ResearchPad - Endocrinology, Diabetes and Metabolism https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Bone health assessment in older people with or without muscle health impairment]]> https://www.researchpad.co/product?articleinfo=5b59ad5e463d7e792f619098

Summary

This study investigated the relationship between muscle and bone status in elderly individuals. Our results suggested links between sarcopenia and osteoporosis; impairment in muscle status (i.e., muscle mass, muscle strength, and physical performance) is associated with deterioration in bone mass and texture subsequently leading to an increased risk of fracture.

Introduction

Accumulating evidence has shown associations between sarcopenia and osteoporosis, but existing studies face inconsistencies in the clinical definition of both conditions. Thus, we sought to investigate bone health among older individuals with or without muscle health impairment.

Methods

We conducted an analysis of cross-sectional data available from the Sarcopenia and Physical Impairment with Advancing Age (SarcoPhAge) study. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People (EWGSOP) (i.e., a low muscle mass plus either low muscle strength or low physical performance). Muscle mass and areal bone mineral density (aBMD) were determined using dual-energy X-ray absorptiometry (DEXA). Muscle strength was assessed using a hand dynamometer, and physical performance was assessed with the Short Physical Performance Battery test. Using the cutoff limits proposed by the EWGSOP, we have classified women in the “low SMI group” when its value was < 5.50 kg/m2, in the “low muscle strength group” when strength was < 20 kg, and in the “low physical performance group” when SPPB < 8 points. The thresholds of < 7.26 kg/m2 (for SMI), < 30 kg (for muscle strength), and SPPB < 8 points were used for men. The 10-year fracture risk was obtained using the FRAX® tool. Moreover, bone texture was determined using the trabecular bone score (TBS) method.

Results

The study sample consisted of 288 older subjects aged 74.7 ± 5.7 years, and 59.0% of the subjects were women. Sarcopenia was diagnosed in 43 individuals (14.9%), and osteoporosis was diagnosed in 36 subjects (12.5%). Moreover, aBMD values were, most of the time, lower in older men and women with muscle impairment (i.e., low muscle mass, low muscle strength, and low physical performance). For these subjects, we also noted a higher probability of fracture. When comparing bone quality, there were no significant differences in the TBS values between sarcopenic and non-sarcopenic older men and women or between those with low and high muscle mass. However, when controlling for confounders (i.e., age, BMI, number of co-morbidities, smoking status, and nutritional status), TBS values were lower in older women with low muscle strength (p = 0.04) and in older men with low physical performance (p = 0.01).

Conclusions

Our study showed interrelationships between components of sarcopenia and osteoporosis, with older subjects with muscle impairment having poorer bone health.

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<![CDATA[Improved insulin sensitivity and lower postprandial triglyceride concentrations after cold-pressed turnip rapeseed oil compared to cream in patients with metabolic syndrome]]> https://www.researchpad.co/product?articleinfo=5b597815463d7e5ce270da29

Background

The aim of this study was to compare acute effects of turnip rapeseed oil rich with mono- and polyunsaturated fatty acids and cream on postprandial triglyceride levels and post-glucose load measures of insulin sensitivity in population of men with metabolic syndrome.

Methods

This open-label balanced crossover study included 37 men with metabolic syndrome. They underwent an oral glucose-fat tolerance test where they ingested 75 g of glucose with either 240 mL of cream or 84 mL of turnip rapeseed oil depending on the study arm. Hourly postprandial blood samples were drawn up to 5 h after this oral glucose-fat tolerance test to determine the changes in triglyceride concentrations and to measure insulin sensitivity. Changes in insulin sensitivity were calculated with different insulin sensitivity indices (OGIS, Stumvoll, Gutt and McAuley scores) derived from measured insulin and glucose concentrations. The oral glucose-fat tolerance test was preceded by a period during which the participants consumed a daily portion of either 35 mL of turnip rapeseed oil or 37.5 g of butter depending on the study arm in addition to their habitual diets. Both dietary periods lasted from 6 to 8 weeks. After an 8-week wash-out period the subjects crossed over to the other study arm and underwent the same process with the other fat adjunct.

