Manipulating the #sequence of food ingestion improves glycemic control in type 2 #diabetic patients under free-living conditions
http://www.nature.com/nutd/journal/v6/n8/full/nutd201633a.html
Manipulating the sequence of nutrient ingestion might reveal a rapid, feasible, economic and safe strategy for optimizing glucose control in T2D.
http://www.nature.com/nutd/journal/v6/n8/full/nutd201633a.html
Manipulating the sequence of nutrient ingestion might reveal a rapid, feasible, economic and safe strategy for optimizing glucose control in T2D.
Clinical practice guidelines
#Diabetic #Retinopathy PPP - Updated 2016
https://www.aao.org/preferred-practice-pattern/diabetic-retinopathy-ppp-updated-2016
Preferred Practice Pattern® guidelines should be clinically relevant and specific enough to provide useful information to practitioners. Where evidence exists to support a recommendation for care, the recommendation should be given an explicit rating that shows the strength of evidence.
#Diabetic #Retinopathy PPP - Updated 2016
https://www.aao.org/preferred-practice-pattern/diabetic-retinopathy-ppp-updated-2016
Preferred Practice Pattern® guidelines should be clinically relevant and specific enough to provide useful information to practitioners. Where evidence exists to support a recommendation for care, the recommendation should be given an explicit rating that shows the strength of evidence.
#Diabetic #Retinopathy: A Position Statement by the American Diabetes Association
http://care.diabetesjournals.org/content/40/3/412
Optimize glycemic control to reduce the risk or slow the progression of diabetic retinopathy. A
Optimize blood pressure and serum lipid control to reduce the risk or slow the progression of diabetic retinopathy. A
Promptly refer patients with any level of macular edema, severe nonproliferative diabetic retinopathy (a precursor of proliferative diabetic retinopathy), or any proliferative diabetic retinopathy to an ophthalmologist who is knowledgeable and experienced in the management and treatment of diabetic retinopathy. A
Laser photocoagulation therapy reduces the risk of vision loss in patients with high-risk proliferative diabetic retinopathy and, in some cases, severe nonproliferative diabetic retinopathy. A
Intravitreous injections of anti–vascular endothelial growth factor are indicated for central-involved diabetic macular edema, which occurs beneath the foveal center and may threaten reading vision. A
The presence of retinopathy is not a contraindication to aspirin therapy for cardioprotection, as aspirin does not increase the risk of retinal hemorrhage. A
http://care.diabetesjournals.org/content/40/3/412
Optimize glycemic control to reduce the risk or slow the progression of diabetic retinopathy. A
Optimize blood pressure and serum lipid control to reduce the risk or slow the progression of diabetic retinopathy. A
Promptly refer patients with any level of macular edema, severe nonproliferative diabetic retinopathy (a precursor of proliferative diabetic retinopathy), or any proliferative diabetic retinopathy to an ophthalmologist who is knowledgeable and experienced in the management and treatment of diabetic retinopathy. A
Laser photocoagulation therapy reduces the risk of vision loss in patients with high-risk proliferative diabetic retinopathy and, in some cases, severe nonproliferative diabetic retinopathy. A
Intravitreous injections of anti–vascular endothelial growth factor are indicated for central-involved diabetic macular edema, which occurs beneath the foveal center and may threaten reading vision. A
The presence of retinopathy is not a contraindication to aspirin therapy for cardioprotection, as aspirin does not increase the risk of retinal hemorrhage. A
Diabetes Care
Diabetic Retinopathy: A Position Statement by the American Diabetes Association
Diabetic retinopathy diagnostic assessment and treatment options have improved dramatically since the 2002 American Diabetes Association Position Statement (1). These improvements include the widespread adoption of optical coherence tomography to assess retinal…
Anti-#diabetic action of all-trans #retinoic acid and the orphan G protein coupled receptor GPRC5C in pancreatic β-cells
https://www.jstage.jst.go.jp/article/endocrj/64/3/64EJ16-0338/article
Pancreatic islets express high levels of the orphan G-protein coupled receptor C5C (GPRC5C), the function of which remains to be established. Here we have examined the role of GPRC5C in the regulation of insulin secretion and β-cell survival and proliferation using human and mouse pancreatic islets RNA sequencing in human islets revealed GPRC5C expression correlated with the expression of genes controlling apoptosis, cell survival and proliferation. A reduction in Gprc5c mRNA and protein expression was observed in islets isolated from old mice (>46 weeks of age) compared to that in islets from newborn (<3 weeks) mice Potentiation of glucose-stimulated insulin secretion concomitant with enhanced islet cAMP level by all-trans retinoic acid (ATRA) was attenuated upon Gprc5c-KD.
