Type 2 Diabetes Mellitus Subjects Research Articles

Patients with Type 2 Diabetes Exhibit a More Mineralized Deep Cartilage Layer Compared with Nondiabetic Controls: A Pilot Study.

To assess differences in biochemical composition of the deep cartilage layer in subjects with type 2 diabetes mellitus (T2DM) and nondiabetic controls using UTE (ultra-short echo time) T2* mapping and to investigate the association of vascular health and UTE T2* measurements. Ten subjects with T2DM matched for age, sex, and body mass index with 10 nondiabetic controls. A 3D UTE sequence with 6 echo times was acquired using 3T magnetic resonance imaging of the knee. For UTE T2* analysis, the deep cartilage layer was segmented and analyzed in 5 compartments (patella, medial, and lateral femur and tibia). The ankle brachial index (ABI) was obtained in all subjects. Linear regression analyses were used to assess associations of T2DM and UTE T2* relaxation times and the associations of ABI measurements and UTE measurements. Compared with nondiabetic controls, T2DM subjects had significantly lower mean T2*-UTE in the patella (mean difference 4.87 ms; 95% confidence interval [CI] 1.09-8.65; P = 0.015), the lateral tibia (mean difference 2.26 ms; 95% CI 0.06-4.45; P = 0.045), and the lateral femur (mean difference 4.96 ms; 95% CI 0.19-9.73; P = 0.043). Independent of diabetic status, subjects with higher ABI values, indicating better vascular health, had higher T2*-UTE of the patella (coefficient 15.2; 95% CI 3.3-21.4; P = 0.017), the medial tibia (coefficient 9.8; 95% CI 1.0-18.6; P = 0.031), and the lateral femur (coefficient 18.8; 95% CI 3.3-34.3; P = 0.021). T2*-UTE measurements of the deep cartilage layer were consistently lower in subjects with T2DM and in subjects with impaired vascular health, likely indicating increased mineralization of this layer.

The association between type 2 diabetes mellitus, hip fracture, and post-hip fracture mortality: a multi-state cohort analysis.

Previous research suggests that individuals with T2DM are at an excess risk of both fractures and overall mortality, but their combined effect is unknown. Using multi-state cohort analyses, we estimate the association between T2DM and the transition to hip fracture, post-hip fracture mortality, and hip fracture-free all-cause death. Population-based cohort from Catalonia, Spain, including all individuals aged 65 to 80years with a recorded diagnosis of T2DM on 1 January 2006; and non-T2DM matched (up to 2:1) by year of birth, gender, and primary care practice. A total of 44,802 T2DM and 81,233 matched controls (53% women, mean age 72years old) were followed for a median of 8years: 23,818 died without fracturing and 3317 broke a hip, of whom 838 subsequently died. Adjusted HRs for hip fracture-free mortality were 1.32 (95% CI 1.28 to 1.37) for men and 1.72 (95% CI 1.65 to 1.79) for women. HRs for hip fracture were 1.24 (95% CI 1.08 to 1.43) and 1.48 (95% CI 1.36 to 1.60), whilst HRs for post-hip fracture mortality were 1.28 (95% CI 1.02 to 1.60) and 1.57 (95% CI 1.31 to 1.88) in men and women, respectively. T2DM individuals are at increased risk of hip fracture, post-hip fracture mortality, and hip fracture-free death. After adjustment, T2DM men were at a 28% higher risk of dying after suffering a hip fracture and women had 57% excess risk of post-hip fracture mortality.

Evaluation of Female Sexual Function in Persons With Type 2 Diabetes Mellitus Seen in a Tertiary Hospital in Southeast Nigeria With Emphasis on its Frequency and Predictors

Women with diabetes are at increased risk of sexual problems. However, this problem is underreported; hence, the need for this study. This was a cross sectional case-controlled study. Seventy-five consenting females with type 2 diabetes mellitus (T2DM) were enrolled from the Diabetes Clinic of the Federal Medical Center, Umuahia, while 75 persons, which included hospital workers and female companions of subjects, were recruited as a control group. Sexual dysfunction in both groups was diagnosed and characterized using the female sexual function index (FSFI). Data obtained from this study was presented as Mean ± SD and analyzed using SPSS 17 software. The mean age of the T2DM group and control were 44.5 years and 38.9 years, respectively. The mean total female sexual score was 22.10 ± 6.66 in the T2DM subjects, while in the control subjects it was 22.43 ± 5.29. This was not statistically significant. The FSFI scores in the desire, lubrication, and orgasm domains were all lower in the diabetic women and this was statistically significant (p < 0.05). The domains of pain and arousal were also lower in the diabetic women, although this was not statistically significant (p > 0.05). The proportion of diabetic females who reported problems in the arousal, lubrication, orgasm, and pain domains was higher (40.0, 36.4, 32.7, 29.1) than the controls (27.9, 16.2, 14.7, 19.1; p < 0.05). The prevalence of female sexual dysfunction in our study was high. Similarly, the FSFI score was low in women with diabetes when compared with controls. The domains of arousal, pain, orgasm, and satisfaction were the most affected in subjects with DM. Age, marital status, body mass index, fasting blood sugar, and hypertension were predictive of sexual dysfunction in the diabetic women.

