Cumulative intake of artificially sweetened and sugar-sweetened beverages and risk of incident type 2 diabetes in young adults: the Coronary Artery Risk Development In Young Adults (CARDIA) Study

ABSTRACT Background Epidemiological evidence has demonstrated a positive association between artificially sweetened beverage (ASB) and sugar-sweetened beverage (SSB) consumption and type 2 diabetes (T2D) risk. However, research informing this topic in young adults is limited. Objective This study examined the association between ASB, SSB, and total sweetened beverage (TSB; combined ASB and SSB) consumption and T2D risk in young adults. Methods A prospective analysis of 4719 Black and White men and women aged 18–30 y at baseline was conducted from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Each participant's beverage intake was assessed using the CARDIA Diet History at baseline and at study Years 7 and 20. Multivariable Cox proportional hazards regression models were used to examine cumulative average ASB, SSB, and TSB intakes and risk of T2D. Results During the 30-y follow-up period, 680 participants developed T2D. ASB consumption was associated with a 12% greater risk of T2D per serving/day (HR 1.12, 95% CI 1.04–1.20) in a model adjusted for lifestyle factors, diet quality, and dieting behavior. Further adjustments for baseline BMI (HR 1.07, 95% CI 0.99–1.14) and weight change during follow-up (HR 1.04, 95% CI 0.97–1.12) attenuated the association. SSB and TSB consumption as continuous variables per 1 serving/day of intake were associated with 6% and 5% increased risks of T2D, respectively (HRSSB 1.06, 95% CI 1.01–1.10; HRTSB 1.05, 95% CI 1.01–1.09), in the model accounting for lifestyle factors, dieting behavior, baseline BMI, and weight change. Results were consistent when the exposures were modeled in categories of consumption and quintiles. Conclusions In young adults, long-term ASB, SSB, and TSB consumption were associated with increased risks of T2D. However, the estimates for ASB were attenuated when accounting for weight changes.

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Life Course Change Towards a Plant-Centered Diet and Incidence of Type 2 Diabetes: The Coronary Artery Risk Development in Young Adults (CARDIA) Study (OR33-03-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz039.or33-03-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Yuni Choi ◽

David Jacobs ◽

Kristin Hirahatake ◽

Nicole Larson ◽

Andrew Odegaard ◽

...

Keyword(s):

Type 2 Diabetes ◽

Young Adults ◽

Coronary Artery ◽

Diet Quality ◽

Proportional Hazards ◽

Dietary Quality ◽

Food Groups ◽

Incident Type

Abstract Objectives There has been limited study of long-term change towards a plant-centered diet in relation to incident type 2 diabetes (T2DM). We examined this question in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort. Methods Analyses included 2717 participants in CARDIA, a US multicenter, community-based prospective cohort study, currently with 30 years of follow-up. Participants were free of diabetes through year 20, with follow-up for incident T2DM through year 30. Dietary intake at years 0 and 20 was assessed by interviewer-administered diet history; overall dietary quality was assessed using a hypothesis-driven index based on 46 food groups, the A Priori Diet Quality Score (APDQS). The APDQS has possible scores 0 to 132 and increasing score is largely led by consumption of nutritionally rich plant foods–fruits and vegetables and plant-derived fats (e.g., seeds, nut, vegetable oils) and proteins (e.g., avocado, legume, soy). Change in diet quality (year 20 – year 0) and its quintiles were calculated. Diagnosis of T2DM was based on self-reported use of antidiabetic medication treatment or lab tests (fasting glucose, 2-hour glucose, or glycated hemoglobin). In proportional hazards regression, covariates included sociodemographics, baseline APDQS, and time-varying energy intake, smoking, and physical activity. Results Mean baseline age was 25.0 ± 3.6y, 43% were black, and 58% were women. During 10 years of follow-up after year 20, 206 cases of incident T2DM occurred. Mean year 0 APDQS was 64 ± 13 points and mean 20-year changes in APDQS was 7 ± 11. In multivariable-adjusted analysis, we found that the greatest increase in dietary quality over 20 years (median APDQS increased by 22 points) was associated with a 60% decrease in risk of T2DM as compared to a small decrease in diet quality (median APDQS decreased by 8 points); HRQ5 vs. Q1: 0.40; 95% CI:0.24–0.67). For every 10-point increase in APDQS over 20 years, there was a 23% decrease in risk of T2DM (95% CI: 0.67–0.88, P-trend = 0.0009). The pattern of findings persisted within below median and within above median year 0 APDQS. Conclusions Our finding suggests that young adults would benefit from improving diet quality by shifting toward a more plant-centered diet over time for the prevention of T2DM. Funding Sources This research was funded by an NHLBI contract and the University of Minnesota Healthy Food, Healthy Lives Institute. Supporting Tables, Images and/or Graphs

