. Subgroup analysis of those with T2DM revealed that the low TSH group also had a greater proportion of patients with high fasting glucose (≥170 mg/dL) and high hemoglobin A1c (≥8.5%) compared with the high TSH group. Similarly, those with a low TSH had 6 times greater odds of having high fasting glucose (OR 6.66, 95% CI 1.31–33.69, P = 0.022) and high hemoglobin A1c (OR 6.11, 95% CI 1.19–31.16, P = 0.029). ConclusionsIn Latinx euthyroid patients receiving medical services at a community clinic, a relationship between low-normal TSH levels, fasting glucose and hemoglobin A1c was demonstrated. As the population ages and the risk of both obesity and multimorbidity increases, understanding how thyroid hormone dysfunction can influence chronic disease status may help address health disparities suffered in disadvantaged and vulnerable populations. Funding SourcesFIU RCMI/NIMHD

Pomegranate juice intake enhances the effects of aerobic training on insulin resistance and liver enzymes in type 2 diabetic men: a single-blind controlled trial

BackgroundLifestyle interventions are the first-line treatment for Type 2 diabetes mellitus (T2DM), highly prevalent in the community. This study aimed to examine the 8-week separate and combined effects of aerobic training (AT) and pomegranate juice intake (PJI) on insulin resistance and serum levels of liver enzymes, liver enzymes, and insulin resistance in men with T2DM.MethodsThis study evaluated the alterations of anthropometric indices, insulin resistance, and liver enzymes in 40 middle-aged men (40–50) with T2DM. Participants were randomly assigned into four groups: AT+PJI (n = 10); AT (n = 10); PJI (n = 10), and control (C) (n = 10). The AT program consisted of 60–75% of maximum heart rate (HRmax), 40–60 min/day, and 3 days/wk. Participants in the PJI group consumed 240 ml of pomegranate juice (sugar or additive-free) daily for 8 weeks.ResultsAT+PJI, PJI, and AT groups decreased anthropometric indices, HOMA-IR, and liver enzymes after 8 weeks. In contrast, the C group significantly increased the mentioned variables after the intervention. The result showed that AT+PJI significantly lowered liver enzymes, anthropometric indices, and HOMA-IR than AT or PJI alone. Also, the results of this study showed no significant difference between AT and PJI groups. However, in these groups, significant improvements in these variables were observed compared to the control group.ConclusionDue to the effect of combined AT+PJI in improving T2DM risk factors, it could be recommended for T2DM patients to prevent increased liver enzymes and insulin resistance.

Change of Fibroblast Growth Factor 21 Level Correlates with the Severity of Diabetic Sensory Polyneuropathy after Six-Week Physical Activity.

Diabetic neuropathy (DN) is a very frequent microvascular complication of type 2 diabetes mellitus (T2DM). Obesity and physical inactivity are well-known risk factors for T2DM. Fibroblast growth factor 21 (FGF21) is a liver-secreted hormone with several beneficial effects on obesity-related metabolic disorders. We aimed to investigate the effect of short-term physical activity on the levels of FGF21, and its correlation with the severity of peripheral sensory polyneuropathy in T2DM patients. Thirty patients with DN were enrolled in the study, compared to age- and gender-matched controls. We conducted a six-week aerobic training program, which meant treadmill and cycle ergometers three times a week. Anthropometric and laboratory parameters were measured for each patient before and after intervention. Serum levels of FGF21, TNF-alpha, irisin, leptin and adiponectin were measured by ELISA. The sensory perception threshold (CPT) was quantitatively measured using Neurometer®. We found significant decreases in BMI, waist circumference, HbA1c and TNF-alpha levels. From baseline to six-week follow-up, FGF21 levels were significantly increased in DN patients. Significant negative correlations were shown between the changes in FGF21 levels and BMI, between changes in FGF21 and the improvement of CPT values, and between the changes in FGF21 and TNF-alpha levels. There was no difference in irisin, adiponectin and leptin levels in DN patients after aerobic training program. The physical activity may increase the level of FGF21 in T2DM patients with neuropathy. Our results highlight the importance of regular physical activity in the treatment of diabetic neuropathy.

Research for type 2 diabetes mellitus in endemic arsenism areas in central China: role of low level of arsenic exposure and KEAP1 rs11545829 polymorphism.

