Preventing Type 2 Diabetes with Home Cooking: Current Evidence and Future Potential

Background: Prediabetes is defined as a state of glucose metabolism between normal glucose tolerance and type 2 diabetes. Continuous β-cell failure and death are the reasons for the evolution from normal glucose tolerance to prediabetes and finally type 2 diabetes. Introduction: The necessity of new therapeutic approaches in order to prevent or delay the development of type 2 diabetes is obligatory. Liraglutide, a long-acting GLP-1 receptor agonist, has 97% homology for native GLP-1. Identification of the trophic and antiapoptotic properties of liraglutide in preclinical studies, together with evidence of sustained β-cell function longevity during its administration in type 2 diabetes individuals, indicated its earliest possible administration during this disease, or even before its development, so as to postpone or delay its onset. Methods: Pubmed and Google databases have been thoroughly searched and relevant studies were selected. Results: This paper explores the current evidence of liraglutide administration both in humans and animal models with prediabetes. Also, it investigates the safety profile of liraglutide treatment and its future role to postpone or delay the evolution of type 2 diabetes. Conclusion: Liralgutide remains a valuable tool in our therapeutic armamentarium for individuals who are overweight or obese and have prediabetes. Future well designed studies will give valuable information that will help clinicians to stratify individuals who will derive the most benefit from this agent, achieving targeted therapeutic strategies.

Download Full-text

Efficacy and Cardiovascular Safety of Meglitinides

Current Drug Safety ◽

10.2174/1574886315666201026125848 ◽

2020 ◽

Vol 15 ◽

Author(s):

Jim Philip ◽

Cornelius James Fernandez

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Cardiovascular Outcomes ◽

Individual Therapy ◽

Hypoglycemic Agents ◽

Current Evidence ◽

Minimal Risk ◽

Cardiovascular Safety

: Meglitinides are a group of oral hypoglycemic medications currently approved for the treatment of type 2 diabetes mellitus (T2DM). Two meglitinide molecules, Repaglinide and Nateglinide,are presently in use. Repaglinide is preferred because of its superior glycemic efficacy.They have modest efficacy with a mean decrement of glycosylated haemoglobin (HbA1c) ranging between -0.2 to -1.50% with individual therapy. Additional HbA1c reduction can occur with combination therapy with other oral hypoglycemics. This class of drugs is effective in controlling postprandial hyperglycemia with minimal risk of hypoglycemia.It is also useful in patients in with variable meal timings, especially in the elderly, and in patients with renal failure. There are is a dearth of long-term studies on meglitinides to assess cardiovascular outcomes or mortality in T2DM,although the Nateglinide and Valsartan in Impaired Glucose ToleranceOutcomes Research (NAVIGATOR) study showed no difference between Nateglinide and placebo with regard to the core composite cardiovascular outcomes. Based on a PubMed literature search using key words: ‘meglitinides’, ‘repaglinide’, ‘nateglinide’, ‘HbA1c’, ‘glycated haemoglobin’, ‘cardiovascular safety’, ‘cardiovascular events’, ‘cardiovascular outcome trials’, ‘type 2 diabetes mellitus’ and heart failure, and combining the search terms using Boolean operators ‘AND’, ‘OR’ and ‘NOT’ as needed we compiled current evidence for use of these oral hypoglycemic agents in clinical use. This article is an attempt to review the efficacy and cardiovascular (CV) safety of Meglitinides to help clinicians to use this class of oral hypoglycaemic agents prudently.