Our results demonstrate that agents activating GPRC5C represent a novel modality for the treatment and/or prevention of diabetes by restoring and/or maintaining functional β-cell mass.
https://www.jstage.jst.go.jp/article/endocrj/64/3/64EJ16-0338/article
Pancreatic islets express high levels of the orphan G-protein coupled receptor C5C (GPRC5C), the function of which remains to be established. Here we have examined the role of GPRC5C in the regulation of insulin secretion and β-cell survival and proliferation using human and mouse pancreatic islets RNA sequencing in human islets revealed GPRC5C expression correlated with the expression of genes controlling apoptosis, cell survival and proliferation. A reduction in Gprc5c mRNA and protein expression was observed in islets isolated from old mice (>46 weeks of age) compared to that in islets from newborn (<3 weeks) mice Potentiation of glucose-stimulated insulin secretion concomitant with enhanced islet cAMP level by all-trans retinoic acid (ATRA) was attenuated upon Gprc5c-KD.
Our results demonstrate that agents activating GPRC5C represent a novel modality for the treatment and/or prevention of diabetes by restoring and/or maintaining functional β-cell mass.
Prognosis of the infected #diabetic foot #ulcer: a 12-month prospective observational study
http://onlinelibrary.wiley.com/doi/10.1111/dme.13537/full
To determine clinical outcomes and explore prognostic factors related to ulcer healing in people with a clinically infected diabetic foot ulcer
In the first year after culture of the index ulcer, 45/299 participants (15.1%) had died. The ulcer had healed in 136 participants (45.5%), but recurred in 13 (9.6%). An ipsilateral lower extremity amputation was recorded in 52 (17.4%) and revascularization surgery in 18 participants (6.0%). Participants with an ulcer present for ~2 months or more had a lower incidence of healing (hazard ratio 0.55, 95% CI 0.39 to 0.77), as did those with a PEDIS (perfusion, extent, depth, infection, sensation) perfusion grade of ≥2 (hazard ratio 0.37, 95% CI 0.25 to 0.55). Participants with a single ulcer on their index foot had a higher incidence of healing than those with multiple ulcers (hazard ratio 1.90, 95% CI 1.18 to 3.06).
Conclusions
Clinical outcomes at 12 months for people with an infected diabetic foot ulcer are generally poor. Our data confirm the adverse prognostic effect of limb ischaemia, longer ulcer duration and the presence of multiple ulcers
http://onlinelibrary.wiley.com/doi/10.1111/dme.13537/full
To determine clinical outcomes and explore prognostic factors related to ulcer healing in people with a clinically infected diabetic foot ulcer
In the first year after culture of the index ulcer, 45/299 participants (15.1%) had died. The ulcer had healed in 136 participants (45.5%), but recurred in 13 (9.6%). An ipsilateral lower extremity amputation was recorded in 52 (17.4%) and revascularization surgery in 18 participants (6.0%). Participants with an ulcer present for ~2 months or more had a lower incidence of healing (hazard ratio 0.55, 95% CI 0.39 to 0.77), as did those with a PEDIS (perfusion, extent, depth, infection, sensation) perfusion grade of ≥2 (hazard ratio 0.37, 95% CI 0.25 to 0.55). Participants with a single ulcer on their index foot had a higher incidence of healing than those with multiple ulcers (hazard ratio 1.90, 95% CI 1.18 to 3.06).
Conclusions
Clinical outcomes at 12 months for people with an infected diabetic foot ulcer are generally poor. Our data confirm the adverse prognostic effect of limb ischaemia, longer ulcer duration and the presence of multiple ulcers
Wiley
Prognosis of the infected diabetic foot ulcer: a 12‐month prospective observational study
To determine clinical outcomes and explore prognostic factors related to ulcer healing in people with a clinically infected diabetic foot ulcer.This multicentre, prospective, observational study reviewed...
!!
#diabetic patients are more at risk of death from alcohol, accidents and #suicide
https://www.eurekalert.org/pub_releases/2018-10/esoe-dpa100918.php
Diabetic patients are more likely to die from alcohol-related factors, accidents or suicide, according to a study published in the European Journal of Endocrinology. The study findings suggest that the increased risk of death from these causes may be related to the mental health of patients, which may be adversely affected by the psychological burden of living with and self-treating this debilitating disease, with potentially serious complications.