Type 2 diabetes mellitus (T2DM) is one of the major public health problems worldwide; both genetic and environmental factors are its risk factors. Arsenic, an environmental pollutant, might be a risk factor for T2DM, but the association of low-to-moderate level arsenic exposure with the risk of T2DM is still inconsistent. Single nucleotide polymorphisms (SNPs) can affect the development of T2DM, but the study on KEAP1 rs11545829(G>A) SNP is few. In this paper, we explored the effect of KEAP1 rs11545829(G>A) SNP and low-to-moderate level arsenic exposure on risk of T2DM in a cross-sectional case-control study conducted in Shanxi, China. Total of 938 participants, including 318 T2DM cases and 618 controls, were enrolled. Blood glycosylated haemoglobin (HbA1c) was detected by Automatic Biochemical Analyzer, and participants with HbA1c≧6.5% were diagnosed as T2DM. Urinary total arsenic (tAs, mg/L), as the indicator of arsenic exposure, was detected by liquid chromatography-atomic fluorescence spectrometry (LC-AFS). Genomic DNA was extracted and the genotypes of KEAP1 rs11545829 SNP were examined by multiplex polymerase chain reaction (PCR). The urinary tAs concentration in recruited participants was 0.075(0.03-0.15) mg/L, and was associated with an increased risk of T2DM (OR = 8.45, 95% CI 2.63-27.17); rs11545829 mutation homozygote AA genotype had a protective effect on risk of T2DM (OR = 0.42, 95 % CI 0.25-0.73). Although this protective effect of AA genotype was found in participants with higher urinary tAs level (>0.032mg/L) (OR = 0.48, 95%CI 0.26-0.86), there was no interaction effect for arsenic exposure and rs11545829 SNP on risk of T2DM. In addition, BMI modified the association between rs11545829 SNP and the risk of T2DM (RERI = -1.11, 95% CI -2.18-0.04). The present study suggest that low-to-moderate level arsenic exposure may be a risk factor, while KEAP1 rs11545829 SNP mutation homozygote AA genotype may be a protective factor for risk of T2DM, especially for T2DM patients with urinary tAs level>0.032mg/L.

Potential impact of GCK, MIR-196A-2 and MIR-423 gene abnormalities on the development and progression of type 2 diabetes mellitus in Asir and Tabuk regions of Saudi Arabia.

Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by persistent hyperglycemia and is associated with serious complications. The risk factors for T2DM include both genetic and lifestyle factors. Genome-wide association studies have indicated the association of genetic variations with many diseases, including T2DM. Glucokinase (GCK) plays a key role in the regulation of insulin release in the pancreas and catalyzes the first step in glycolysis in the liver. Genetic alterations in the GCK gene have been implicated in both hyperglycemia and hypoglycemia. MicroRNAs (miRNAs/miRs) are small non-coding RNA molecules that are involved in the important physiological processes including glucose metabolism. In the present study, the association of the single nucleotide polymorphisms (SNPs) in the GCK, MIR-196A-2 and MIR-423 genes with susceptibility to T2DM in patients from two regions of Saudi Arabia were examined, using the tetra-primer amplification refractory mutation system. The results showed that the AA genotype and the A allele of GCK rs1799884 were associated with T2DM [odds ratio (OR)=2.25, P=0.032 and OR=1.55, P=0.021, respectively]. Likewise, the CT genotype and T allele of MIR-196A-2 rs11614913 were associated with an increased risk of T2DM (OR=2.36, P=0.0059 and OR=1.74, P=0.023, respectively). In addition, the CA genotype of MIR-423 rs6505162 C>A was found to be linked with T2DM (OR=2.12 and P=0.021). It was concluded in the present research study that gene variations in GCK, MIR-196A-2 and MIR-423 are potentially associated with an increased risk of T2DM. These results, in the future, may help in the identification and stratification of individuals susceptible to T2DM. Future longitudinal studies with larger sample sizes and in different ethnic populations are recommended to validate these findings.