Download Full-text

Intermittent fasting: is there a role in the treatment of diabetes? A review of the literature and guide for primary care physicians

Clinical Diabetes and Endocrinology ◽

10.1186/s40842-020-00116-1 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Michael Albosta ◽

Jesse Bakke

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Treatment Option ◽

Primary Care Physicians ◽

Case Series ◽

Current Evidence ◽

Intermittent Fasting ◽

Diabetic Patients ◽

Medicinal Treatment

Abstract Background Type 2 Diabetes is a metabolic disorder characterized by hyperglycemia that causes numerous complications with significant long-term morbidity and mortality. The disorder is primarily due to insulin resistance particularly in liver, skeletal muscle, and adipose tissue. In this review, we detail the hormonal mechanisms leading to the development of diabetes and discuss whether intermittent fasting should be considered as an alternative, non-medicinal treatment option for patients with this disorder. Methods We searched PubMed, Ovid MEDLINE, and Google Scholar databases for review articles, clinical trials, and case series related to type 2 diabetes, insulin resistance, and intermittent fasting. Articles were carefully reviewed and included based on relevance to our topic. We excluded abstracts and any non-English articles. Results The majority of the available research demonstrates that intermittent fasting is effective at reducing body weight, decreasing fasting glucose, decreasing fasting insulin, reducing insulin resistance, decreasing levels of leptin, and increasing levels of adiponectin. Some studies found that patients were able to reverse their need for insulin therapy during therapeutic intermittent fasting protocols with supervision by their physician. Conclusion Current evidence suggests that intermittent fasting is an effective non-medicinal treatment option for type 2 diabetes. More research is needed to delineate the effects of intermittent fasting from weight loss. Physicians should consider educating themselves regarding the benefits of intermittent fasting. Diabetic patients should consult their physician prior to beginning an intermittent fasting regimen in order to allow for appropriate oversight and titration of the patients medication regimen during periods of fasting.

Download Full-text

Social networks and type 2 diabetes: a narrative review

Diabetologia ◽

10.1007/s00125-021-05496-2 ◽

2021 ◽

Author(s):

Miranda T. Schram ◽

Willem J. J. Assendelft ◽

Theo G. van Tilburg ◽

Nicole H. T. M. Dukers-Muijrers

Keyword(s):

Social Support ◽

Type 2 Diabetes ◽

Social Networks ◽

Social Network ◽

Narrative Review ◽

Current Evidence ◽

Favourable Effect ◽

Effective Prevention ◽

Network Variable

AbstractIt has been known for decades that social networks are causally related to disease and mortality risk. However, this field of research and its potential for implementation into diabetes care is still in its infancy. In this narrative review, we aim to address the state-of-the-art of social network research in type 2 diabetes prevention and care. Despite the diverse nature and heterogeneity of social network assessments, we can draw valuable lessons from the available studies. First, the structural network variable ‘living alone’ and the functional network variable ‘lack of social support’ have been associated with increased type 2 diabetes risk. The latter association may be modified by lifestyle risk factors, such as obesity, low level of physical activity and unhealthy diet. Second, smaller network size and less social support is associated with increased risk of diabetes complications, particularly chronic kidney disease and CHD. Third, current evidence shows a beneficial impact of social support on diabetes self-management. In addition, social support interventions were found to have a small, favourable effect on HbA1c values in the short-term. However, harmonisation and more detailed assessment of social network measurements are needed to utilise social network characteristics for more effective prevention and disease management in type 2 diabetes. Graphical abstract

Download Full-text

Quinoa’s Potential to Enhance Dietary Management of Obesity and Type-2 Diabetes: A Review of the Current Evidence

Diabetology ◽

10.3390/diabetology2020007 ◽

2021 ◽

Vol 2 (2) ◽

pp. 77-94

Author(s):

Alexander Little ◽

Kevin Murphy ◽

Patrick Solverson

Keyword(s):