Results

The area under the curve for hourly triglyceride concentrations was 16% smaller after turnip rapeseed oil than after cream (13.86 [interquartile range 8.54] vs. 16.41 [9.09] mmol/l, p < 0.001). The insulin sensitivity markers of OGIS (324 [38.97] vs. 377 [68.38] p < 0.001), Stumvoll score (0.079 [0.029] vs. 0.085 [0.029], p = 0.038) and Gutt score (67.0 ± 2.78 vs. 78.8 ± 4.97 p = 0.001) were higher after turnip rapeseed oil period than after butter period. There was a non-significant change in the McAuley score.

Conclusion

Dietary turnip rapeseed oil improved postprandially measured insulin sensitivity and triglyceride concentrations compared to cream and butter. This provides a possible efficient dietary mean to treat cardiovascular risk factors.

Trial registration ClinicalTrials.gov NCT01119690 (05-06-2010)

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<![CDATA[Ovarian reserve evaluation after laparoscopic cyst enucleation, depending on applied haemostasis technique and with particular consideration of endometrial cysts]]> https://www.researchpad.co/product?articleinfo=5b592bc9463d7e57a32e3e53

Aim of the study

was an evaluation of the effects, exerted by obtained haemostasis on ovarian reserve, depending on haemostasis technique, applied after laparoscopic enucleation of endometrial cysts.

Material and methods

Sixty-six female patients, at the age of 20-35 years, were included into the study. The diameters of the cystic lesions were within 40-70 mm. The patients were randomly assigned to two study groups. Group 1 involved patients after laparoscopic enucleation of ovarian cysts, in whom haemostasis was achieved by ovary suturing, while Group 2 included patients with haemostasis achieved by bipolar coagulation technique. Cyst enucleation was performed in all the patients by the stripping method. Ovarian reserve markers: AFC (antral follicle count), AMH (anti-Müllerian hormone), and inhibin B were assayed before and three months after the surgery.

Results

The preoperative values of AMH, AFC, and inhibin B were similar in both studied groups. After a three-month follow up, the post-operative levels of AMH and inhibin B were significantly lower (p < 0.05), while the numbers of antral follicles did not reveal any statistical differences (p > 0.05). While comparing endometrial and dermoid cysts in the sutured group of patients, the difference, regarding AMH, was statistically significant (2.13 vs. 4.69, p = 0.03). In the group of patients after bipolar coagulation, the corresponding differences did not attain statistical significance (2.21 vs. 6.51, p = 0.86)

Conclusions

Comparing pre- and post-operative levels of AMH and inhibin B, regardless of the applied haemostasis technique, a statistically significant reduction of the ovarian reserve was observed in either group. Comparing both haemostasis techniques, no method was demonstrated that would have decreased less the levels of AMH, AFC, or inhibin B.

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<![CDATA[Letter: Patient Understanding of Hypoglycemia in Tertiary Referral Centers (Diabetes Metab J 2018;42:43-52)]]> https://www.researchpad.co/product?articleinfo=5b58ee5c463d7e5414116042 ]]> <![CDATA[Chikungunya and diabetes, what do we know?]]> https://www.researchpad.co/product?articleinfo=5bfd9586d5eed0c48451971d

Background

Chikungunya (CHIK) is a viral disease transmitted by mosquitoes. The first cases in Brazil were confirmed in 2014. Between 2016 and 2017, over 300,000 cases were identified during this period, with nearly 300 deaths. The clinical manifestations, pathogenesis and risk factors for occurrence of severe cases are not yet well understood, although it is known that the severity of the cases is associated with the presence of comorbidities, especially diabetes mellitus (DM).

Objective

To review the medical literature for the associations between DM and CHIK and to understand the potential impact on metabolic state and its complications.

Methods

Literature review was carried out to search for articles (English, Portuguese and Spanish) in Medline and Virtual Health Library databases for the period between 1952 and 2017, with the following keywords: “Chikungunya fever”, “Chikungunya virus”, “diabetes mellitus”, “diabetes”, “diabetes complications “and “multi-morbidities (MeSH) “with interposition of the Boolean operator “AND”.

Results

After removal of duplicities and following exclusion criteria, 11 articles were selected. Our results showed that the patients of CHIK with DM had more severe and prolonged symptoms of CHIK and more frequently required hospitalization. No study investigated the biological process to explain how hyperglycemic state worsened the clinical manifestations of Chikungunya in diabetic patients.

