scholarly journals Study protocol for the Cities Changing Diabetes programme: a global mixed-methods approach

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e015240 ◽  
Author(s):  
A. David Napier ◽  
John J Nolan ◽  
Malene Bagger ◽  
Louise Hesseldal ◽  
Anna-Maria Volkmann
Keyword(s):  
Type 2 Diabetes ◽  
Study Protocol ◽  
Vision Loss ◽  
Scientific Journal ◽  
Research Priorities ◽  
Well Being ◽  
Overweight And Obesity ◽  
Urban Living ◽  
Global Study

IntroductionUrban living has been shown to affect health in various ways. As the world is becoming more urbanised and almost two-thirds of people with diabetes now live in cities, research into the relationship between urban living, health and diabetes is key to improving the lives of many. The majority of people with diabetes have type 2 diabetes, a subset linked to overweight and obesity, decreased physical activity and unhealthy diets. Diabetes has significant consequences for those living with the condition as well as their families, relationships and wider society. Although care and management are improving, complications remain common, and diabetes is among the leading causes of vision loss, amputation, neuropathy and renal and cardiovascular disease worldwide. We present a research protocol for exploring the drivers of type 2 diabetes and its complications in urban settings through the Cities Changing Diabetes (CCD) partnership programme.Methods and analysisA global study protocol is implemented in eight collaborating CCD partner cities. In each city, academic institutions, municipal representatives and local stakeholders collaborate to set research priorities and plan implementation of findings. Local academic teams execute the study following the global study protocol presented here. A quantitative Rule of Halves analysis obtains measures of the magnitude of the diabetes burden, the diagnosis rates in each city and the outcomes of care. A qualitative Diabetes Vulnerability Assessment explores the urban context in vulnerability to type 2 diabetes and identifies social factors and cultural determinants relevant to health, well-being and diabetes.Ethics and disseminationThe protocol steers the collection of primary and secondary data across the study sites. Research ethics board approval has been sought and obtained in each site. Findings from each of the local studies as well as the result from combined multisite (global) analyses will be reported in a series of core scientific journal papers.

scholarly journals The role of oat products in the prevention and therapy of type 2 diabetes, hypercholesterolemia and obesity*

2019 ◽  
Vol 65 (4) ◽  
Author(s):  
Katarzyna Janda ◽  
Anna Orłowska ◽  
Katarzyna Watychowicz ◽  
Karolina Jakubczyk
Keyword(s):  
Type 2 Diabetes ◽  
Essential Element ◽  
Well Being ◽  
Overweight And Obesity ◽  
The Body ◽  
Water Soluble ◽  
Biologically Active ◽  
Blood Cholesterol ◽  
Excess Body Weight

A healthy diet, of which unrefined grain products are an essential element, is crucial to maintaining health and well-being. Both oats and oat products have been used for centuries and are a widely popular dietary component. They are rich in nutrients, vitamins and minerals, as well as other biologically active compounds, which gives them many health-promoting properties. Because of their high nutritional value, these products are widely used in many branches of industry.The aim of this article is to present the current body of knowledge about the influence of oat products on human health, and also their industrial applications. A special emphasis is placed on the relationship between the intake of products made from oats and the development and treatment of such disorders as type 2 diabetes, cardiovascular diseases and excess body weight. There are many scientific reports indicating that the incorporation of oat products into the diet is associated with beneficial effects in the context of the above conditions, notably due to the high content of water-soluble dietary fibre, particularly β-glucans, which deserve special recognition. According to the body of academic literature, high consumption of the latter is linked to enhanced glycemic control, reduction in blood cholesterol and may also contribute to weight loss in overweight and obesity. For these reasons, oat products deserve special attention and should be recommended for both prophylactic and therapeutic use in metabolic disorders.

scholarly journals Free Sugars Consumption in Canada

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1471
Author(s):  
Huma Rana ◽  
Marie-Claude Mallet ◽  
Alejandro Gonzalez ◽  
Marie-France Verreault ◽  
Sylvie St-Pierre
Keyword(s):  
Type 2 Diabetes ◽  
Weight Gain ◽  
Total Energy ◽  
Children And Adolescents ◽  
Overweight And Obesity ◽  
Free Sugars ◽  
Added Sugars ◽  
Increased Risk ◽  
Baked Products

Free sugars (FS) are associated with a higher risk of dental decay in children and an increased risk of weight gain, overweight and obesity and type 2 diabetes. For this reason, Canada’s Food Guide recommends limiting foods and beverages that contribute to excess free sugars consumption. Estimating FS intakes is needed to inform policies and interventions aimed at reducing Canadians’ consumption of FS. The objective of this study was to estimate FS intake of Canadians using a new method that estimated the free sugars content of foods in the Canadian Nutrient File, the database used in national nutrition surveys. We define FS as sugars present in food products in which the structure has been broken down. We found that 12% of total energy (about 56 g) comes from FS in the diet of Canadians 1 year of age and older (≥1 year). The top four sources were: (1) sugars, syrups, preserves, confectionary, desserts; (2) soft drinks; (3) baked products and (4) juice (without added sugars), and accounted for 60% of total free sugars intake. The results show that efforts need to be sustained to help Canadians, particularly children and adolescents, to reduce their FS intake.