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Circulating metabolites and the risk of type 2 diabetes: a prospective study of 11,896 young adults from four Finnish cohorts

Diabetologia ◽

10.1007/s00125-019-05001-w ◽

2019 ◽

Vol 62 (12) ◽

pp. 2298-2309 ◽

Cited By ~ 16

Author(s):

Ari V. Ahola-Olli ◽

Linda Mustelin ◽

Maria Kalimeri ◽

Johannes Kettunen ◽

Jari Jokelainen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Young Adults ◽

Fasting Glucose ◽

Diabetes Risk ◽

Increased Risk ◽

Metabolic Biomarkers ◽

Incident Cases ◽

Future Diabetes

Abstract Aims/hypothesis Metabolomics technologies have identified numerous blood biomarkers for type 2 diabetes risk in case−control studies of middle-aged and older individuals. We aimed to validate existing and identify novel metabolic biomarkers predictive of future diabetes in large cohorts of young adults. Methods NMR metabolomics was used to quantify 229 circulating metabolic measures in 11,896 individuals from four Finnish observational cohorts (baseline age 24–45 years). Associations between baseline metabolites and risk of developing diabetes during 8–15 years of follow-up (392 incident cases) were adjusted for sex, age, BMI and fasting glucose. Prospective metabolite associations were also tested with fasting glucose, 2 h glucose and HOMA-IR at follow-up. Results Out of 229 metabolic measures, 113 were associated with incident type 2 diabetes in meta-analysis of the four cohorts (ORs per 1 SD: 0.59–1.50; p< 0.0009). Among the strongest biomarkers of diabetes risk were branched-chain and aromatic amino acids (OR 1.31–1.33) and triacylglycerol within VLDL particles (OR 1.33–1.50), as well as linoleic n-6 fatty acid (OR 0.75) and non-esterified cholesterol in large HDL particles (OR 0.59). The metabolic biomarkers were more strongly associated with deterioration in post-load glucose and insulin resistance than with future fasting hyperglycaemia. A multi-metabolite score comprised of phenylalanine, non-esterified cholesterol in large HDL and the ratio of cholesteryl ester to total lipid in large VLDL was associated with future diabetes risk (OR 10.1 comparing individuals in upper vs lower fifth of the multi-metabolite score) in one of the cohorts (mean age 31 years). Conclusions/interpretation Metabolic biomarkers across multiple molecular pathways are already predictive of the long-term risk of diabetes in young adults. Comprehensive metabolic profiling may help to target preventive interventions for young asymptomatic individuals at increased risk.

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Prognostic Utility of Coronary Computed Tomographic Angiography: A 5-Year Follow-Up in Type 2 Diabetes Patients with Suspected Coronary Artery Disease

Journal of Diabetes Research ◽

10.1155/2014/103459 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Daliang Liu ◽

Huijuan Jia ◽

Yucun Fu ◽

Wen He ◽

Daqing Ma

Keyword(s):

Computed Tomography ◽

Type 2 Diabetes ◽

Coronary Artery ◽

Predictive Value ◽

Coronary Computed Tomography Angiography ◽

Control Group ◽

Study Group ◽

Coronary Events

Objectives.To analyze the predictive value of coronary computed tomography angiography on acute coronary artery events in patients with type 2 diabetes.Methods.Coronary computed tomography angiography was performed in 250 type 2 diabetic patients. After a follow-up for 5 years, 145 patients were excluded as they did not have any coronary events. The remaining 95 patients were divided into study group and control group. According to their density and shape, the coronary artery plaques were classified into 3 types and 4 types, respectively.Results.There is no statistically significant difference in the degree of stenosis between two groups. The proportion of calcified plaques in the study group was lower than in the control group. The proportion of mixed-calcified plaques in the study group was higher than in the other. Type III plaques have a 76.2% sensitivity and negative predictive value was 64.5% for acute coronary events; type IV plaques have a sensitivity of 52.6% and positive predictive value of 63% for chronic coronary events.Conclusions.CCTA may be used as a non-invasive modality for evaluating and predicting vulnerable coronary atherosclerosis plaques in patients with type 2 diabetes.

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Abstract P031: Weight Changes and Their Predictors Among 11,140 Patients With Type 2 Diabetes in The Advance Trial

Circulation ◽

10.1161/circ.125.suppl_10.ap031 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Susan van Dieren ◽

Andre Pascal Kengne ◽

John Chalmers ◽

Joline Beulens ◽

Yvonne van der Schouw ◽

...