Conclusion

An important association between DM and the severity of CHIK is observed. Prospective and more rigorous controlled studies are required to generate evidence that might y elucidate the causes of this relationship. Given the fast expanding viral infection of Chikungunya in Central and South America, Asia and Africa in recent years in the context of exponential increase in diabetes globally, the issue deserves global attention.

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<![CDATA[Kisspeptin neurones in the posterodorsal medial amygdala modulate sexual partner preference and anxiety in male mice]]> https://www.researchpad.co/product?articleinfo=5bfb99dad5eed0c484b171a1

The posterodorsal medial amygdala (MePD) is a neural site in the limbic brain involved in regulating emotional and sexual behaviours. There is, however, limited information available on the specific neuronal cell type in the MePD functionally mediating these behaviours in rodents. The recent discovery of a significant kisspeptin neurone population in the MePD has raised interest in the possible role of kisspeptin and its cognate receptor in sexual behaviour. The present study therefore tested the hypothesis that the MePD kisspeptin neurone population is involved in regulating attraction towards opposite sex conspecifics, sexual behaviour, social interaction and the anxiety response by selectively stimulating these neurones using the novel pharmacosynthetic DREADDs (designer receptors exclusively activated by designer drugs) technique. Adult male Kiss‐Cre mice received bilateral stereotaxic injections of a stimulatory DREADD viral construct (AAV‐hSyn‐DIO‐hM3D(Gq)‐mCherry) targeted to the MePD, with subsequent activation by i.p. injection of clozapine‐N‐oxide (CNO). Socio‐sexual behaviours were assessed in a counter‐balanced fashion after i.p. injection of either saline or CNO (5 mg kg‐1). Selective activation of MePD kisspeptin neurones by CNO significantly increased the time spent by male mice in investigating an oestrous female, as well as the duration of social interaction. Additionally, after CNO injection, the mice appeared less anxious, as indicated by a longer exploratory time in the open arms of the elevated plus maze. However, levels of copulatory behaviour were comparable between CNO and saline‐treated controls. These data indicate that DREADD‐induced activation of MePD kisspeptin neurones enhances both sexual partner preference in males and social interaction and also decreases anxiety, suggesting a key role played by MePD kisspeptin in sexual motivation and social behaviour.

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<![CDATA[Calcitriol Supplementation Causes Decreases in Tumorigenic Proteins and Different Proteomic and Metabolomic Signatures in Right versus Left-Sided Colon Cancer]]> https://www.researchpad.co/product?articleinfo=5b4c8a2a463d7e0cf681798c

Vitamin D deficiency is a common problem worldwide. In particular, it is an issue in the Northern Hemisphere where UVB radiation does not penetrate the atmosphere as readily. There is a correlation between vitamin D deficiency and colorectal cancer incidence and mortality. Furthermore, there is strong evidence that cancer of the ascending (right side) colon is different from cancer of the descending (left side) colon in terms of prognosis, tumor differentiation, and polyp type, as well as at the molecular level. Right-side tumors have elevated Wnt signaling and are more likely to relapse, whereas left-side tumors have reduced expression of tumor suppressor genes. This study seeks to understand both the proteomic and metabolomic changes resulting from treatment of the active metabolite of vitamin D, calcitriol, in right-sided and left-sided colon cancer. Our results show that left-sided colon cancer treated with calcitriol has a substantially greater number of changes in both the proteome and the metabolome than right-sided colon cancer. We found that calcitriol treatment in both right-sided and left-sided colon cancer causes a downregulation of ribosomal protein L37 and protein S100A10. Both of these proteins are heavily involved in tumorigenesis, suggesting a possible mechanism for the correlation between low vitamin D levels and colon cancer.

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<![CDATA[A single-center retrospective study of factors related to the effects of intravenous glucocorticoid therapy in moderate-to-severe and active thyroid-associated ophthalmopathy]]> https://www.researchpad.co/product?articleinfo=5b4b05c7463d7e70c3bdeb01

Background

Intravenous glucocorticoids (ivGC) have been recommended as a first-line treatment of moderate-to-severe and active thyroid-associated ophthalmopathy (TAO). However, not all patients are responsive to ivGC. The identification of potential factors used to predict their efficacy and the selection of suitable patients have both been lacking.