scholarly journals Psychosocial barriers to well‐being and quality of life among type 2 diabetes patients in Ghana

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Margaret Amankwah‐Poku ◽  
Josephine Akpalu ◽  
Araba Sefa‐Dedeh ◽  
Albert G. B. Amoah
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Well Being ◽  
Psychosocial Barriers ◽  
Diabetes Patients

scholarly journals A review of flash glucose monitoring in type 2 diabetes

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Marcio Krakauer ◽  
Jose Fernando Botero ◽  
Fernando J. Lavalle-González ◽  
Adrian Proietti ◽  
Douglas Eugenio Barbieri
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Real World ◽  
Glucose Monitoring ◽  
Well Being ◽  
Main Body ◽  
Flash Glucose Monitoring ◽  
Glucose Levels ◽  
Freestyle Libre

Abstract Background Continuous glucose monitoring systems are increasingly being adopted as an alternative to self-monitoring of blood glucose (SMBG) by persons with diabetes mellitus receiving insulin therapy. Main body The FreeStyle Libre flash glucose monitoring system (Abbott Diabetes Care, Witney, United Kingdom) consists of a factory-calibrated sensor worn on the back of the arm which measures glucose levels in the interstitial fluid every minute and stores the reading automatically every 15 min. Swiping the reader device over the sensor retrieves stored data and displays current interstitial glucose levels, a glucose trend arrow, and a graph of glucose readings over the preceding 8 h. In patients with type 2 diabetes (T2D) receiving insulin therapy, pivotal efficacy data were provided by the 6-month REPLACE randomized controlled trial (RCT) and 6-month extension study. Compared to SMBG, the flash system significantly reduced the time spent in hypoglycemia and frequency of hypoglycemic events, although no significant change was observed in glycosylated hemoglobin (HbA1c) levels. Subsequent RCTs and real-world chart review studies have since shown that flash glucose monitoring significantly reduces HbA1c from baseline. Real-world studies in both type 1 diabetes or T2D populations also showed that flash glucose monitoring improved glycemic control. Higher (versus lower) scanning frequency was associated with significantly greater reductions in HbA1c and significant improvements in other measures such as time spent in hypoglycemia, time spent in hyperglycemia, and time in range. Additional benefits associated with flash glucose monitoring versus SMBG include reductions in acute diabetes events, all-cause hospitalizations and hospitalized ketoacidosis episodes; improved well-being and decreased disease burden; and greater treatment satisfaction. Conclusion T2D patients who use flash glucose monitoring might expect to achieve significant improvement in HbA1c and glycemic parameters and several associated benefits.

scholarly journals Depression-related weight change and incident diabetes in a community sample

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eva Graham ◽  
Tristan Watson ◽  
Sonya S. Deschênes ◽  
Kristian B. Filion ◽  
Mélanie Henderson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Weight Gain ◽  
Weight Change ◽  
Short Form ◽  
Community Sample ◽  
Overweight And Obesity ◽  
Community Dwelling ◽  
Increased Risk

AbstractThis cohort study aimed to compare the incidence of type 2 diabetes in adults with depression-related weight gain, depression-related weight loss, depression with no weight change, and no depression. The study sample included 59,315 community-dwelling adults in Ontario, Canada. Depression-related weight change in the past 12 months was measured using the Composite International Diagnostic Interview—Short Form. Participants were followed for up to 20 years using administrative health data. Cox proportional hazards models compared the incidence of type 2 diabetes in adults with depression-related weight change and in adults with no depression. Adults with depression-related weight gain had an increased risk of type 2 diabetes compared to adults no depression (HR 1.70, 95% CI 1.32–2.20), adults with depression-related weight loss (HR 1.62, 95% CI 1.09–2.42), and adults with depression with no weight change (HR 1.39, 95% CI 1.03–1.86). Adults with depression with no weight change also had an increased risk of type 2 diabetes compared to those with no depression (HR 1.23, 95% CI 1.04–1.45). Associations were stronger among women and persisted after adjusting for attained overweight and obesity. Identifying symptoms of weight change in depression may aid in identifying adults at higher risk of type 2 diabetes and in developing tailored prevention strategies.

scholarly journals Life-course trajectories of weight and their impact on the incidence of type 2 diabetes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Diego Yacamán-Méndez ◽  
Ylva Trolle-Lagerros ◽  
Minhao Zhou ◽  
Antonio Monteiro Ponce de Leon ◽  
Hrafnhildur Gudjonsdottir ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Life Course ◽  
Risk Ratio ◽  
Absolute Risk ◽  
Early Adulthood ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Increased Risk ◽  
Incident Cases