Thyroid Nodules in Type 2 Diabetes Mellitus.

The present analysis aims to investigate the prevalence of thyroid nodules in type 2 diabetes mellitus (T2DM) population. We searched PubMed, EMBASE, and Web of Science from inception to the March 1, 2018. The studies were selected to estimate the prevalence of thyroid nodules in T2DM subjects and to compare the prevalence of thyroid nodules in different glucose tolerance status. The random effects model was used, and the outcome was presented as a pooled prevalence proportion with 95% confidence interval (95% CI) or a summary odds ratio (OR) with 95% CI. In the end, 9 studies met the inclusion criteria and were included in the analysis. The pooled prevalence of thyroid nodules was 60% (95% CI: 0.52, 0.68) for T2DM 2 diabetes patients, 50% (95% CI: 0.48, 0.51) for pre-diabetes, and 43% (95% CI: 0.34, 0.52) for normal glucose tolerance population. Compared with patients without diabetes, diabetes subjects are more likely to develop thyroid nodules, adjusted OR for thyroid nodule was 1.78 (95% CI: 1.25, 2.55). Insulin resistance might be involved in thyroid nodule development.

OXIDATIVE STRESS LEVELS ARE INCREASED IN TYPE 2 DIABETES MELLITUS AND OBESITY

Objective: The relationship between obesity, type 2 diabetes mellitus (T2DM) and oxidative stress (OS) is complex and insufficiently studied. Chronic hyperglycemia causes endothelial damage by increasing reactive oxygen species (ROS) production and decreasing the activity of antioxidant enzymes, explaining why OS is a main contributor in T2DM pathogenesis. The adipose tissue is also a source of ROS via low-grade chronic inflammation and deregulation of adipokine secretion. Thus, we aimed to evaluate OS levels in obese T2DM subjects and obese non-T2DM subjects vs. controls. Design and method: OS was measured in 20 T2DM obese patients (mean age 64.85 ± 7.74 years), 20 obese non-T2DM patients (mean age 61.30 ± 10.59 years) and 20 non-obese non-T2DM controls (mean age 64.10 ± 2.26 years). ROS were evaluated via the Free Oxygen Radical Testing (FORT; normal range: < = 2.3 mmol/L H2O2) assay. The total antioxidant capacity was measured by the Free Oxygen Radical Defense (FORD; normal range: 1.07 – 1.53 mmol/L Trolox) test. Results: T2DM obese subjects registered higher FORT (3.33 ± 0.30 vs. 3.10 ± 0.34; p = 0.017) and lower FORD (0.60 ± 0.10 vs. 0.71 ± 0.15; p = 0.008) values compared to their obese non-T2DM counterparts. Both obese T2DM subjects and obese non-T2DM subjects depicted higher FORT and lower FORD values vs. controls (p < 0.001) (Table 1). In obese T2DM subjects, FORT values correlated positively with BMI, LDL-cholesterol, total cholesterol, triglycerides, uric acid and HDL/cholesterol value and negatively with age. FORD values evolved oppositely (Table 2).Conclusions: Obese T2DM subjects recorded higher FORT and lower FORD values vs. obese non-T2DM. In both obese T2DM and obese non-T2DM subjects, OS levels were higher vs. controls. In obese T2DM subjects, ROS levels correlated positively with lipid values, BMI, uric acid and, surprisingly, negatively with age. The total antioxidant capacity evolved oppositely. The negative correlation between age and ROS levels and the positive correlation between FORD and age are paradoxical since the ageing process is associated with higher ROS and lower antioxidant values.

The association between omentin and diabetes: a systematic review and meta-analysis of observational studies.