Characteristics of pregnancy with gestational diabetes mellitus and the consecutive pregnancy as predictors for future diabetes mellitus type 2

AimTo explore possible obstetrical history-related, modifiable risk factors of future type 2 diabetes mellitus (T2DM), with focus on characteristics of the index gestational diabetes mellitus (GDM) pregnancy and the consecutive pregnancy. MethodsThis retrospective, population-based, cohort study included 788 women with GDM, who had consecutive deliveries at Emek Medical Center during 1991–2012. Women with pre-existing diabetes were excluded. Factors associated with T2DM development were examined using stepwise multiple Cox regression model. ResultsOverall 178 women developed T2DM (23%). Multivariable analysis demonstrated that the most significant independent risk factors for T2DM development were birth weight ≥ 4000 g (HRadj1.7 95% CI [1.001–2.8]), fasting oral glucose tolerance test value (OGTT, HRadj1.03 95% CI [1.01–1.04], 1-hour post-OGTT glucose value (HRadj1.01 95% CI [1.006–1.02]), earlier gestational week in which GDM was diagnosed (HRadj 0.96 95% CI [0.93–0.99]), higher parity (HRadj 1.15 95% CI [1.06–1.25] and GDM recurrence in the consecutive delivery (HRadj2.4 95% CI [1.6–3.7]). Kaplan Meier survival curve of the time from the consecutive pregnancy until T2DM development showed a statistically significant effect of GDM recurrence and the risk for T2DM. Body mass index (BMI) gain between pregnancies and inter-pregnancy interval were not independent risk factors for T2DM. ConclusionsObstetric characteristics of women with GDM and particularly GDM recurrence are associated with increased risk for T2DM. Strategies to prevent those factors and especially GDM recurrence might reduce the risk of future T2DM.

Different Complement Activation Pathways Underly Cognitive Impairment and Type 2 Diabetes Mellitus Combined With Cognitive Impairment.

BackgroundThe immune response and the complement system are associated with cognitive impairment and diabetes mellitus, respectively. Activation of the complement system in these diseases occurs mainly through either the classical pathway or the alternative pathway. However, the specific complement proteins involved in the development of the type 2 diabetes mellitus (T2DM) and cognitive impairment are still unclear. Here, we investigated complement proteins in serum from patients with T2DM, cognitive impairment, or both T2DM and cognitive impairment.ObjectiveTo investigate the levels of serum immune complement proteins in patients with T2DM, cognitive impairment, or T2DM combined with cognitive impairment and the associations between these complement proteins and risk factors for T2DM or cognitive impairment.MethodsClinical markers were collected from blood samples of 264 participants. Luminex multiplex assays were used to detect serum complement proteins. All statistical analyses were performed using Prism or R studio.ResultsThere was a difference in serum levels of the complement proteins C1q, C3, C3b, and FH between the three different groups. Hyperglycemia was significantly correlated with elevated C3b or reduced C3, C1q, and FH. In addition, hyperlipidemia was positively correlated with elevated levels of C3, C4, C1q, and FH proteins. There was an association between C1q, C3, C4, and FH and β-pancreas cell function, whereas only FH was associated with insulin resistance. Higher serum C1q was significantly associated with an increased risk of cognitive impairment.ConclusionSerum levels of complement proteins were closely associated with hyperglycemia and hyperlipidemia. We found that classical complement pathway activation mainly occurred in the cognitive impairment only group, whereas the alternative pathway may reflect T2DM and T2DM with cognitive impairment.

Longitudinal changes in concentrations of persistent organic pollutants (1986-2016) and their associations with type 2 diabetes mellitus.

Positive associations have been reported between persistent organic pollutants (POPs) and type 2 diabetes mellitus (T2DM); however, causality has not been established. Over the last decades, environmental exposure to legacy POPs has decreased, complicating epidemiological studies. In addition, physiological risk factors for T2DM may also influence POP concentrations, contributing to a complex network of factors that could impact associations with T2DM. Longitudinal studies on this topic are lacking, and few have assessed prospective and cross-sectional associations between repeated POP measurements and T2DM in the same individuals, which may shed light on causality. To compare longitudinal trends in concentrations of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) in T2DM cases and controls, and to examine prospective and cross-sectional associations between PCBs, OCPs and T2DM at different time-points before and after T2DM diagnosis in cases. We conducted a longitudinal, nested case-control study (1986-2016) of 116 T2DM cases and 139 controls from the Tromsø Study. All participants had three blood samples collected before T2DM diagnosis in cases, and up to two samples thereafter. We used linear mixed-effect models to assess temporal changes of POPs within and between T2DM cases and controls, and logistic regression models to investigate the associations between different POPs and T2DM at different time-points. PCBs, trans-nonachlor, cis-nonachlor, oxychlordane, cis-heptachlor epoxide, p,p'-DDE, and p,p'-DDT declined more slowly in cases than controls, whereas β-HCH and HCB declined similarly in both groups. Most POPs showed positive associations between both pre- and post-diagnostic concentrations and T2DM, though effect estimates were imprecise. These associations were most consistent for cis-heptachlor epoxide. The observed positive associations between certain POPs and T2DM may be because of higher POP concentrations within prospective T2DM cases, due to slower temporal declines as compared to controls.

