Circulating microRNAs associated with prediabetes and geographic location in Latinos

Abstract Background Globally, type 2 diabetes is highly prevalent in individuals of Latino ancestry. The reasons underlying this high prevalence are not well understood, but both genetic and lifestyle factors are contributors. Circulating microRNAs are readily detectable in blood and are promising biomarkers to characterize biological responses (i.e., changes in gene expression) to lifestyle factors. Prior studies identified relationships between circulating microRNAs and risk for type 2 diabetes, but Latinos have largely been under-represented in these study samples. Aims/hypothesis The aim of this study was to assess for differences in expression levels of three candidate microRNAs (miR-126, miR-146, miR-15) between individuals who had prediabetes compared to normal glycemic status and between individuals who self-identified with Latino ancestry in the United States (US) and native Mexicans living in or near Leon, Mexico. Methods This was a cross-sectional study that included 45 Mexicans and 21 Latino participants from the US. Prediabetes was defined as fasting glucose 100–125 mg/dL or 2-h post-glucose challenge between 140 and 199 mg/dL. Expression levels of microRNAs from plasma were measured by qPCR. Linear and logistic regression models were used to assess relationships between individual microRNAs and glycemic status or geographic site. Results None of the three microRNAs was associated with risk for type 2 diabetes. MiR-146a and miR-15 were significantly lower in the study sample from Mexico compared to the US. There was a significant interaction between miR-146a and BMI associated with fasting blood glucose. Conclusions/interpretation This study did not replicate in Latinos prior observations from other racial groups of associations between miR-126, miR-146a, and miR-15 and risk for type 2 diabetes. Future studies should consider other microRNAs related to different biological pathways as possible biomarkers for type 2 diabetes in Latinos.

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How Family Physicians Practice the Principle of Remission Along the Glycemic Continuum

Journal of Primary Care & Community Health ◽

10.1177/2150132720977744 ◽

2020 ◽

Vol 11 ◽

pp. 215013272097774

Author(s):

Stephanie T. Fulleborn ◽

Paul F. Crawford ◽

Jeremy T. Jackson ◽

Christy J.W. Ledford

Keyword(s):

Type 2 Diabetes ◽

Medical Record ◽

The United States ◽

Case Scenario ◽

Cross Sectional ◽

Normal Glucose ◽

Normal Glucose Regulation

Introduction Recent evidence reveals that diabetes and prediabetes (preDM) can be reversed to normal glucose regulation (NGR) through significant weight loss, but how physicians clinically identify the principles of partial and complete remission of diabetes is largely unknown. Methods As part of the cross-sectional omnibus survey conducted in March 2019 at a professional annual meeting in the United States, physician participants answered case scenario questions about the diagnosis and documentation of patients with preDM and type 2 diabetes (T2DM). Results Of the registered conference attendees, 387 (72.7%) responded. When presented with the initial case of preDM, 201 physicians (70.8%) selected R73.03 Prediabetes. In a follow-up encounter with improved lab results, 118 physicians (58.7%) indicated that they would not chart any diabetes-related code and 62 (30.8%) would chart preDM again. When presented with the case of T2DM, 256 physicians (90.1%) indicated E11.0–E11.9 Type 2 Diabetes. In the follow-up encounter, only 38 (14.8%) coded a diagnosis reflecting remission from T2DM to prediabetes and 211 (82.4%) charted T2DM. Conclusion Physicians may be reluctant to document diabetes regression as there is little evidence for long-term outcomes and “downgrading” the diagnosis in the medical record may cause screenings to be missed. Documenting this regression in the medical record should communicate the accurate point on the continuum of glucose intolerance with both the patient and the care team.

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Association of HIV-1 Infection and Antiretroviral Therapy With Type 2 Diabetes in the Hispanic Population of the Rio Grande Valley, Texas, USA

Frontiers in Medicine ◽

10.3389/fmed.2021.676979 ◽

2021 ◽

Vol 8 ◽

Author(s):

Juan Carlos Lopez-Alvarenga ◽

Dora A. Martinez ◽

Alvaro Diaz-Badillo ◽

Liza D. Morales ◽

Rector Arya ◽

...