AimsA number of studies have examined the association between the serum levels of omentin and diabetes, but the findings have been inconclusive. Herein, we systematically reviewed available observational studies to elucidate the overall relationship between omentin and diabetes, including type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and impaired glucose tolerance (IGT) among adolescent and adult population.MethodsPubMed, Cochrane’s Library, Science Direct, Scopus, Google Scholar, and ISI Web of Science databases were searched for all available literature until January 2019 for studies assessing the association between omentin and diabetes. The Newcastle–Ottawa Quality Assessment Scale was used to assess the quality of each study.ResultsA total of 28 articles met the inclusion criteria and were included in our systematic review and meta-analysis. There was a significant association between serum omentin and diabetes (WMD−1.68; 95% CI, −2.17 to −1.19; P<0.001). The result of our sub-group analysis based on participants’ health status revealed that omentin was significantly lower in T2DM and IGT subjects but not in T1DM ones compared to healthy controls.ConclusionWe found that serum omentin level is significantly lower in T2DM and IGT patients but not in T1DM ones. These data could be used by clinicians for early diagnosis and management of diabetes. Furthermore, we need more clinical trials to investigate new agents which could influence omentin levels.

Association between glycemic status and thyroid dysfunction in patients with type 2 diabetes mellitus.

BackgroundThyroid dysfunction has been widely reported to be more common in patients with type 2 diabetes mellitus (T2DM) in various parts of the world; however, there is paucity of data on this in our environment.ObjectiveThe aim of this study was to determine the possible relationship between glycemic status and thyroid dysfunction.MethodologyA total of 354 T2DM patients and 118 non-diabetic persons (controls) were recruited for the study. A pretested questionnaire was filled for each subject after due explanations. Their blood samples were tested for HbA1c, fT3, fT4, and TSH. Information retrieved from patient's medical records included age at diagnosis of diabetes (DM) and duration of DM. Testing statistics done included Student's t-test, chi square test, and regression analysis. P-value of less than 0.05 was taken to be statistically significant.ResultsThe results show that 43.5% and 37.3% of T2DM and control subjects, respectively, were males. Mean HbA1c was significantly higher in T2DM patients than in the controls (7.8±2.0% vs 5.8±1.2%, p=0.001), while mean fT3 was significantly lower in T2DM patients than in the controls (2.3±1.5 pg/mL vs 2.7±2.2 pg/mL, p=0.03). Mean HbA1c was significantly higher in T2DM patients with thyroid dysfunction compared to their euthyroid counterparts (8.1±1.9% vs 5.1±1.2%, p=0.001). HbA1c had a positive linear relationship with the presence of thyroid dysfunction (regression coefficient=1.89, p=0.001).ConclusionThere was a positive linear relationship between HbA1c and the presence of thyroid dysfunction in the T2DM patients in this study. There was an inverse relationship between HbA1c and serum fT3.

Serum IL-6 and sIL-6R in type 2 diabetes contribute to impaired capillary-like network formation.

We hypothesized that the serum from individuals with type 2 diabetes mellitus (T2DM) and impaired glucose tolerance (IGT) would reduce in vitro capillary-like network formation compared with normal glucose tolerance (NGT) serum and that this would occur along with higher serum concentrations of inflammatory cytokines and lower concentrations of angiogenic growth factors. Subjects were sedentary, older (55-65 yr) adults with NGT, IGT, or T2DM (n = 10/group) matched for body mass index. Human retroviral telomerized endothelial cells (HRVT-ECs) or coronary artery endothelial cells (CECs) were used in a capillary-like network formation assay using endothelial basal medium supplemented with 7.5% serum. Quantification of HRVT-EC network length indicated that serum from the T2DM group resulted in 32 and 35% lower network formation than when using serum from the NGT and IGT groups, respectively (P < 0.05). Serum from T2DM subjects resulted in CEC network formation that was 11 and 8% lower than when using serum from NGT and IGT subjects, respectively (P < 0.05). Analysis of serum cytokines indicated that IL-6 was 41% and 49% higher in the IGT and T2DM groups, respectively, compared with the NGT group (P < 0.05) and there was a trend for higher soluble interleukin-6 receptor (sIL-6R; P = 0.06) and IL-8 (P = 0.08) in the T2DM serum compared with NGT. The use of recombinant IL-6 and sIL-6R at concentrations detected in the T2DM serum also reduced capillary network formation compared with NGT concentrations (P < 0.05). These results suggest that IL-6 and sIL-6R present in the serum of T2DM individuals impair in vitro endothelial cell function across different cell lines. Our findings may have implications for the microvascular complications associated with T2DM.NEW & NOTEWORTHY Higher concentrations of serum factors, specifically Interleukin-6 and its soluble receptor found in individuals with type 2 diabetes (T2DM) appear to impair endothelial cell capillary-like network formation compared with those present in serum from individuals with impaired glucose tolerance and normal glucose tolerance. This may have implications for the vascular complications associated with T2DM.