Methods

It was a single center retrospective study. Potential factors related to the effects of ivGC were analyzed using logistic regression in 90 consecutive patients with moderate-to-severe and active TAO, who received 4.5 g ivGC therapy. Response was defined as the achievement of at least three points of the overall response.

Results

Fifty-two (57.8%) patients showed a positive response to ivGC therapy. Significant correlations were observed between the effects of ivGC and pretreatment clinical activity score (CAS), duration of eye symptoms, and restoration of euthyroidism. The two latter factors were both independent. The duration of eye symptoms was negatively correlated with the effects of ivGC, with an odds ratio (OR) of 0.984 (p = 0.012). Restoration of euthyroidism (OR = 3.282, p = 0.039) and pretreatment CAS (OR = 1.653, p < 0.01) were both positively correlated with the effects of ivGC. The diagnostic accuracy of the duration of eye symptoms was ≤13 months (p = 0.000), with a specificity of 76.9%, and sensitivity of 65.8%. The diagnostic accuracy of the pretreatment CAS was more than 2.5 (p = 0.000), with a specificity of 61.5% and sensitivity of 80.5%. Besides, a multi-variables prediction model were established as well, which was better in the forecasting aspect with an area under curve of 0.784 (p = 0.000).

Conclusions

The duration of eye symptoms and restoration of euthyroidism are independent factors that are associated with the effects of ivGC. The following practical implications were inferred: firstly, the shorter the duration of eye symptoms, the more favorable the effects of ivGC therapy. Thus, prompt diagnosis and treatment (within 13 months) is important. Secondly, the restoration of euthyroidism improves the efficacy of ivGC. Thirdly, hope the multi-variables prediction model can be applied to clinical therapy in the future.

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<![CDATA[Role of the T and B lymphocytes in pathogenesis of autoimmune thyroid diseases]]> https://www.researchpad.co/product?articleinfo=5b4ae2a7463d7e6cefa31ed8

Autoimmune thyroid disorders (AITD) broadly include Graves’ disease and Hashimoto’s thyroiditis which are the most common causes of thyroid gland dysfunctions. These disorders develop due to complex interactions between environmental and genetic factors and are characterized by reactivity to self-thyroid antigens due to autoreactive lymphocytes escaping tolerance. Both cell-mediated and humoral responses lead to tissue injury in autoimmune thyroid disease. The differentiation of CD4+ cells in the specific setting of immune mediators (for example cytokines, chemokines) results in differentiation of various T cell subsets. T cell identification has shown a mixed pattern of cytokine production indicating that both subtypes of T helper, Th1 and Th2, responses are involved in all types of AITD. Furthermore, recent studies described T cell subtypes Th17 and Treg which also play an essential role in pathogenesis of AITD. This review will focus on the role of the T regulatory (Treg) and T helper (Th) (especially Th17) lymphocytes, and also of B lymphocytes in AITD pathogenesis. However, we have much more to learn about cellular mechanisms and interactions in AITD before we can develop complete understanding of AITD pathophysiology.

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<![CDATA[Anti-Insulin Antibodies and Adverse Events with Biosimilar Insulin Lispro Compared with Humalog Insulin Lispro in People with Diabetes]]> https://www.researchpad.co/product?articleinfo=5b4a48c6463d7e44fe5eb457

Abstract

Background: SAR342434 (SAR-Lis) is a biosimilar (follow-on) of insulin lispro (Humalog®; Ly-Lis). Two randomized, controlled, open-label, parallel-group, phase 3 studies were conducted to compare the efficacy and safety of SAR-Lis and Ly-Lis, both in combination with insulin glargine (Lantus®). SORELLA 1 was a 12-month study in 507 people with type 1 diabetes mellitus (T1DM); SORELLA 2 was a 6-month study in 505 people with type 2 diabetes mellitus (T2DM). In this study, the impact of anti-insulin antibodies (AIA) to SAR-Lis and Ly-Lis on safety and glycemic control is reported.

Methods: AIA were measured regularly throughout both studies at a centralized laboratory blinded to treatment groups using a drug-specific AIA assay. The AIA status (positive or negative), AIA titers, and cross-reactivity to human insulin, insulin glargine, and insulin glargine metabolite M1 were analyzed. The potential effect of AIA on safety, particularly as related to hypersensitivity reactions, hypoglycemia, and treatment-emergent adverse events, as well as on glycemic control (HbA1c, insulin dose), was evaluated.