Keyword(s):

Type 2 Diabetes ◽

Mexican American ◽

Robust Regression ◽

Rio Grande Valley ◽

Rio Grande ◽

The United States ◽

Cross Sectional ◽

Mean Values ◽

Cell Counts

The Rio Grande Valley (RGV) in South Texas has one of the highest prevalence of obesity and type 2 diabetes (T2D) in the United States (US). We report for the first time the T2D prevalence in persons with HIV (PWH) in the RGV and the interrelationship between T2D, cardiometabolic risk factors, HIV-related indices, and antiretroviral therapies (ART). The PWH in this study received medical care at Valley AIDS Council (VAC) clinic sites located in Harlingen and McAllen, Texas. Henceforth, this cohort will be referred to as Valley AIDS Council Cohort (VACC). Cross-sectional analyses were conducted using retrospective data obtained from 1,827 registries. It included demographic and anthropometric variables, cardiometabolic traits, and HIV-related virological and immunological indices. For descriptive statistics, we used mean values of the quantitative variables from unbalanced visits across 20 months. Robust regression methods were used to determine the associations. For comparisons, we used cardiometabolic trait data obtained from HIV-uninfected San Antonio Mexican American Family Studies (SAMAFS; N = 2,498), and the Mexican American population in the National Health and Nutrition Examination Survey (HHANES; N = 5,989). The prevalence of T2D in VACC was 51% compared to 27% in SAMAFS and 19% in HHANES, respectively. The PWH with T2D in VACC were younger (4.7 years) and had lower BMI (BMI 2.43 units less) when compared to SAMAFS individuals. In contrast, VACC individuals had increased blood pressure and dyslipidemia. The increased T2D prevalence in VACC was independent of BMI. Within the VACC, ART was associated with viral load and CD4+ T cell counts but not with metabolic dysfunction. Notably, we found that individuals with any INSTI combination had higher T2D risk: OR 2.08 (95%CI 1.67, 2.6; p < 0.001). In summary, our results suggest that VACC individuals may develop T2D at younger ages independent of obesity. The high burden of T2D in these individuals necessitates rigorously designed longitudinal studies to draw potential causal inferences and develop better treatment regimens.

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Glycaemic control in type 2 diabetes patients and its predictors: a retrospective database study at a tertiary care diabetes centre in Ningbo, China

BMJ Open ◽

10.1136/bmjopen-2017-019697 ◽

2018 ◽

Vol 8 (3) ◽

pp. e019697 ◽

Cited By ~ 11

Author(s):

Jialin Li ◽

Kaushik Chattopadhyay ◽

Miao Xu ◽

Yanshu Chen ◽

Fangfang Hu ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Glycaemic Control ◽