ApoB/ApoA1 ratio and non-HDL-cholesterol/HDL-cholesterol ratio are associated to metabolic syndrome in patients with type 2 diabetes mellitus subjects and to ischemic cardiomyopathy in diabetic women

Background and aimPresence of metabolic syndrome (MS) in patients with type 2 diabetes mellitus (T2DM) involves an increased risk of cardiovascular disease and death. Markers such as ApoB/ApoA1 and non-HDL-cholesterol/HDL-cholesterol ratios have been used to predict this risk with conflicting results. The study objective was to establish the relationship between the apoB/apoA1 and non-HDL-cholesterol/HDL-cholesterol ratios and MS in T2DM patients from a Madrid (Spain) district. Patients and methodsOne hundred patients with T2DM who attended University Hospital Infanta Leonor (Vallecas, Madrid, Spain) between January 2014 and June 2017 were enrolled. A blood sample was taken every 6 months from all patients to measure the different lipid parameters and to calculate ApoB/ApoA1 and non-HDL-cholesterol/HDL-cholesterol ratios. A Mann–Whitney's U test to compare means and a Spearman's correlation test for correlations between variables were used, and a multivariate regression analysis was performed to determine the association between MS and the ApoB/ApoA1 and non-HDL-cholesterol/HDL-cholesterol ratios. Values of p<0.05 were considered significant. ResultsAssociations were found between MS and ApoA1 (R2=0.164, p=0.028), ApoB/ApoA1 (R2=0.187, p=0.001), and non-HDL-cholesterol/HDL-cholesterol (R2= 0.269, p=0.0001) ratios and, in women with MS, between ApoB/ApoA1 ratio and ischemic cardiomyopathy (IC) (R2=0.160, p=0.032). Associations remained after adjusting for comorbidities and risk factors. ConclusionsIn the T2DM patients studied, MS was independently associated to ApoA1 and the ApoB/ApoA1 and non-HDL-cholesterol/HDL-cholesterol ratios. Both ratios were better predictors of MS in T2DM subjects that its components alone. The ApoB/ApoA1 ratio could be used as a cardiovascular risk marker in women with MS.

Relationship between retinol and risk of diabetic retinopathy: a case-control study.

The aim of the present study was to evaluate the relationship between retinol and risk of diabetic retinopathy in Chinese adults. Eighty-six subjects with type 2 diabetes mellitus (T2DM) and 40 healthy subjects (healthy comparison group, HCG) were recruited in Beijing Luhe Hospital. Of the 86 T2DM subjects, 43 subjects were diagnosed with diabetic retinopathy (DRG), and 43 subjects had no retinopathy (DNRG). Dietary intake of retinol (p<0.001) and retinol equivalent (p<0.05) was significantly higher but serum retinol and (p<0.001) retinol binding protein 4 (RBP4) (p<0.05) were significantly lower in DNRG compared with HCG. Dietary intake of retinol (p<0.05) and retinol equivalent (p<0.05) was significantly lower, and serum retinol and (p<0.01) retinol binding protein 4 (RBP4) (p<0.01) were significantly higher in DRG compared with DNRG. In T2DM subjects, per 100 μg/day higher dietary retinol intake was associated with 17% lower risk of diabetic retinopathy (odds ratio (OR), 0.83; 95% CI, 0.70 to 0.98; p=0.032), and after adjusting for potential confounding factors, the OR was 0.82 (95% CI, 0.69 to 0.99; p=0.036); per 100 μg/day higher in dietary retinol equivalent intake was associated with 12% lower risk of diabetic retinopathy (OR, 0.88; 95% CI, 0.79 to 0.97; p=0.010), and after adjusting for potential confounding factors, the OR was 0.88 (95% CI, 0.79 to 0.98; p=0.025). Higher dietary intake of retinol or retinol equivalent is associated with lower risk of diabetic retinopathy.