Keyword(s):

Type 2 Diabetes ◽

Weight Gain ◽

Weight Change ◽

Glucose Control ◽

Diabetes Research ◽

Mixed Effect ◽

Glucose Lowering ◽

The Mean

Background/Aim: To determine the baseline characteristics and glucose lowering therapies associated with weight change among subjects with type 2 diabetes. Methods: 11,140 participants in the ADVANCE trial, were randomly assigned to an intensive (aiming for an HbA 1c ≤ 6.5%) or a standard blood glucose control strategy. Weight was measured at baseline and every 6 months over a median follow-up of 5 years. Multivariable linear regression and linear mixed effect models were used to examine predictors of weight change. Results: The mean difference in weight between the intensive and standard glucose control arm during follow-up was 0.75 kg (95% CI: 0.56 to 0.94), p-value<0.001. The mean weight decreased by 0.70 kg (95% CI: 0.53 to 0.87), p <0.001 by the end of follow-up in the standard arm but remained stable in the intensive arm, with a non-significant gain of 0.16 kg (95% CI: -0.02 to 0.34), p=0.075. Baseline factors associated with weight gain were younger age, higher HbA 1c , Caucasian ethnicity and number of glucose lowering medications. Treatment combinations including insulin [3.20 kg (95% CI: 2.90 to 3.50)] and thiazolidinediones [3.05 kg (95% CI: 2.68 to 3.42)] were associated with the greatest weight gain whilst treatment combinations including sulphonylureas were associated with less weight gain [0.71 kg (95%CI: 0.39 to 1.03)] (Figure 1). Conclusion: Intensive glucose control regimens are not necessarily associated with substantial weight gain. Patient characteristic associated with weight change were age, ethnicity, smoking and HbA1c. The main treatment strategies predicting weight gain were the use of insulin and thiazolidinediones. Acknowledgements: This research was supported by a program grant from the National Health and Medical Research Council of Australia, the Center for Translational Molecular Medicine (CTMM) and the Netherlands Heart Foundation, Dutch Diabetes Research Foundation and Dutch Kidney Foundation (PREDICCt).

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Potassium intake and risk of incident type 2 diabetes mellitus: the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Diabetologia ◽

10.1007/s00125-012-2487-3 ◽

2012 ◽

Vol 55 (5) ◽

pp. 1295-1303 ◽

Cited By ~ 39

Author(s):

R. Chatterjee ◽

L. A. Colangelo ◽

H. C. Yeh ◽

C. A. Anderson ◽

M. L. Daviglus ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Young Adults ◽

Coronary Artery ◽

Incident Type ◽

Potassium Intake ◽

Incident Type 2 Diabetes

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Long-term Predictions of Incident Coronary Artery Calcium to 85 Years of Age for Asymptomatic Individuals with and without Type 2 Diabetes

10.2337/figshare.14365538 ◽

2021 ◽

Author(s):

Bart S. Ferket ◽

M.G. Myriam Hunink ◽

Umesh Masharani ◽

Wendy Max ◽

Joseph Yeboah ◽

...

Keyword(s):

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Heart Disease ◽

Coronary Artery ◽

Coronary Artery Calcium ◽

Cardiovascular Events ◽

Diabetes Treatment ◽

The Impact

Objective To examine the utility of repeated computed tomography (CT) coronary artery calcium (CAC) testing, we assessed risks of detectable CAC and its cardiovascular consequences in individuals with and without type 2 diabetes from ages 45 to 85 years. Research Design and Methods We included 5836 individuals (618 with type 2 diabetes, 2972 without baseline CAC) from the Multi-Ethnic Study of Atherosclerosis. Logistic and Cox regression evaluated the impact of type 2 diabetes, diabetes treatment duration and other predictors on prevalent and incident CAC. We used time-dependent Cox modeling of follow-up data (median 15.9 years) for two repeat CT exams and cardiovascular events to assess the association of CAC at follow-up CT with cardiovascular events. Results For 45-year-olds with type 2 diabetes, the likelihood of CAC at baseline was 23% versus 17% for those without. Median age at incident CAC was 52.2 versus 62.3 years for those with and without diabetes. Each 5 years of diabetes treatment increased the odds and hazard rate of CAC by 19% (95% confidence interval [CI] 8-33%) and 22% (95% CI 6-41%). Male gender, white ethnicity/race, hypertension, hypercholesterolemia, obesity, and low serum creatinine also increased CAC. CAC at follow-up CT independently increased coronary heart disease rates. Conclusions We estimated cumulative CAC incidence to age 85. Patients with type 2 diabetes develop CAC at a younger age than those without diabetes. Because incident CAC is associated with increased coronary heart disease risk, the value of periodic CAC-based risk assessment in type 2 diabetes should be evaluated.

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Evaluation of the University of California Diabetes Prevention Program (UC DPP) Initiative

BMC Public Health ◽

10.1186/s12889-021-11731-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Maryam Gholami ◽

Nicholas J. Jackson ◽

Un Young Rebecca Chung ◽

O. Kenrik Duru ◽

Kelly Shedd ◽

...