Risk and Risk Factors for Postpartum Type 2 Diabetes Mellitus in Women with Gestational Diabetes: A Korean Nationwide Cohort Study.

BackgroundThere are differences in risk and risk factor findings of postpartum type 2 diabetes mellitus (T2DM) after gestational diabetes depending on study design and subjects of previous studies. This study aimed to assess these risk and risk factors more accurately through a population-based study to provide basic data for prevention strategies.MethodsThis open retrospective cohort included data of 419,101 women with gestational diabetes and matched 1,228,802 control women who delivered between 2004 and 2016 from the South Korea National Health Information Database of the National Health Insurance Service. Following 14 (median 5.9) years of follow-up, the incidence and hazard ratio (HR) of postpartum T2DM were evaluated using Kaplan-Meier curves and Cox proportional regression models.ResultsThe incidence and HR of postpartum T2DM in women with gestational diabetes (compared to women without gestational diabetes) after the 14-year follow-up was 21.3% and 2.78 (95% confidence interval [CI], 2.74 to 2.82), respectively. Comorbid obesity (body mass index [BMI] ≥25 kg/m2) increased postpartum T2DM risk 7.59 times (95% CI, 7.33 to 7.86). Significant risk factors for postpartum T2DM were fasting glucose level, BMI, age, family history of diabetes, hypertension, and insulin use during pregnancy.ConclusionThis population-based study showed higher postpartum T2DM risk in women with gestational diabetes than in those without, which was further increased by comorbid obesity. BMI and fasting glucose level were important postpartum risk factors. The management of obesity and glycemic control may be important strategies to prevent the incidence of diabetes after delivery.

Fructose prevents the development of hyperglycaemia in WBN/Kob diabetic fatty rats via maintaining high insulin levels.

Fructose is considered to negatively affect type 2 diabetes mellitus (T2DM); however, there are contradictory reports. The present study aimed to elucidate the effects of fructose-rich diet (FRD) on glucose metabolism of Wistar Bonn Kobori (WBN/Kob) fatty diabetic (WBKDF) rats, a spontaneous T2DM model, and Wistar rats. Wistar Bonn Kobori fatty diabetic and Wistar rats were fed either FRD or standard diet (STD) for 4weeks. The food intake, body weight, plasma glucose and insulin were measured weekly. After the 4-week challenge, rats were subjected to an intravenous glucose tolerance test (IVGTT). The liver and pancreas were used for histological analysis. The 4-week challenge of FRD in Wistar rats did not cause hyperglycaemia, but increased insulin resistance (Homeostatic Model Assessment for Insulin Resistance [HOMA-IR]). Feeding WBKDF rats with a FRD accelerated obesity, but prevented the onset of severe hyperglycaemia via maintaining high plasma insulin levels. Homeostatic Model Assessment for Insulin Resistance in WBKDF rats was not changed by FRD feeding. Intravenous glucose tolerance test revealed that FRD feeding in Wistar rats did not affect glucose tolerance, but slightly increased the plasma insulin level. In contrast, FRD feeding in WBKDF rats significantly reduced the glucose tolerance, but insulin response was not improved. Fructose-rich diet feeding did not alter the β cell area in Wistar rats, but significantly increased it in WBKDF rats. In conclusion, FRD caused insulin resistance in Wistar rats, suggesting that fructose overconsumption is a risk factor for T2DM, whereas FRD inhibited severe hyperglycaemia by maintaining high insulin levels in WBKDF rats. Fructose may be a beneficial sugar for T2DM patients with severe obesity-induced insulin resistance.