1935-P: Decoupling between ATP Utilization and Replenishment in Insulin Resistant Skeletal Muscle

For optimal energy utilization, depletion and recovery of phosphocreatine (PCr) during exercise must be tightly coupled. Aim: To measure metabolites in vastus lateralis (VL) muscle of normal glucose tolerant (NGT) and type 2 diabetes mellitus (T2DM) subjects by phosphorus-31 magnetic resonance spectroscopy (31P-MRS) during and following exercise. Matsuda index (MI) of insulin sensitivity, fasting plasma glucose (FPG), intramyocellular lipid concentration [IMCL], and mitochondrial density (MitoD) were also measured. Methods: 12 NGT (age=50±11y; A1c=5.6±0.3%; BMI=28.5±4.1kg/m-2) and 10 T2DM (age=53±10y; A1c=7.5±0.8%; BMI=30.4±4.6kg/m-2) subjects received an OGTT to determine MI. [IMCL] in VL was quantified by 1H-MRS. In 15 subjects (7 T2DM, 8 NGT) MitD was determined by electron microscopy. Results: The PCr recovery time constant (k) was lower in T2DM (0.01±0.004 vs. 0.02±0.01 s-1; p=0.05). Baseline [PCr] (25.3±3.0 vs. 28.5±3.3 mM; p=0.03) and average [PCr] over the last minute of exercise (14.5±4.7 vs. 20.9±4.7 mM; p&amp;lt;0.05) were lower in T2DM. PCr percent decrease, (%Δ), was negatively correlated with PCr recovery halftime, t (ρ=0.77; p&amp;lt;0.05). The initial rate of PCr depletion and initial rate of PCr recovery were correlated in NGT (r=0.83; p&amp;lt;0.05) but not in T2DM subjects (r=0.30; p=0.39). FPG negatively correlated with baseline [PCr] (ρ=-0.63; p&amp;lt;0.05) and MI negatively correlated with %Δ (ρ=-0.50; p&amp;lt;0.05) in all subjects. [IMCL] was increased in T2DM (6.9±1.2 vs. 9.1±1.4; p&amp;lt;0.05) and correlated negatively with t (ρ=0.47; p=0.03). MitoD in T2DM subjects correlated with k (r=0.76; p&amp;lt;0.05). Conclusion: These data suggest a disruption in the regulation of energy utilization and production of ATP and PCr, which may be due to reduced mitochondrial density and/or altered substrate dynamics in T2DM skeletal muscle. Disclosure J.A. Vasquez: None. C. Solis-Herrera: Advisory Panel; Self; Sanofi. D. Tripathy: None. M. Abdul-Ghani: None. R.A. DeFronzo: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Elcelyx Therapeutics, Inc., Intarcia Therapeutics, Inc., Janssen Pharmaceuticals, Inc., Novo Nordisk Inc. Research Support; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc., Merck &amp; Co., Inc. Speaker's Bureau; Self; AstraZeneca, Novo Nordisk Inc. G.D. Clarke: None. Funding National Institutes of Health (DK-24092-34 to R.A.D), (K25-DK-089012 to G.D.C.)

Association of CAPN10 SNP-19 (rs3842570) Polymorphism on Fasting Plasma Glucose, Blood Pressure and Body Mass Index of Javanese Type-2 Diabetes Patients

Polymorphism of CAPN10 has been reported to be responsible for risk of Type 2 Diabetes Mellitus (T2DM), and CAPN 10 SNP-19 (rs3842570) is associated with elevation of blood glucose, obesity, and metabolic syndrome. Aims of this study are to analyze the association between polymorphism CAPN10 SNP-19 (rs3842570) on fasting plasma glucose (FPG), blood pressure (BP) and body mass index (BMI) of Javanese T2DM patients. The study sample comprised 107 T2DM subjects as well as 107 healthy subjects of Javanese origin. T2DM subjects were obtained from several Primary Public Health Centers in Semarang. The polymorphism of CAPN10 SNP19 was examined using PCR. FPG, BP, and BMI also were examined. The association between FPG, BP, and BMI in each genotype class was analyzed using Kruskal Wallis test. In the T2DM group, the 2R/3R genotype had the highest mean of FPG (138,42±6,77mg/dl), BMI (26,49±0,41). However, the highest mean of blood pressure was 2R/2R genotype with systolic 142,00±7,27mmHg and diastolic 83,11± 3, 17mmHg.There was no significant association between polymorphism in T2DM group with FPG, systolic BP, diastolic BP and BMI with p-value 0,563; 0,734; 0,939; 0,087, respectively. In conclusion, CAPN10 SNP-19 (rs3842570) polymorphism does not contribute to elevating FPG, BP, and BMI of Javanese T2DM patients.