Rural Areas ◽

Tertiary Care ◽

Fasting Blood Glucose ◽

Information Management System ◽

Cross Sectional ◽

Poor Glycaemic Control

ObjectivesThe objectives of the study were to assess glycaemic control in patients with type 2 diabetes (T2DM) at a tertiary care diabetes centre in Ningbo, China and to determine factors that independently predict their glycaemic control.DesignRetrospective cross-sectional study using an existing database, the Diabetes Information Management System.SettingTertiary care diabetes centre in Ningbo, China.ParticipantsThe study included adult patients with T2DM, registered and received treatment at the diabetes centre for at least six consecutive months. The study inclusion criteria were satisfied by 1387 patients, from 1 July 2012 to 30 June 2017.Primary outcome measureGlycaemic control (poor was defined as glycated haemoglobin (HbA1c)>=7% or fasting blood glucose (FBG)>7.0 mmol/L).ResultsIn terms of HbA1c and FBG, the 5-year period prevalence of poor glycaemic control was 50.3% and 57.3%, respectively. In terms of HbA1c and FBG, the odds of poor glycaemic control increased with the duration of T2DM (>1 to 2 years: OR 1.84, 95% CI 1.06 to 3.19; >2 to 4 years: 3.32, 1.88 to 5.85 and >4 years: 5.98, 4.09 to 8.75 and >1 to 2 years: 2.10, 1.22 to 3.62; >2 to 4 years: 2.48, 1.42 to 4.34 and >4 years: 3.34, 2.32 to 4.80) and were higher in patients residing in rural areas (1.68, 1.24 to 2.28 and 1.42, 1.06 to 1.91), with hyperlipidaemia (1.57, 1.12 to 2.19 and 1.68, 1.21 to 2.33), on diet, physical activity and oral hypoglycaemic drug (OHD) as part of their T2DM therapeutic regimen (1.80, 1.01 to 3.23 and 2.40, 1.36 to 4.26) and on diet, physical activity, OHD and insulin (2.47, 1.38 to 4.41 and 2.78, 1.58 to 4.92), respectively.ConclusionsMore than half of patients with T2DM at the diabetes centre in Ningbo, China have poor glycaemic control, and the predictors of glycaemic control were identified. The study findings could be taken into consideration in future interventional studies aimed at improving glycaemic control in these patients.

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A Novel Variant of the SH2B1 Gene in an Obese Child With Type 2 Diabetes

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.062 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A32-A32

Author(s):

Mariaester Makacio Morillo ◽

Supamit Ukarapong ◽

Tossaporn Seeherunvong

Keyword(s):

Type 2 Diabetes ◽

Behavioral Problems ◽

Novel Mutation ◽

Fasting Blood Glucose ◽

Pathogenic Mutation ◽

The United States ◽

Maladaptive Behavior ◽

Leptin Resistance ◽

Protein Functions

Abstract Obesity in children and adolescents is at epidemic levels in the United States and creates high risk for comorbidities later in life. Childhood obesity is thought to be the result of behavioral and nutritional problems. Although genetic factors may play a role in the etiology of obesity, monogenic forms of obesity are rare. We present a child with obesity, behavioral problems, leptin resistance, and type 2 diabetes who also carries a mutation of Sarcoma Homologous 2B adapter protein 1 (SH2B1). The subject was evaluated at 13 7/12 years old. He had polyphagia, learning disability, aggressive behavior and marked obesity. At ages 9,11, and 13 years respectively, his BMI was 9%, 16%, and 52% above the 95th percentile. At 13 7/12 years old, his height was at the 80th percentile and BMI was 66% above the 95th percentile. He had marked acanthosis nigricans and he was prepubertal. Fasting blood glucose and insulin levels were 116 mg/dl and 592 mIU/L, respectively. Hemoglobin A1c was 6.5% and metformin therapy was initiated for type 2 diabetes. Fasting leptin level (41.5 ng/mL) was markedly elevated indicating leptin resistance. DNA methylation study excluded Prader-Willi syndrome. DNA sequencing indicated a novel heterozygous c.1555G>T variant of SH2B1 gene, which is predicted to result in the amino acid substitution p. Asp519Tyr. The analysis by PolyPhen-2 and MutationTaster predicts that the variant is a pathogenic mutation affecting protein functions. SH2B1 interacts with JAK2 and may play a role in insulin signaling. Pathogenic heterozygous variants in SH2B1 have been associated with obesity, insulin resistance and maladaptive behavior phenotypes (Pearce et al, 2014). Sh2b1-null mice develop severe leptin resistance, obesity, and type 2 diabetes. Our report underscores the importance of investigating monogenic causes of obesity in subjects who present severe obesity, diabetes, and behavioral problems. Additional studies are needed to determine the association between this novel mutation and the clinical features of this patient.