Type 2 Diabetes ◽

Best Management Practices ◽

Management Practices ◽

The United States ◽

Lipid Absorption ◽

Current Evidence ◽

Future Research ◽

Dietary Management ◽

Obesity And Diabetes

The prevalence of diet-induced obesity and type-2 diabetes remains a growing concern in the United States. As best management practices still include improved diet and physical activity, bioactive food components, contained within functional foods, show promise in curbing the cardiometabolic complications associated with excess weight and diabetes. Quinoa is an emerging candidate crop for its versatility in wide-ranging growing conditions as one approach to address food security, but it also contains several components that may serve as a dietary tool for post-industrial countries struggling with the health complications of caloric excess. Preliminary rodent feeding studies demonstrate that components within quinoa, namely, phytosteroids, phenolics, polysaccharides, and peptides, can prevent adiposity, dyslipidemia, and hyperglycemia. Mechanistic activity may involve reduced lipid absorption and adipogenesis, increased energy expenditure and glucose oxidation and corrected gut microbiota. Other intestinal actions may include blocked carbohydrate digestion with enhanced incretin signaling. Evidence in clinical trials is lacking and future research spanning cells to the clinic is needed to further elucidate the interesting preliminary reports reviewed here. Quinoa offers several unique attributes that could be harnessed to improve the dietary management of obesity and diabetes.

Download Full-text

Association between Hypertriglyceridemic-Waist Phenotype and Risk of Type 2 Diabetes Mellitus in Middle-Aged and Older Chinese Population: A Longitudinal Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18189618 ◽

2021 ◽

Vol 18 (18) ◽

pp. 9618

Author(s):

Dezhong Chen ◽

Ziyun Liang ◽

Huimin Sun ◽

Ciyong Lu ◽

Weiqing Chen ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Waist Circumference ◽

Cohort Analysis ◽

Current Evidence ◽

Middle Aged ◽

Baseline Information ◽

Older Chinese

Current evidence remains inconsistent with regard to the association between different triglyceridemic-waist phenotypes and the risks for type 2 diabetes mellitus (T2DM). We aimed to investigate this association among a retrospective cohort analysis of 6918 participants aged ≥ 45 years in the China Health and Retirement Longitudinal Study (CHARLS). Participants were categorized into four triglyceridemic-waist phenotypes consisting of NWNT (normal waist circumference and normal triglycerides), NWHT (normal waist circumference and high triglycerides), EWNT (enlarged waist circumference and normal triglycerides), and EWHT (enlarged waist circumference and high triglycerides) based on participants’ baseline information. Multivariate log-binomial regression was used to assess the T2DM risk in different phenotypes. Subgroup analysis was conducted to test the robustness of the findings. After 4-years of follow-up, participants with EWHT (Relative Risk [RR]: 1.909, 95% Confidence Interval [CI]: 1.499 to 2.447) or EWNT (RR: 1.580, 95%CI: 1.265 to 1.972) phenotypes had significantly higher likelihood of incident T2DM compared to the NWNT phenotype, whereas the association was not significant for the NWHT phenotype (RR: 1.063, 95%CI: 0.793 to 1.425). The subgroup analyses generally revealed similar associations across all subgroups. Among middle-aged and older adults, we suggested a combined use of waist circumference and triglycerides measures in identifying participants who are at high risk of developing T2DM.

Download Full-text

Physical activity versus metformin for increasing insulin sensitivity in children and adolescents at-risk for type 2 diabetes

University of Western Ontario Medical Journal ◽

10.5206/uwomj.v85i2.2228 ◽

2016 ◽

Vol 85 (2) ◽

pp. 26-28

Author(s):

Andrew D Hanna ◽

Natalie V Scime

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

At Risk ◽

Insulin Sensitivity ◽

Children And Adolescents ◽

Pediatric Population ◽

Current Evidence ◽

Beneficial Effects ◽

Pediatric Populations

Global rates of type 2 diabetes (T2D) among children and adolescents are steadily rising. As such, an increasing amount of attention and research has begun to focus on strategies to prevent this chronic and burdensome disease in pediatric populations. The purpose of this article is to briefly review current evidence pertaining to the effectiveness of physical activity versus metformin in improving insulin sensitivity of children at-risk (ie, obese and/or insulin resistant) for developing T2D. Potential barriers to each preventative intervention will also be discussed. Physical activity, both aerobic and resistance, has demonstrated effectiveness in a moderate number of demographically diverse pediatric studies. However, the pediatric population is already alarmingly sedentary with barriers such as lack of motivation, social stigma and discomfort presenting a challenge. A small number of studies have demonstrated the beneficial effects of metformin in children and adolescents for improved insulin sensitivity. However, longer and larger studies are required to confirm these findings and elucidate upon the long-term safety and efficacy of this pharmaceutical in pediatric populations. While no head-to-head studies examining physical activity and metformin exist in pediatric populations and more research is needed, current evidence seems to favour the use of physical activity given the larger quantity of studies and generalizability of its beneficial effects. Thus, physical activity should be emphasized in clinical and public health practice when targeting at-risk children and adolescents to prevent a T2D diagnosis.