Keyword(s):

Type 2 Diabetes ◽

Health Outcomes ◽

Weight Change ◽

Diabetes Prevention ◽

Diabetes Prevention Program ◽

University Of California ◽

The University ◽

Diabetes And Obesity

Abstract Background Type 2 diabetes can negatively impact long term health outcomes, healthcare costs and quality of life. However, intensive lifestyle interventions, including the Diabetes Prevention Program (DPP), can significantly lower risk of incident type 2 diabetes among overweight adults with prediabetes. Unfortunately, the majority of adults in the US who are at risk of developing diabetes do not engage in DPP-based lifestyle change programs. Increased adoption of evidence-based obesity and diabetes prevention interventions, such as the DPP, may help large employers reduce health risks and improve health outcomes among employees. In 2018, the University of California Office of thePresident (UCOP) implemented the UC DPP Initiative, a novel, multi-component program to address diabetes and obesity prevention across the UC system. Methods The goal of our study is to conduct a multifaceted evaluation of the UC DPP Initiative using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Our evaluation will integrate unique and diverse UC data sources, including electronic health record (EHR) data, administrative claims, campus-based DPP cohort data, qualitative interviews and site visits. Our primary outcome of interest is the mean percent weight change among three groups of overweight/obese UC beneficiaries at risk for diabetes at 12-month follow-up. Secondary outcomes include mean percent weight change at 24-month follow-up, barriers and facilitators associated with implementatio, as well as the degree of program adoption and maintenance. Discussion Our study will help inform diabetes and obesity prevention efforts across the UC system. Findings from this evaluation will also be highly applicable to universities and large employers, as well as community organizers, healthcare organizations and insurers implementing the DPP and/or other health promotion interventions.

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THE ROLE OF METABOLIC SURGERY FOR PATIENTS WITH OBESITY GRADE I AND TYPE 2 DIABETES NOT CONTROLLED CLINICALLY

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-6720201600s10025 ◽

2016 ◽

Vol 29 (suppl 1) ◽

pp. 102-106 ◽

Cited By ~ 6

Author(s):

Josemberg CAMPOS ◽

Almino RAMOS ◽

Thomaz SZEGO ◽

Bruno ZILBERSTEIN ◽

Heládio FEITOSA ◽

...

Keyword(s):

Type 2 Diabetes ◽

Risk Score ◽

Metabolic Surgery ◽

Metabolic Risk ◽

Safety And Efficacy ◽

Baseline Bmi ◽

Metabolic Risk Score

ABSTRACT Introduction Even considering the advance of the medical treatment in the last 20 years with new and more effective drugs, the outcomes are still disappointing as the control of obesity and type 2 Diabetes Mellitus (T2DM) with a large number of patients under the medical treatment still not reaching the desired outcomes. Objective: To present a Metabolic Risk Score to better guide the surgical indication for T2DM patients with body mass index (BMI) where surgery for obesity is still controversial. Method: Research was conducted in Pubmed, Medline, Pubmed Central, Scielo and Lilacs between 2003-2015 correlating headings: metabolic surgery, obesity and type 2 diabetes mellitus. In addition, representatives of the societies involved, as an expert panel, issued opinions. Results: Forty-five related articles were analyzed by evidence-based medicine criteria. Grouped opinions sought to answer the following questions: Why metabolic and not bariatric surgery?; Mechanisms involved in glycemic control; BMI as a single criterion for surgical indication for uncontrolled T2DM; Results of metabolic surgery studies in BMI<35 kg/m2; Safety of metabolic surgery in patients with BMI<35 kg/m2; Long-term effects of surgery in patients with baseline BMI<35 kg/m2 and Proposal for a Metabolic Risk Score. Conclusion: Metabolic surgery has well-defined mechanisms of action both in experimental and human studies. Gastrointestinal interventions in T2DM patients with IMC≤35 kg/m2 has similar safety and efficacy when compared to groups with greater BMIs, leading to the improvement of diabetes in a superior manner than clinical treatment and lifestyle changes, in part through weight loss independent mechanisms . There is no correlation between baseline BMI and weight loss in the long term with the success rate after any surgical treatment. Gastrointestinal surgery treatment may be an option for patients with T2DM without adequate clinical control, with a BMI between 30 and 35, after thorough evaluation following the parameters detailed in Metabolic Risk Score defined by the surgical societies. Roux-en-Y gastric bypass (RYGB), because of its well known safety and efficacy and longer follow-up studies, is the main surgical technique indicated for patients eligible for surgery through the Metabolic Risk Score. The vertical sleeve gastrectomy may be considered if there is an absolute contraindication for the RYGB. T2DM patients should be evaluated by the multiprofessional team that will assess surgical eligibility, preoperative work up, follow up and long term monitoring for micro and macrovascular complications.

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