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Alterations in Serum Electrolyte Homeostasis in Type-2 Diabetes Mellitus Patients - A Cross-Sectional Study in VIMSAR, Burla

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2020/641 ◽

2020 ◽

Vol 7 (52) ◽

pp. 3148-3152

Author(s):

Labanyabati Pattanaik ◽

Madhusmita Acharya ◽

Manoj Kumar Yadav ◽

Prafulla Kumar Mishra ◽

Madhab Nayak

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Blood Glucose ◽

Fasting Blood Glucose ◽

Cross Sectional Study ◽

Cross Sectional ◽

Electrolyte Disturbances ◽

Uncontrolled Diabetes ◽

Diabetes Patients

BACKGROUND Type 2 diabetes mellitus is a widely prevalent lifestyle disease associated with high morbidity and mortality due to dead end complications like acute coronary syndrome, chronic kidney failure and acute stroke. Diabetes mellitus patients frequently develop problems of dyselectrolytemia which is common among hospitalised patients with decompensated diabetes. But there is little information on the prevalence of electrolyte disturbances among diabetes patients. Our aim is to find out the pattern of dyselectrolytemia among type 2 diabetes patients and to know if there is any association of blood glucose level with dyselectrolytemia. METHODS An analytical cross-sectional study was done among type 2 diabetes patients admitted in the department of medicine. Fasting blood glucose (FBG), glycosylated haemoglobin level (HbA1c), blood sodium (Na+), potassium (K+) and calcium (Ca2+) were analysed. Occurrence of dyselectrolytemia was compared between patients of very much controlled versus uncontrolled blood glucose levels. RESULTS Out of 199 patients included in the study, 112 (56 %) had uncontrolled diabetes mellitus (DM) with HbA1c level > / = 7.0 %. Occurrence of hyponatremia, hypokalaemia, hyperkalaemia, hypocalcaemia and hypercalcemia were 35 %, 13 %, 7 %, 16 % and 2 % respectively. In diabetes patients, hyponatremia was seen more commonly in patients with uncontrolled DM than those with very much controlled blood glucose (52.67 % versus 12.64 %, p < 0.001). The extent of patients with hypokalaemia or hyperkalaemia didn't vary between the two groups. Patients on insulin treatment were more likely to have hyponatremia than noninsulin patients (p < 0.001). CONCLUSIONS Type 2 DM patients specifically those who have uncontrolled diabetes mellitus have an increased chance to develop dyselectrolytemia. The most well-known electrolyte disturbances seen were hyponatremia followed by hypocalcaemia in our study and they were generally predominant among patients with uncontrolled DM. KEYWORDS Type 2 Diabetes, Dyselectrolytemia, Hyperglycaemia, Fasting Blood Glucose, Hyponatremia

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Circulating MicroRNAs predict glycemic improvement and response to a behavioral intervention

Biomarker Research ◽

10.1186/s40364-021-00317-5 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Elena Flowers ◽

Isabel Elaine Allen ◽

Alka M. Kanaya ◽

Bradley E. Aouizerat

Keyword(s):

Type 2 Diabetes ◽

Blood Glucose ◽

Linear Models ◽

Longitudinal Design ◽

Fasting Blood Glucose ◽

Intervention Group ◽

Control Group ◽

Behavioral Risk ◽

Circulating Micrornas

Abstract Background MicroRNAs may be important regulators of risk for type 2 diabetes. The purpose of this longitudinal observational study was to assess whether circulating microRNAs predicted improvements in fasting blood glucose, a major risk factor for type 2 diabetes, over 12 months. Methods The study included participants (n = 82) from a previously completed trial that tested the effect of restorative yoga on individuals with prediabetes. Circulating microRNAs were measured using a flow cytometry miRNA assay. Linear models were used to determine the optimal sets of microRNA predictors overall and by intervention group. Results Subsets of microRNAs were significant predictors of final fasting blood glucose after 12-months (R2 = 0.754, p < 0.001) and changes in fasting blood glucose over 12-months (R2 = 0.731, p < 0.001). Three microRNAs (let-7c, miR-363, miR-374b) were significant for the control group only, however there was no significant interaction by intervention group. Conclusions Circulating microRNAs are significant predictors of fasting blood glucose in individuals with prediabetes. Among the identified microRNAs, several have previously been associated with risk for type 2 diabetes. This is one of the first studies to use a longitudinal design to assess whether microRNAs predict changes in fasting blood glucose over time. Further exploration of the function of the microRNAs included in these models may provide new insights about the complex etiology of type 2 diabetes and responses to behavioral risk reduction interventions. Trial registration This study was a secondary analysis of a previously completed clinical trial that is registered at clinicaltrials.gov (NCT01024816) on December 3, 2009.