Processed meat consumption increases risk of type 2 diabetes mellitus in adults aged 40 years and older

Background Type 2 diabetes mellitus (T2DM) remains a public health problem in the world, including Indonesia. The high mortality of T2DM is triggered by an unhealthy eating pattern and sedentary lifestyle. We aimed to investigate the relationship of food intake pattern and its related factors with T2DM in adults 40 years and older. MethodsThis was a cross-sectional study conducted on 11,022 men and women with T2DM aged 40 years and older. Major dietary patterns were collected and multiple logistic regression analysis was used to determine the effect of covariates. Statistical significance was set at a p-value of &lt;0.05. ResultsMales and individuals aged &gt;40 years comprised 50.17% and 26.19%, respectively, of the 11,022 respondents. Individuals aged over 50 years had a higher risk of developing diabetes than those aged less than 50 years (AOR =5.67, 95% CI=1.37-21.94, p&lt;0.05). Dietary processed meat was associated with a higher risk of T2DM (AOR = 4.9; 95% CI=1.08-22.20, p&lt;0.05). Carbohydrate and fruit intakes were negatively associated with and protective factors for DM (AOR= 0.01; 95% CI=0.01-0.06, p&lt;0.01; AOR = 0.35; 95% CI=0.15-0.83, p&lt;0.01). However, physical activity was not a risk factor for T2DM. ConclusionsProcessed meat consumption, age over 50 years, and carbohydrate intake may increase the risk of T2DM in adults. Conversely, fruit intake may decrease the risk of T2DM in adults. There is a need to control the diet and lifestyle for the early prevention of DM.

High L-Valine Concentrations Associate with Increased Oxidative Stress and Newly-Diagnosed Type 2 Diabetes Mellitus: A Cross-Sectional Study.

ObjectiveBranched-chain amino acids (BCAAs) are essential AAs which are widely used as antioxidants in patients with liver and kidney dysfunction. However, BCAAs are strongly correlated with insulin resistance (IR) and diabetes. This study aimed to evaluate the relationship among BCAAs, oxidative stress, and type 2 diabetes mellitus (T2DM) in a Chinese population.MethodsAnthropometric and biochemical examinations were performed in 816 individuals who participated in the Huai’an Diabetes Prevention Program. Serum BCAAs concentrations were measured by hydrophilic interaction chromatography-tandem mass spectrometric method. Oxidative stress was evaluated by malondialdehyde (MDA) as an index of lipid peroxidation and the superoxide dismutase (SOD) activity.ResultsA total of 816 participants were divided into three groups: normal glucose metabolism (NGM), prediabetes, and newly-diagnosed diabetes mellitus (NDM). Subjects in NDM group show higher MDA and lower SOD levels than subjects in other groups. L-Val levels positively correlated with MDA levels and negatively with SOD in NDM groups. After adjusting for T2DM risk factors, high L-Val levels were significantly associated with higher BMI, WC, FPG, increased LnTG and decreased HDL-C. L-Val was also independently associated with NDM (OR 1.06, 95% CI 1.02–1.10; P = 0.005). Furthermore, the odds ratios for NDM among participants with high L-Val (≥35.25μg/mL) levels showed a 2.25-fold (95% CI 1.11–4.57; P = 0.024) increase compared to participants with low L-Val (<27.26 μg/mL) levels after adjusting for MDA and confounding factors.ConclusionHigh serum L-Val levels are independently associated with oxidative stress, thus promoting IR and NDM. Further study should be done to clarify the mechanism.

Single Point Insulin Sensitivity Estimator for predicting type 2 diabetes mellitus in obese adolescents.