Type-1 and type-2 diabetes are highly prevalent global diseases, causing millions of deaths every year. It is well known that diabetic patients have a higher risk of developing cardiovascular disease, cancer and kidney disorders, which can lead to earlier death. However, more recently diabetes has been linked to an increased risk of depression but how poor mental health may affect patients with diabetes has not been fully investigated.
Prof Leo Niskanen states, "This study has highlighted that there is a need for effective psychological support for people with diabetes. If they feel like they are under a heavy mental burden or consider that their use of alcohol is excessive, they should not hesitate to discuss these issues with their primary care physician. There are many ways that these problems can be managed, provided they are communicated."
#diabetic patients are more at risk of death from alcohol, accidents and #suicide
https://www.eurekalert.org/pub_releases/2018-10/esoe-dpa100918.php
Diabetic patients are more likely to die from alcohol-related factors, accidents or suicide, according to a study published in the European Journal of Endocrinology. The study findings suggest that the increased risk of death from these causes may be related to the mental health of patients, which may be adversely affected by the psychological burden of living with and self-treating this debilitating disease, with potentially serious complications.
Type-1 and type-2 diabetes are highly prevalent global diseases, causing millions of deaths every year. It is well known that diabetic patients have a higher risk of developing cardiovascular disease, cancer and kidney disorders, which can lead to earlier death. However, more recently diabetes has been linked to an increased risk of depression but how poor mental health may affect patients with diabetes has not been fully investigated.
Prof Leo Niskanen states, "This study has highlighted that there is a need for effective psychological support for people with diabetes. If they feel like they are under a heavy mental burden or consider that their use of alcohol is excessive, they should not hesitate to discuss these issues with their primary care physician. There are many ways that these problems can be managed, provided they are communicated."
EurekAlert!
Diabetic patients are more at risk of death from alcohol, accidents and suicide
Diabetic patients are more likely to die from alcohol-related factors, accidents or suicide, according to a study published in the European Journal of Endocrinology. The study findings suggest that the increased risk of death from these causes may be related…
!!
A high serum #cortisol/DHEA-S ratio is a risk factor for #sarcopenia in elderly #diabetic patients
https://academic.oup.com/jes/advance-article/doi/10.1210/js.2018-00271/5368377
Elderly patients with type 2 diabetes mellitus (T2DM) have a high prevalence of frailty and/or sarcopenia. Sarcopenia is thought to be related to discordant secretions of the adrenal hormones cortisol and dehydroepiandrosterone, and the sulfate ester of dehydroepiandrosterone (DHEA-S). The present study aimed to evaluate the risk factors for sarcopenia in elderly patients with T2DM.
Multiple regression analysis showed that the independent risk factors for sarcopenia were a serum cortisol/DHEA-S ratio ≥0.2, diastolic blood pressure <70 mmHg, hemoglobin concentration <13 g/dL, and an ankle brachial index <1.0. The strongest risk factor for sarcopenia was a serum cortisol/DHEA-S ratio ≥0.2. An increase in the serum cortisol/DHEA-S ratio reflected higher cortisol values and lower DHEA-S values in patients with sarcopenia compared with those in non-sarcopenic patients. The concentrations of cortisol and DHEA-S, and the cortisol/DHEA-S ratio changed in accordance with the severity of sarcopenia.
Conclusions
A relative increase in cortisol may reflect the presence of stress and stimulate muscle catabolism, while a relative decrease in DHEA-S may cause a decrease in the anabolic action of DHEA on muscle; the combination of these factors may lead to sarcopenia
A high serum #cortisol/DHEA-S ratio is a risk factor for #sarcopenia in elderly #diabetic patients
https://academic.oup.com/jes/advance-article/doi/10.1210/js.2018-00271/5368377
Elderly patients with type 2 diabetes mellitus (T2DM) have a high prevalence of frailty and/or sarcopenia. Sarcopenia is thought to be related to discordant secretions of the adrenal hormones cortisol and dehydroepiandrosterone, and the sulfate ester of dehydroepiandrosterone (DHEA-S). The present study aimed to evaluate the risk factors for sarcopenia in elderly patients with T2DM.