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Associations of Plasma BACE1 Level and BACE1 C786G Gene Polymorphism with Cognitive Functions in Patients with Type 2 Diabetes: A Cross- Sectional Study

Current Alzheimer Research ◽

10.2174/1567205017666200522210957 ◽

2020 ◽

Vol 17 (4) ◽

pp. 355-364 ◽

Cited By ~ 1

Author(s):

Sai Tian ◽

Rong Huang ◽

Dan Guo ◽

Hongyan Lin ◽

Jiaqi Wang ◽

...

Keyword(s):

Type 2 Diabetes ◽

Gene Polymorphism ◽

Glycosylated Hemoglobin ◽

Fasting Blood Glucose ◽

Multivariable Logistic Regression Analysis ◽

Model Assessment ◽

Cross Sectional ◽

Logical Memory ◽

Bace1 Level

Background: β-Site APP-cleaving enzyme 1 (BACE1) is a key enzyme involved in the pathophysiology of Type 2 Diabetes Mellitus (T2DM) and Mild Cognitive Impairment (MCI). We aimed to investigate the potential associations of plasma BACE1 levels and BACE1 gene polymorphism with different cognitive performances in T2DM patients with MCI. Methods: The recruited 186 T2DM subjects were divided into 92 MCI group and 94 healthy-cognition controls, according to the Montreal Cognitive Assessment (MoCA) scores. Sociodemographic characteristics, clinical parameters and neuropsychological tests were assessed. BACE1 C786G gene polymorphism and plasma BACE1 level were determined. Results: Compared to controls, MCI patients exhibited higher plasma BACE1 levels. Plasma BACE1 levels were negatively associated with MoCA, Clock Drawing Test and Logical Memory Test scores, whereas positively associated with Trail Making Test-B time in the MCI group (all p<0.05), after adjusting fasting blood glucose, glycosylated hemoglobin, and homeostasis model assessment of insulin resistance by C-peptide. Multivariable logistic regression analysis showed a significant trend towards increased MCI risk with high plasma BACE1 level in T2DM patients (OR = 1.492, p = 0.027). The plasma BACE1 levels of GG and GC genotypes were obviously higher than that of CC genotype in T2DM-MCI patients (p = 0.035; p = 0.026, respectively). Conclusion: Increased plasma BACE1 levels were associated with poor overall cognition functions, especially visuospatial abilities, visual/logical memory and executive functions in T2DM-MCI patients. Additionally, elevated plasma BACE1 level was a risk factor for MCI in T2DM patients, and might be influenced by BACE1 C786G gene mutations.

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Breastfeeding and Postpartum Glucose Regulation Among Women With Prior Gestational Diabetes: A Systematic Review

Journal of Human Lactation ◽

10.1177/0890334420950259 ◽

2020 ◽

Vol 36 (4) ◽

pp. 723-738

Author(s):

Marie Tarrant ◽

Rishma Chooniedass ◽

Heidi Sze Lok Fan ◽

Katie Del Buono ◽

Stephanie Masina

Keyword(s):