EFFECTIVENESS OF CASSIA AURICULATA FLOWER (AVARAM POO) EXTRACT IN REDUCING BLOOD GLUCOSE AMONG PRE DIAGNOSED TYPE 2 DIABETES MELLITUS CLIENTS IN SELECTED AREA OF PUDUCHERRY, INDIA

A study to evaluate the effectiveness of Cassia auriculata (Avaram poo) Flower extract in reducing blood glucose among pre diagnosed Type 2 Diabetes Mellitus clients in selected area of Puducherry. Objectives of the study are to assess the pretest level blood glucose among the control and experimental group. To administer the Cassia auriculata (Avaram poo) flower extract to the study group, To assess the post test level blood glucose among the control and experimental group, To evaluate the effectiveness of Cassia auriculata Flower (Avaram poo) extract in reduction of blood glucose level among type2 Diabetes Mellitus subjects, To associate the effectiveness of Cassia auricular Flower (Avaram poo) extract with demographic variables in experimental group. The research approach selected for the study was Quantitative approach, quasi Experimental design (pre-test and post test with control group). The study was conducted in selected PHC Kalapet, at Puducherry. Sample size was 60, 30 in experimental and 30 in control group were randomly assigned. The standardized glucometer was used to assess the blood glucose level. Pretest was done to assess the level blood glucose (FBS and PPBS) for both the groups. Experimental group received Cassia auriculata Flower (Avaram poo) extract for 30 days and control group did not receive any measures. Post test level of blood Glucose (FBS and PPBS) was evaluated on 30th day for both experimental and control group. The results of the study were the result revealed that the pretest mean score of fasting blood glucose was 133.50±37.43 and after the administrations of Cassia auriculata flower extract the post test mean score was 109.93±18.14. The mean difference score was 23.57. The calculated paired‘t’ value of t =5.478 was found to statistically highly significant at p<0.,001 level. This clearly indicates that the Cassia auriculata flower extract was found to be effective in reducing the fasting blood glucose level among type 2 diabetes mellitus clients in the experimental group. The pretest mean score of post prandial blood glucose was 262.40±73.18 and after the administrations of Cassia auriculata flower extract the post test mean score was 193.43±45.99. The mean difference score was 68.97. The calculated paired ‘t’ value of t = 8.103 was found to statistically highly significant at p<0.001 level. This clearly indicates that the Cassia auriculata flower extract was found to be effective in reducing the post prandial blood glucose level among pre diagnosed type 2 diabetes mellitus clients in the experimental group. The demographic variable of marriage had shown significant association with the post test level of fasting blood glucose among the study group. Article DOI: https://dx.doi.org/10.20319/lijhls.2019.51.126136 This work is licensed under the Creative Commons Attribution-Non-commercial 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc/4.0/ or send a letter to Creative Commons, PO Box 1866, Mountain View, CA 94042, USA.

U-Shaped Association Between Serum Uric Acid Levels and Cognitive Functions in Patients with Type 2 Diabetes: A Cross-Sectional Study.

Serum uric acid (SUA) is a natural antioxidant that may exert neuroprotective effects against neurodegenerative diseases. The relationship between uric acid and cognitive functions has been extensively studied, but results remain conflicting. To investigate potential associations between SUA level and mild cognitive impairment (MCI), and different domains of cognitive performances in patients with type 2 diabetes mellitus (T2DM). A total of 352 T2DM subjects (208 males and 144 females) were enrolled. SUA level was determined by using the uricase method. Cognitive performances were assessed using a validated neuropsychological test battery. Generalized additive models and binary logistic regression analysis were fitted to determine the association between SUA and cognitive functions. A total of 157 T2DM patients had MCI, and 195 displayed normal cognition. Compared with the controls, MCI patients exhibited lower SUA level (p = 0.009). Generalized additive models revealed a U-shaped curve relationship among SUA with Montreal Cognitive Assessment, Auditory Verbal Learning Test-immediate recall and Trail Making Test-B scores (all p < 0.05). Further logistic regression analysis showed a significant trend toward decreased MCI risk with increased SUA level among the subjects whose SUA level was below the cut-point (388.63 μmol/L); each unit increment in SUA level reduced the MCI risk by 0.7% (p = 0.003). A U-shaped association between SUA level and global cognitive function, especially executive and memory function, existed in T2DM patients. Our findings will provide additional suggestions that an increase of SUA to a certain level may be a novel method to reduce the burden of T2DM-associated cognitive impairment.