Results: AIA positive status at baseline was similar for the two insulins, but higher in T1DM than in T2DM. In both studies, the percentage of people newly developing AIA in the two treatment groups, or having a ≥4-fold increase in AIA titers, did not differ. No relationship was observed between maximum individual AIA titers and change in HbA1c or insulin dose, hypoglycemia, or hypersensitivity reactions or between efficacy/safety measures and subgroups by presence or absence of treatment-emergent AIA. Hypersensitivity events and events adjudicated as allergic reactions were few and did not differ between the two groups.

Conclusion: Insulin lispro SAR342434 and the originator insulin lispro had a similar immunogenicity profile in people with T1DM or T2DM.

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<![CDATA[Positive association between musclin and insulin resistance in obesity: evidence of a human study and an animal experiment]]> https://www.researchpad.co/product?articleinfo=5b40ab52463d7e5ac5b6a8d8

Background

Musclin is a novel skeletal muscle-derived secretory factor considered to be a potent regulator of the glucose metabolism and therefore may contribute to the pathogenesis of obesity and insulin resistance (IR).

Methods

To test this hypothesis, we examined the plasma musclin levels in overweight/obese subjects and lean controls. Rats on a high fat diet (HFD) were used as the annimal model of obesity. Radioimmunoassay and western blot were used to determine musclin levels in plasma and skeletal muscle.

Results

According to radioimmunoassays,the overweight/obese subjects exhibited elevated musclin plasma levels compared with the lean controls (89.49 ± 19.00 ng/L vs 80.39 ± 16.35 ng/L, P < 0.01). The musclin levels were positively correlated with triglyceride, fasting plasma glucose, and homeostasis model assessment of IR levels. These observations were confirmed with a high-fat diet(HFD) rat model. HFD rats also exhibited increased musclin immunoreactivity in plasma (P < 0.01) and in skeletal muscle (P < 0.05), as well as increased musclin mRNA levels in skeletal muscle (P < 0.01). Musclin incubation significantly inhibited muscles 3H-2-DG uptake in the normal diet(ND) group (P < 0.01). The protein expression of glucose transporter type 4 was significantly down regulated by 30% (P < 0.05) in the ND group after soleusmuscle was incubated with musclin compared with the control. Musclin incubation also increased the protein levels of glucose-regulated protein (GRP)78 and GRP94 by 146.8 and 54% (both P < 0.05), respectively, in ND rats.

Conclusions

Our data support the hypothesis that musclin has a strong relationship with obesity-associated IR by impairing the glucose metabolism and, at least in part, through causing endoplasmic reticulum stress.

Electronic supplementary material

The online version of this article (doi:10.1186/s12986-017-0199-x) contains supplementary material, which is available to authorized users.

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<![CDATA[The Hypoglycemic Phenotype Is Islet Cell–Autonomous in Short-Chain Hydroxyacyl-CoA Dehydrogenase–Deficient Mice]]> https://www.researchpad.co/product?articleinfo=5be4891ad5eed0c484b9a873 <![CDATA[Increased risk of metabolic disorders in healthy young adults with family history of diabetes: from the Korea National Health and Nutrition Survey]]> https://www.researchpad.co/product?articleinfo=5989db58ab0ee8fa60bde713

Background

We assessed the impact of a family history of diabetes on type 2 diabetes, metabolic syndrome, and behavioral traits in young Korean adults.

Methods

Subjects aged 25–44 years were included, and the presence of a family history of diabetes was obtained by a self-reported questionnaire (the Korea National Health and Nutrition Survey 2010). We compared the prevalence of type 2 diabetes and metabolic syndrome, and other metabolic parameters, including blood pressure and lipid profile.

Results

Of 2059 participants, those with a family history of diabetes involving first-degree relatives (n = 489, 23.7%) had a significantly higher prevalence of impaired fasting glucose (14.3 vs. 11.7%) and type 2 diabetes (6.7 vs. 1.8%), compared to those without a family history (P < 0.001). The prevalence of metabolic syndrome (21.3 vs. 12.1%, P < 0.001) and its components (except for high-density lipoprotein cholesterol) were greater in subjects with a family history of diabetes. Among subjects exhibiting normal glucose tolerance (n = 1704), those with a family history of diabetes had higher fasting glucose (89.0 vs. 87.8 mg/dL, P < 0.001) and triglyceride (100.5 vs. 89.0 mg/dL, P < 0.001), and lower beta cell function by the homeostasis model assessment (HOMA-β; 134.2 vs. 137.5, P = 0.020). The obesity indices (body mass index, waist circumference, and triglyceride) were significantly correlated with those of both parents (P < 0.01 for all variables). Risk-reducing behavior, including regular exercise (18.2 vs. 19.7%, P = 0.469) and calorie intake (2174.8 vs. 2149.1 kcal/day, P = 0.636), did not markedly differ according to a family history of diabetes.