Type 2 Diabetes ◽

Blood Glucose ◽

Gestational Diabetes ◽

Glucose Tolerance ◽

Infant Feeding ◽

The United States ◽

Glucose Regulation ◽

Glycemic Status ◽

Mean Blood Glucose

Background Gestational diabetes mellitus is associated with adverse maternal and fetal outcomes and increases subsequent risk of Type 2 diabetes. Researchers have shown that breastfeeding may reduce diabetes risk in women with recent gestational diabetes. Research aim To assess association between infant feeding and postpartum glucose tolerance in mothers with recent gestational diabetes within 1 year postpartum. Methods A literature search was performed up to December 31, 2019, retrieving articles related to infant feeding, gestational diabetes, and postpartum glucose regulation in four major databases (PubMed, Cochrane, CINAHL, and Embase). Methodological quality was assessed using tools from the United States National Institutes of Health and the National Heart, Lung, and Blood Institute. Results The search yielded 15 cohort studies meeting the selection criteria. Of the 15 studies, 13 (86.7%) examined the influence of breastfeeding on postpartum glycemic status, and eight (53.4%) compared the mean blood glucose values between breastfeeding and non-breastfeeding participants. Of the 13 studies that compared postpartum glycemic status, nine (60%) of the research teams found that breastfeeding lowered rates of impaired glucose tolerance, and four (26.7%) showed no significant change. In eight of the studies reporting mean blood glucose values, six (75%) reported significantly lower fasting plasma glucose in breastfeeding participants, with reductions ranging from 3.7 to 7.4 mg/dL (0.2–0.4 mmol/L). Conclusion Breastfeeding has been associated with improved postpartum glucose regulation in mothers with gestational diabetes. In pregnant women with gestational diabetes, breastfeeding may reduce the risk of Type 2 diabetes, and women with gestational diabetes should be strongly encouraged and supported to breastfeed.

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Rationale and design of a cross-sectional study to investigate and describe the chronotype of patients with type 2 diabetes and the effect on glycaemic control: the CODEC study

BMJ Open ◽

10.1136/bmjopen-2018-027773 ◽

2019 ◽

Vol 9 (11) ◽

pp. e027773 ◽

Cited By ~ 3

Author(s):

Emer M Brady ◽

Andrew P Hall ◽

Emma Baldry ◽

Sudesna Chatterjee ◽

Lois J Daniels ◽

...

Keyword(s):

Type 2 Diabetes ◽

Glycaemic Control ◽

Dietary Habits ◽

Linear Regression Analysis ◽

Well Being ◽

Lifestyle Factors ◽

Cardiometabolic Health ◽

Cross Sectional ◽

Family History Of Diabetes

IntroductionA person’s chronotype is their entrained preference for sleep time within the 24 hours clock. It is described by the well-known concept of the ‘lark’ (early riser) and ‘owl’ (late sleeper). Evidence suggests that the ‘owl’ is metabolically disadvantaged due to the standard organisation of our society which favours the ‘lark’ and places physiological stresses on this chronotype. The aim of this study is to explore cardiometabolic health between the lark and owl in a population with an established metabolic condition - type 2 diabetes.MethodsThis cross-sectional, multisite study aims to recruit 2247 participants from both secondary and primary care settings. The primary objective is to compare glycaemic control between late and early chronotypes. Secondary objectives include determining if late-chronotype is associated with poorer cardiometabolic health and other lifestyle factors, including well-being, compared with early-chronotype; describing the prevalence of the five different chronotypes in this cohort and examining the trends in glycaemic control, cardiometabolic health, well-being and lifestyle factors across chronotype.AnalysisThe primary outcome (glycated haemoglobin (HbA1c)), linear regression analysis will compare HbA1c between early and late chronotypes, with and without adjustment for confounding variables. Chronotype will be modelled as a categorical variable with all five levels (from extreme-morning to extreme-late type), and as a continuous variable to calculate p for trend across the five categories. A number of models will be created; unadjusted through to adjusted with age, sex, ethnicity, body mass index, duration of diabetes, family history of diabetes, current medication and dietary habits. All secondary outcomes will be analysed using the same method.EthicsEthical approval from the West Midlands - Black Country Research Ethics Committee (16/WM/0457).DisseminationThe results will be disseminated through publication in peer-reviewed medical journal, relevant medical/health conferences and a summary report sent to patients.Trial registration numberNCT02973412 (Pre-Results).

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