Association of hemoglobin A1C with circulating metabolites in Dutch with European, African Surinamese and Ghanaian background

BackgroundThe prevalence of type 2 diabetes mellitus (T2DM) varies significantly across ethnic groups. A better understanding of the mechanisms underlying the variation in different ethnic groups may help to elucidate the pathophysiology of T2DM. The present work aims to generate a hypothesis regarding “why do subjects with African background have excess burden of T2DM?”.MethodsIn the current study, we performed metabolite profiling of plasma samples derived from 773 subjects of three ethnic groups (Dutch with European, Ghanaian and African Surinamese background). We performed Bayesian lognormal regression analyses to assess associations between HbA1c and circulating metabolites.ResultsHere we show that subjects with African Surinamese and Ghanaian background had similar associations of HbA1c with circulating amino acids and triglyceride-rich lipoproteins as subjects with European background. In contrast, subjects with Ghanaian and African Surinamese background had different associations of HbA1c with acetoacetate, small LDL particle and small HDL particle concentrations, compared to the subjects with European background.ConclusionsOn the basis of the observations, we hypothesize that the excess burden of T2DM in subjects with African background may be due to impaired cholesterol efflux capacity or abnormal cholesterol uptake.

Sense of smell and quality of life in children with diabetes mellitus

IntroductionDiabetes mellitus is one of the most common chronic systemic diseases seen in children. The increasing prevalence of Type 1 diabetes mellitus (T1DM) among children is alarming. Although olfaction has been found to be altered in some adult T1DM subjects, it is unknown whether this is the case in children and, if so, whether the dysfunction adversely influences their quality of life (QOL). MethodsUsing the Pediatric Smell Wheel® (PSW), we measured the olfactory function of 30 T1DM patients and 30 healthy controls [mean ages = 13.1 & 13.0, respectively]. The Turkish version of the Pediatric Quality of Life Inventory (PedsQL) was also administered. ResultsThe PSW scores were lower in the T1DM patients than in the controls (9.17 vs 10.37; p < 0.0001), although, in both cases, the scores fell within the normal range for individuals of their age (i.e., at or above 80%). Interestingly, such scores were lower in left-handed than in right-handed patients (8.00 vs 9.46; p = 0.001). Lower QOL indices were also found for the T1DM than for the controls for the domains of Emotional Function (p = 0.02), Social Function (p = 0.014), School Function (p = 0.011), and Psychosocial Status (p = 0.002). No significant associations were evident between PSW scores and disease duration and QOL scales. ConclusionsOur study demonstrates, for the first time, that modest decrements in smell function are evident in children with TIDM.

Effects of curcumin on glycemic control and lipid profile in prediabetes and type 2 diabetes mellitus: A systematic review and meta-analysis.

ScopeStudies have demonstrated inconsistent effects of curcumin on glycemic outcomes and lipid parameters in patients with prediabetes and type 2 diabetes mellitus (T2DM). This study aimed to assess the effect of curcumin on glycemic control and lipid profile in prediabetes and T2DM.Methods and resultsA systematic search of randomized controlled trials (RCTs) was conducted from inception to June 2018 in electronic sources including AMED, ANZCTR, BioMed Central, CENTRAL, CINAHL, ClinicalTrials.gov, Expanded Academic Index, Google Scholar, ISRCTN, LILACS, MEDLINE, NCCIH, Science Direct, Scopus, Web of Science, and WHO ICTRP. Hand search was also performed. Of the total 486 records, four trials (N = 508) and eight trials (N = 646) were eligible for the meta-analysis of individuals with prediabetes and T2DM, respectively. Curcumin significantly reduced glycosylated hemoglobin (HbA1c) in prediabetics (MD: -0.9%, 95% CI: -1.7 to -0.1%, p = 0.03). Furthermore, T2DM subjects gained favorable reduction in both HbA1c (MD: -0.5%, 95% CI: -1.0 to -0.0%, p = 0.04) and fasting plasma glucose (MD: -11.7 mg/dL, 95% CI: -22.1 to -1.3 mg/dL, p = 0.03). Tendency of lipid profile improvement was also observed.ConclusionOur findings may encourage curcumin supplementation based on its meaningful effect on glycemic control and positive trend on lipid outcomes in prediabetes and T2DM.

Hypertension Contributes to Neuropathy in Patients With Type 1 Diabetes.