PurposeThe prevalence of adolescents with type 2 diabetes mellitus (T2DM) has rapidly increased in Korea over the past few decades with the increase in the number of obese adolescents. The single point insulin sensitivity estimator (SPISE) was recently introduced as a surrogate marker for insulin sensitivity to predict T2DM in adults. We aimed to determine risk factors for T2DM in obese adolescents, including SPISE.MethodsThis retrospective study included 104 adolescents diagnosed with T2DM at Korea University Hospital between January 2010 and December 2020. We compared clinical and biochemical parameters and the SPISE of normoglycemic overweight and obese individuals with those of prediabetic and diabetic adolescents to determine risk factors for T2DM. Receiver operating characteristic analysis was performed with the Youden index to determine the cutoff point of SPISE.Results Frequency of fatty liver and family history of T2DM were significantly higher and SPISE level was significantly lower in patients with T2DM than in normoglycemic overweight/obese and prediabetic adolescents (P<0.01). A family history of T2DM, fatty liver, and SPISE value below the cutoff point (4.49) were identified as significant risk factors for T2DM in multiple logistic regression analysis after controlling for age, sex, and body mass index standard deviation score (P<0.01).ConclusionsFamily history of T2DM, fatty liver, and low SPISE (<4.49) are risk factors that can independently affect the occurrence of T2DM in obese adolescents. Among these risk factors, SPISE is a promising marker for predicting adolescent T2DM; careful monitoring of these individuals is needed to prevent progression to T2DM.

Survey of Primary Care Physicians' Screening and Treatment Practices for Prediabetes in Saudi Arabia.

BackgroundPrediabetes is defined as a condition in which glucose levels do not fulfill the criteria for type 2 diabetes mellitus (T2DM), indicating that the patient is at an increased risk of developing T2DM. The risk of developing T2DM can be decreased by adequately managing prediabetes. This study aimed to assess screening and therapeutic approaches to prediabetes among primary care physicians in Saudi Arabia because there is little contemporary data available on this topic.MethodologyA cross-sectional study was performed among primary care physicians in Saudi Arabia. The participants completed a validated online survey questionnaire via Google Forms. Data collected included participants’ demographic information, knowledge of T2DM risk factors, and opinions and beliefs on prediabetes management.ResultsIn total, 155 primary care physicians responded to the questionnaire; 51% were male, 18.7% worked in Riyadh City, and 81.3% specialized in family medicine. Most study respondents (71.9%) were residents, and 64.5% worked for the Ministry of Health. Overall, 93.5% of the respondents had completed part of their postgraduate training in Saudi Arabia. Moreover, 27.7% of the respondents were aware of all nine risk factors associated with T2DM. The correct fasting glucose and hemoglobin A1c ranges for the diagnosis of prediabetes were identified by 50% and 43.6% of participants, respectively. Most respondents believed lifestyle modification and metformin to be the most effective management approaches to prediabetes, whereas lack of motivation toward lifestyle changes was deemed to be a major barrier.ConclusionsWe found significant gaps in primary care physicians’ knowledge regarding prediabetes in Saudi Arabia, contributing to underscreening of the condition and undertreatment. Identifying these gaps is essential for focussing educational endeavors toward primary care physicians.

Prevalence of type 2 diabetes mellitus, metabolic syndrome, and related morbidities in overweight and obese children.

The aim of the study was to determine the prevalence of metabolic syndrome (MetS), type 2 diabetes mellitus (T2DM), and other comorbidities in overweight and obese children in Malatya, Turkey. Retrospective cross-sectional study. We studied 860 obese and overweight children and adolescents (obese children Body mass index (BMI) >95th percentile, overweight children BMI >85th percentile) aged between 6 and 18 years. The diagnosis of MetS, impaired glucose tolerance (IGT), impaired fasting glucose (IFG), and T2DM were defined according to modified the World Health Organization criteria adapted for children. Other comorbidities were studied. Subjects (n=860) consisted of 113 overweight and 747 obese children of whom 434 (50.5%) were girls. MetS was significantly more prevalent in obese than overweight children (43.8 vs. 2.7%, p<0.001), and in pubertal than prepubertal children (41.1 vs. 31.7%, p<0.001). Mean homeostasis model assessment for insulin ratio (HOMA-IR) was 3.6±2.0 in the prepubertal and 4.9±2.4 in pubertal children (p<0.001). All cases underwent oral glucose tolerance test and IGT, IFG, and T2DM were diagnosed in 124 (14.4%), 19 (2.2%), and 32 (3.7%) cases, respectively. Insulin resistance (IR) was present in 606 cases (70.5%). Puberty and obesity are important risk factors for MetS, T2DM, and IR. The prevalence of MetS, T2DM, and other morbidities was high in the study cohort. Obese children and adolescents should be carefully screened for T2DM, insulin resistance, hyperinsulinism, dyslipidemia, hypertension, IGT, and IFG. The prevention, early recognition, and treatment of obesity are essential to avoid associated morbidities.