Conclusions

Young adults with a family history of diabetes had an increased risk of type 2 diabetes and metabolic syndrome, even though they currently exhibited a normal glycemic profile. Proactive lifestyle consultation is requested especially among healthy young population with a family history of diabetes.

Electronic supplementary material

The online version of this article (doi:10.1186/s13098-017-0210-8) contains supplementary material, which is available to authorized users.

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<![CDATA[Effects of Self-Efficacy and Locus of Control on Future Preconception Counseling Plans of Adult Women With Type 1 Diabetes]]> https://www.researchpad.co/product?articleinfo=5bd6fadfd5eed0c48475810d

Objective. The American Diabetes Association (ADA) recommends that women with diabetes attend preconception counseling and improve blood glucose levels before pregnancy to decrease risks of adverse outcomes. However, two-thirds of women with diabetes do not plan their pregnancies. Research has examined views regarding preconception counseling of pregnant women with diabetes, but perceptions of women with diabetes who have never been pregnant have not been explored. The purpose of this study was to examine the relationship between women’s locus of control, self-efficacy, and outcome expectations of preconception counseling.

Design and Methods. A sample of 147 nulligravid women with type 1 diabetes (mean age 25.9 years) was recruited online to complete a self-report survey. Measures included a sociodemographics form, a study-specific questionnaire regarding diabetes management and education, the Reproductive Health Attitudes and Behaviors instrument, and the Diabetes-Specific Locus of Control measure.

Results. A standard multiple linear regression analysis indicated that self-efficacy was positively associated with expectations of preconception counseling (P <0.001), whereas self-blame was negatively associated (P = 0.001). Three-fourths of the women reported not receiving preconception counseling from health care providers.

Conclusion. Self-efficacy was positively associated with women’s expectation of preconception counseling usefulness, whereas self-blame for poor disease management was inversely related. The low reported rates of preconception counseling demonstrate that ADA recommendations for starting preconception counseling at puberty have not been followed uniformly. Women with diabetes should be provided education to increase their belief that they have control over their disease, which may lead to positive perceptions of preconception counseling and healthier pregnancies.

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<![CDATA[Overview of Ocular Anti-Vascular Endothelial Growth Factor Therapy in the Management of Diabetic Eye Complications]]> https://www.researchpad.co/product?articleinfo=5bd6faddd5eed0c4847580b8 ]]> <![CDATA[Analysis of SLC16A11 Variants in 12,811 American Indians: Genotype-Obesity Interaction for Type 2 Diabetes and an Association With RNASEK Expression]]> https://www.researchpad.co/product?articleinfo=5bd6fa2ad5eed0c484754925

Genetic variants in SLC16A11 were recently reported to be associated with type 2 diabetes in Mexican and other Latin American populations. The diabetes risk haplotype had a frequency of 50% in Native Americans from Mexico but was rare in Europeans and Africans. In the current study, we analyzed SLC16A11 in 12,811 North American Indians and found that the diabetes risk haplotype, tagged by the rs75493593 A allele, was nominally associated with type 2 diabetes (P = 0.001, odds ratio 1.11). However, there was a strong interaction with BMI (P = 5.1 × 10−7) such that the diabetes association was stronger in leaner individuals. rs75493593 was also strongly associated with BMI in individuals with type 2 diabetes (P = 3.4 × 10−15) but not in individuals without diabetes (P = 0.77). Longitudinal analyses suggest that this is due, in part, to an association of the A allele with greater weight loss following diabetes onset (P = 0.02). Analyses of global gene expression data from adipose tissue, skeletal muscle, and whole blood provide evidence that rs75493593 is associated with expression of the nearby RNASEK gene, suggesting that RNASEK expression may mediate the effect of genotype on diabetes.