BACKGROUNDDiabetic peripheral neuropathy (DPN) can lead to foot ulceration and amputation. There are currently no disease-modifying therapies for DPN. The aim of this study was to determine if hypertension contributes to DPN in patients with type 1 diabetes mellitus (T1DM).METHODSSubjects with T1DM (n = 70) and controls (n = 78) underwent a comprehensive assessment of DPN.RESULTSHypertension was present in 40 of 70 T1DM subjects and 20 of 78 controls. Hypertension was associated with abnormal nerve conduction parameters (P = 0.03 to <0.001), increased vibration perception threshold (P = 0.01) and reduced corneal nerve fiber density and length (P = 0.02) in subjects with T1DM. However, after adjusting for confounding factors only tibial compound motor action potential and nerve conduction velocity were associated with hypertension (P = 0.03) and systolic blood pressure (P < 0.01 to <0.0001). Hypertension had no effect on neuropathy in subjects without diabetes.CONCLUSIONSThis study shows that hypertension is associated with impaired nerve conduction in T1DM. It supports previous small trials showing that angiotensin-converting enzyme inhibitors improve nerve conduction and advocates the need for larger clinical trials with blood pressure lowering agents in DPN.

SAT-176 Cellular Mechanisms of Impaired Bone Remodeling in Type 1 Diabetes Mellitus

Type 1 Diabetes Mellitus (T1DM) is one of the most common chronic diseases in childhood, with a mean age of ~14 years at diagnosis. Coincidentally, this is also the time peak bone accrual occurs. T1DM subjects show reductions in bone mineral density, which are sustained through adulthood, leading to a high risk for fracture. The cause for reduced BMD in T1DM is not fully understood but is thought to result from suppressed bone turnover. Surprisingly, despite their abundance in bone and their critical importance in regulating bone remodeling, little attention has been given to osteocytes and their response to chronic hyperglycemia. We hypothesize that osteocytes of diabetic NOD mice index cumulative metabolic stress that affects their regulation of bone remodeling. To test our hypothesis we used the non-obese diabetic (NOD) mouse as a model for T1DM. We grouped the NOD mice according to the severity of the disease (no diabetes, moderate and severe diabetes) and studied the effects of T1DM on skeletal morphology by micro-computed tomography (mCT) and bone histomorphometry. Additionally we established primary osteoblasts, osteoclasts, and osteocytes cultures from NOD mice. mCT data showed that NOD mice with severe diabetes exhibited reductions in cortical bone, total cross sectional area, and cortical bone thickness as compared to NOD mice with moderate diabetes or NOD mice with sporadic increases in blood glucose that did not develop full blown diabetes. Histomorphometry of cortical bone at the femur mid-diaphysis revealed complete inhibition of bone formation and mineral apposition rates in the diabetic mice. These data is associated with reduced alkaline-phosphatase positive cells in primary osteoblast cultures, suggesting reductions in osteoprogenitor numbers in diabetic NOD mice. Primary osteocyte cultures from diabetic NOD mice revealed impaired mitochondrial function, which likely contributes to the impaired bone remodeling. Overall, we show significant impairments in bone remodeling in diabetic NOD mice, which results not only from impaired osteoblast function but also from dysfunction of osteocytes. Future studies will focus on the contribution of osteocyte to bone remodeling in T1DM.

Serum magnesium status and its correlation with insulin resistance in newly diagnosed patients with type 2 diabetes mellitus

Hypomagnesaemia has been reported in type 2 diabetes mellitus (T2DM) and an association of low serum magnesium (Mg) with insulin resistance has been observed. In this cross-sectional study, 65 new T2DM patients and 65 healthy controls were investigated to assess the Mg status and see the association between Mg level and insulin resistance. Oral glucose tolerance test, HbA1c, serum Mg, and fasting insulin were measured and the level of insulin resistance was calculated by using the homeostasis model assessment for insulin resistance (HOMA-IR). Serum Mg level was similar in T2DM and control groups; a higher frequency of hypomagnesemia was observed in the T2DM than control group (26.2% vs. 12.3%) though it was not statistically significant (p= 0.074). Level of insulin resistance (HOMA-IR) was higher in the T2DM group and a higher frequency of subjects had insulin resistance in this group compared to controls. No significant differences in age, body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), fasting plasma glucose (FPG), HbA1c, fasting insulin level and HOMA-IR were observed between normomagnesaemic and hypomagnesaemic T2DM subjects. In the T2DM group, age, BMI, WC, WHR, FPG, fasting insulin and HOMA-IR correlated with serum Mg level though in the control group Mg had significant inverse correlations with BMI and fasting insulin. New T2DM subjects and healthy controls had similar Mg status although the frequency of hypomagnesemia was higher (not significant) in the T2DM group and serum Mg level had no correlation with glycemic status, fasting insulin and HOMA-IR in T2DM patients.