Multiple regression analysis showed that the independent risk factors for sarcopenia were a serum cortisol/DHEA-S ratio ≥0.2, diastolic blood pressure <70 mmHg, hemoglobin concentration <13 g/dL, and an ankle brachial index <1.0. The strongest risk factor for sarcopenia was a serum cortisol/DHEA-S ratio ≥0.2. An increase in the serum cortisol/DHEA-S ratio reflected higher cortisol values and lower DHEA-S values in patients with sarcopenia compared with those in non-sarcopenic patients. The concentrations of cortisol and DHEA-S, and the cortisol/DHEA-S ratio changed in accordance with the severity of sarcopenia.
Conclusions
A relative increase in cortisol may reflect the presence of stress and stimulate muscle catabolism, while a relative decrease in DHEA-S may cause a decrease in the anabolic action of DHEA on muscle; the combination of these factors may lead to sarcopenia
OUP Academic
high serum cortisol/DHEA-S ratio is a risk factor for sarcopenia in elderly diabetic patients
AbstractIntroduction. Elderly patients with type 2 diabetes mellitus (T2DM) have a high prevalence of frailty and/or sarcopenia. Sarcopenia is thought to be re
Associations between abdominal #obesity indices and #diabetic complications: Chinese visceral #adiposity index and neck circumference
https://2medical.news/2020/08/09/associations-between-abdominal-obesity-indices-and-diabetic-complications-chinese-visceral-adiposity-index-and-neck-circumference/
Obesity, especially abdominal obesity, has been considered a risk factor for diabetic complications. Many abdominal obesity indices have been established, including neck circumference (NC), waist-to-hip ratio (WHR), lipid accumulation product (LAP), visceral adiposity index (VAI) and the Chinese visceral adiposity index (CVAI). However, studies investigating the associations between these indices and diabetic complications are limited. The objective of this study was to investigate the associations …
https://2medical.news/2020/08/09/associations-between-abdominal-obesity-indices-and-diabetic-complications-chinese-visceral-adiposity-index-and-neck-circumference/
Obesity, especially abdominal obesity, has been considered a risk factor for diabetic complications. Many abdominal obesity indices have been established, including neck circumference (NC), waist-to-hip ratio (WHR), lipid accumulation product (LAP), visceral adiposity index (VAI) and the Chinese visceral adiposity index (CVAI). However, studies investigating the associations between these indices and diabetic complications are limited. The objective of this study was to investigate the associations …
Five-Year Patterns of #Diabetic #Retinopathy Progression in US Clinical Practice
https://2medical.news/2020/11/04/five-year-patterns-of-diabetic-retinopathy-progression-in-us-clinical-practice/
To characterize the natural course of diabetic retinopathy (DR) in contemporary clinical practice. Patients and Methods: This was a retrospective analysis of US claims data collected between January 1, 2006, and April 30, 2017. Patients aged ≥ 18 years with continuous medical and prescription insurance coverage for 18 months before DR diagnosis (index date) and for a follow-up period of 5 years were included (N=14,490). …
https://2medical.news/2020/11/04/five-year-patterns-of-diabetic-retinopathy-progression-in-us-clinical-practice/
To characterize the natural course of diabetic retinopathy (DR) in contemporary clinical practice. Patients and Methods: This was a retrospective analysis of US claims data collected between January 1, 2006, and April 30, 2017. Patients aged ≥ 18 years with continuous medical and prescription insurance coverage for 18 months before DR diagnosis (index date) and for a follow-up period of 5 years were included (N=14,490). …
Association of #Gastric Bypass Surgery With Risk of Developing #Diabetic #Retinopathy Among Patients With #Obesity and Type 2 Diabetes in Sweden
https://2medical.news/2021/02/21/association-of-gastric-bypass-surgery-with-risk-of-developing-diabetic-retinopathy-among-patients-with-obesity-and-type-2-diabetes-in-sweden/
Knowledge of the incidence and progression of diabetic retinopathy (DR) after gastric bypass surgery (GBP) in patients with obesity and diabetes could guide the management of these patients. Objective To investigate the incidence of diabetic ocular complications in patients with type 2 diabetes after GBP compared with the incidence of diabetic ocular complications in a matched cohort of patients with obesity and diabetes who have …
https://2medical.news/2021/02/21/association-of-gastric-bypass-surgery-with-risk-of-developing-diabetic-retinopathy-among-patients-with-obesity-and-type-2-diabetes-in-sweden/