Download Full-text

Type 2 diabetes in women of reproductive age

Women’s Healthcare: A Clinical Journal for NPs ◽

10.51256/whc042108 ◽

2021 ◽

Vol 9 (2) ◽

Author(s):

Donna M. Williams ◽

Kathryn Evans Kreider

Keyword(s):

Type 2 Diabetes ◽

Nurse Practitioners ◽

Diabetes Management ◽

Reproductive Age ◽

Current Evidence ◽

Evidence Based ◽

Women Of Reproductive Age

The prevalence of type 2 diabetes in women of reproductive age ranges from 3% to 7%. Due to the common nature of this condition, it is imperative for nurse practitioners who care for women to understand evidence-based methods of diabetes management. The aim of this article is to describe current screening and diagnostic criteria for type 2 diabetes, discuss current evidence-based management and patient education necessary to prevent long-term complications, and provide the tools for a healthy reproductive plan in women with type 2 diabetes from puberty until menopause. Diabetes management extends well beyond glucose control, and nurse practitioners should be attuned to all factors that can impact cardiovascular risk and quality of life.

Download Full-text

Oral hypoglycaemic agents, insulin resistance and cardiovascular disease in patients with type 2 diabetes

Acta Endocrinologica ◽

10.1530/eje-09-0167 ◽

2009 ◽

Vol 161 (1) ◽

pp. 1-9 ◽

Cited By ~ 12

Author(s):

Bianca Hemmingsen ◽

Søren S Lund ◽

Jørn Wetterslev ◽

Allan Vaag

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Meta Analysis ◽

Current Evidence ◽

Cvd Risk ◽

Oral Hypoglycaemic Agents ◽

Increase Insulin Sensitivity ◽

Hypoglycaemic Agents ◽

Conflicting Evidence

This article is a narrative review of the current evidence of the effects on cardiovascular disease (CVD) of oral hypoglycaemic agents that increase insulin sensitivity in patients with type 2 diabetes (T2D). In overweight T2D patients, metformin has been demonstrated to reduce CVD risk, and this beneficial effect may be conserved with the combination of metformin and insulin treatment. However, the effect of glitazones on CVD is uncertain. There is conflicting evidence from large randomized trials to support a protective effect against CVD of lowering blood glucose per se but a systematic review with meta-analysis is lacking. It may be reasonable to aim for an intervention targeting multiple CVD risk factors such as dyslipidaemia, hypertension and albuminuria in T2D patients.

Download Full-text

Current and emerging psychological models

10.1093/med/9780198789284.003.0015 ◽

2018 ◽

Author(s):

Christopher Garrett

Keyword(s):

Type 2 Diabetes ◽

Attachment Theory ◽

Evidence Base ◽

Behavioural Therapy ◽

Diabetes Control ◽

Current Evidence ◽

Perspective Drawing ◽

Current Evidence Base ◽

Current Psychological

This chapter critiques the current psychological and social interventions used in addressing type 2 diabetes control and depression, suggesting an alternative approach using a lifespan perspective, drawing on attachment theory and personality research. It evaluates the psychological and social interactions of the two conditions and describes how current interventions such as cognitive behavioural therapy approach these difficulties and the limitations suggested in the current evidence base. It goes on to discuss the association of attachment theory and personality traits on both type 2 diabetes control and depression and proposes how this evidence might be harnessed in future interventions to improve outcomes in both conditions.

Download Full-text