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<![CDATA[A Nursing Approach to Self-Management Education for Individuals With Mental Illness and Diabetes]]> https://www.researchpad.co/product?articleinfo=5bd6fae4d5eed0c4847582bc

Patients with serious mental illness (SMI) and diabetes often seek care in primary care settings and have worse health outcomes than patients who have either illness alone. Individual, provider, and system-level barriers present challenges to addressing both psychiatric and medical comorbidities. This article describes the feasibility, acceptability, and implementation of Targeted Training and Illness Management (TTIM), a self-management intervention delivered by trained nurse educators and peer educators to groups of individuals with SMI and diabetes to improve self-management of both diseases. TTIM is intended to be delivered in a primary care setting. Findings are intended to support the future development of nurse-led programs within the primary care setting that teach self-management to individuals with concurrent SMI and diabetes. This approach supports both adaptability and flexibility in delivering the intervention. Interventions such as TTIM can provide self-management skills, accommodate people with both SMI and diabetes in primary care settings such as patient-centered medical homes, and address known barriers to access.

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<![CDATA[Making a Meaningful Difference: Learning From People, Practice, and Research]]> https://www.researchpad.co/product?articleinfo=5bd6fae8d5eed0c484758445

EDITOR’S NOTE: This article is adapted from the address Ms. Delahanty delivered as the recipient of the American Diabetes Association’s (ADA) Outstanding Educator in Diabetes Award for 2015. She delivered the address in June 2015 at the Association’s 75th Scientific Sessions in Boston, Mass. A webcast of this speech is available for viewing at the ADA website (http://professional.diabetes.org/webcasts).

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<![CDATA[Conversation Maps and Diabetes Education Groups: An Evaluation at an Australian Rural Health Service]]> https://www.researchpad.co/product?articleinfo=5bd6faf0d5eed0c4847586c7

Objective. The rural Central Gippsland Health Service (CGHS) assists patients with diabetes through the provision of diabetes education. The purpose of this study was to compare and evaluate the CGHS 5-week didactic program and a modified group-participatory Conversation Maps diabetes education program.

Method. A pre- and post-program survey was conducted of clients who attended the two different diabetes education programs. The survey consisted of a self-constructed demographic questionnaire, the Diabetes Knowledge Test, the Diabetes Empowerment Scale, and the Diabetes Self-Care Activities Measure.

Results. For the CGHS program, there were no differences between pre- and post-program surveys in knowledge scores (11.05 ± 3.56 vs. 12.75 ± 4.19, P = 0.0883, n = 20), self-care activities (4.46 ± 1.11 vs. 4.83 ± 0.68, P = 0.0832, n = 12), or empowerment scores (7.16 ± 1.60 vs. 7.92 ± 1.26, P = 0.0540, n = 17).

For the modified Conversation Maps program, there were significant improvements between pre- and post-program surveys in knowledge scores (12.42 ± 4.15 vs. 15.54 ± 3.79, P = 0.0004, n = 26), self-care activities (4.74 ± 1.09 vs. 5.32 ± 0.80, P = 0.0139, n = 24), and empowerment scores (6.56 ± 2.19 vs. 8.11 ± 1.46, P = 0.0016, n = 21).

The greatest difference between the two programs was observed in knowledge gain (P = 0.0178). Overall, participants were satisfied with both programs, with no difference seen in satisfaction levels (P = 0.9763). A1C results improved in both programs to a mean of 6.7% (P = 0.0071 for CGHS and P = 0.0092 for Conversation Maps).

Conclusion. The modified Conversation Maps program resulted in significant improvements for rural participants.

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<![CDATA[Effect of Sleep Disturbances on Quality of Life, Diabetes Self-Care Behavior, and Patient-Reported Outcomes]]> https://www.researchpad.co/product?articleinfo=5bd6faf1d5eed0c48475871b

IN BRIEF Poor sleep quality and sleep disorders, particularly insomnia, obstructive sleep apnea, and restless legs syndrome, are prevalent among people with type 2 diabetes. Evidence suggests that coexisting diabetes and sleep disturbances are associated with decreases in quality of life, diabetes self-care behaviors, and patient-reported outcomes. Additional research is required to determine the effect of treatment of sleep disorders on patient-centered outcomes in people with type 2 diabetes.

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