Knowledge of the incidence and progression of diabetic retinopathy (DR) after gastric bypass surgery (GBP) in patients with obesity and diabetes could guide the management of these patients. Objective To investigate the incidence of diabetic ocular complications in patients with type 2 diabetes after GBP compared with the incidence of diabetic ocular complications in a matched cohort of patients with obesity and diabetes who have …
#Glucagon blockade restores functional β-cell mass in type 1 #diabetic mice and enhances function of human islets
https://2medical.news/2021/03/05/glucagon-blockade-restores-functional-%CE%B2-cell-mass-in-type-1-diabetic-mice-and-enhances-function-of-human-islets/
Both type 1 and type 2 diabetes are associated with reduced β-cell mass or function, resulting from decreased proliferation and increased apoptosis. Understanding the signals governing β-cell survival and regeneration is critical for developing strategies to maintain healthy populations of these cells in individuals. Both forms of diabetes are associated with hyperglucagonemia and an increased plasma glucagon:insulin ratio. Glucagon excess contributes to metabolic dysregulation of …
https://2medical.news/2021/03/05/glucagon-blockade-restores-functional-%CE%B2-cell-mass-in-type-1-diabetic-mice-and-enhances-function-of-human-islets/
Both type 1 and type 2 diabetes are associated with reduced β-cell mass or function, resulting from decreased proliferation and increased apoptosis. Understanding the signals governing β-cell survival and regeneration is critical for developing strategies to maintain healthy populations of these cells in individuals. Both forms of diabetes are associated with hyperglucagonemia and an increased plasma glucagon:insulin ratio. Glucagon excess contributes to metabolic dysregulation of …
Meta-Analysis of the Relationship between Abdominal #Obesity and Diabetic #Kidney Disease in Type 2 #Diabetic Patients
https://2medical.news/2021/06/28/meta-analysis-of-the-relationship-between-abdominal-obesity-and-diabetic-kidney-disease-in-type-2-diabetic-patients/
https://2medical.news/2021/06/28/meta-analysis-of-the-relationship-between-abdominal-obesity-and-diabetic-kidney-disease-in-type-2-diabetic-patients/
2Medical.News
Meta-Analysis of the Relationship between Abdominal #Obesity and Diabetic #Kidney Disease in Type 2 #Diabetic Patients
The meta-analysis aimed to investigate the association of visceral fat area (VFA), waist circumference (WC), waist-hip ratio (WHR) and waist-height ratio (WHtR) with diabetic kidney disease (DKD) i…
#Time-restricted feeding protects the blood #pressure circadian rhythm in #diabetic mice
https://2medical.news/2021/07/10/time-restricted-feeding-protects-the-blood-pressure-circadian-rhythm-in-diabetic-mice/
https://2medical.news/2021/07/10/time-restricted-feeding-protects-the-blood-pressure-circadian-rhythm-in-diabetic-mice/
2Medical.News
#Time-restricted feeding protects the blood #pressure circadian rhythm in #diabetic mice
The quantity and quality of food intake have been considered crucial for peoples’ wellness. Only recently has it become appreciated that the timing of food intake is also critical. Nondipping…
#Coronavirus induces #diabetic macrophage-mediated inflammation via SETDB2
https://2medical.news/2021/09/12/coronavirus-induces-diabetic-macrophage-mediated-inflammation-via-setdb2/
https://2medical.news/2021/09/12/coronavirus-induces-diabetic-macrophage-mediated-inflammation-via-setdb2/
2Medical.News
#Coronavirus induces #diabetic macrophage-mediated inflammation via SETDB2
COVID-19 induces a robust, extended inflammatory “cytokine storm” that contributes to an increased morbidity and mortality, particularly in patients with type 2 diabetes (T2D). Macrophages are a ke…
#Aging and comorbidities influence the risk of hospitalization and mortality in #diabetic patients experiencing severe hypoglycemia
https://2medical.news/2021/09/29/aging-and-comorbidities-influence-the-risk-of-hospitalization-and-mortality-in-diabetic-patients-experiencing-severe-hypoglycemia/
https://2medical.news/2021/09/29/aging-and-comorbidities-influence-the-risk-of-hospitalization-and-mortality-in-diabetic-patients-experiencing-severe-hypoglycemia/
2Medical.News
#Aging and comorbidities influence the risk of hospitalization and mortality in #diabetic patients experiencing severe hypoglycemia
Severe hypoglycemia requiring access to the Emergency Department is more frequent in older patients with multiple comorbidities.•Risk of hospitalization and mortality within one year since the hypo…