AbstractAlthough exposure to overweight and obesity at different ages is associated to a higher risk of type 2 diabetes, the effect of different patterns of exposure through life remains unclear. We aimed to characterize life-course trajectories of weight categories and estimate their impact on the incidence of type 2 diabetes. We categorized the weight of 7203 participants as lean, normal or overweight at five time-points from ages 7–55 using retrospective data. Participants were followed for an average of 19 years for the development of type 2 diabetes. We used latent class analysis to describe distinctive trajectories and estimated the risk ratio, absolute risk difference and population attributable fraction (PAF) associated to different trajectories using Poisson regression. We found five distinctive life-course trajectories. Using the stable-normal weight trajectory as reference, the stable overweight, lean increasing weight, overweight from early adulthood and overweight from late adulthood trajectories were associated to higher risk of type 2 diabetes. The estimated risk ratios and absolute risk differences were statistically significant for all trajectories, except for the risk ratio of the lean increasing trajectory group among men. Of the 981 incident cases of type 2 diabetes, 47.4% among women and 42.9% among men were attributable to exposure to any life-course trajectory different from stable normal weight. Most of the risk was attributable to trajectories including overweight or obesity at any point of life (36.8% of the cases among women and 36.7% among men). The overweight from early adulthood trajectory had the highest impact (PAF: 23.2% for woman and 28.5% for men). We described five distinctive life-course trajectories of weight that were associated to increased risk of type 2 diabetes over 19 years of follow-up. The variability of the effect of exposure to overweight and obesity on the risk of developing type 2 diabetes was largely explained by exposure to the different life-course trajectories of weight.

scholarly journals Plasma microRNA signature associated with retinopathy in patients with type 2 diabetes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Donato Santovito ◽  
Lisa Toto ◽  
Velia De Nardis ◽  
Pamela Marcantonio ◽  
Rossella D’Aloisio ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Vision Loss ◽  
External Validation ◽  
Diabetic Patients ◽  
Disease Biomarkers ◽  
Response To Stress ◽  
Severity Of The Disease ◽  
Plasma Microrna

AbstractDiabetic retinopathy (DR) is a leading cause of vision loss and disability. Effective management of DR depends on prompt treatment and would benefit from biomarkers for screening and pre-symptomatic detection of retinopathy in diabetic patients. MicroRNAs (miRNAs) are post-transcriptional regulators of gene expression which are released in the bloodstream and may serve as biomarkers. Little is known on circulating miRNAs in patients with type 2 diabetes (T2DM) and DR. Here we show that DR is associated with higher circulating miR-25-3p (P = 0.004) and miR-320b (P = 0.011) and lower levels of miR-495-3p (P < 0.001) in a cohort of patients with T2DM with DR (n = 20), compared with diabetic subjects without DR (n = 10) and healthy individuals (n = 10). These associations persisted significant after adjustment for age, gender, and HbA1c. The circulating levels of these miRNAs correlated with severity of the disease and their concomitant evaluation showed high accuracy for identifying DR (AUROC = 0.93; P < 0.001). Gene ontology analysis of validated targets revealed enrichment in pathways such as regulation of metabolic process (P = 1.5 × 10–20), of cell response to stress (P = 1.9 × 10–14), and development of blood vessels (P = 2.7 × 10–14). Pending external validation, we anticipate that these miRNAs may serve as putative disease biomarkers and highlight novel molecular targets for improving care of patients with diabetic retinopathy.

scholarly journals The fourth decade of life: the age for preventive strategies?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Cuschieri
Keyword(s):  
Type 2 Diabetes ◽  
Multiple Logistic Regression Analysis ◽  
Age Groups ◽  
Overweight And Obesity ◽  
Health Examination ◽  
Preventive Strategies ◽  
Preventive Action ◽  
Starting Point ◽  
Fourth Decade

Abstract Background Non-communicable diseases (NCDs) have been on the health agenda for decades. As the 2020's decade sets in, most of the set health strategies and targets are ending while new goals are expected. Investigating a European country hub known for its high prevalence of NCDs provides evidence-based data that can be used for these new strategies. The aim was to explore potential NCDs trends and associations that could provide evidence for new preventive strategies and goals. Methods Data was obtained from a national representative cross-sectional study through a health examination survey (2014-6). The self-reported data and the results of the examination were used to diagnose participants with type 2 diabetes, dyslipidaemia, hypertension, overweight and obesity. The study population was stratified by ten years and sex for both descriptive and analytic analyses. Results The male population was significantly more metabolically unhealthy that the female counterparts across all age groups (p = &lt;0.01). The females had the highest newly diagnosed diabetes prevalence across all age groups. It was observed that type 2 diabetes, dyslipidaemia and hypertension were present as of the 30-39 years group. Conversely, on binary multiple logistic regression analysis, this age group was negatively associated with NCDs even after adjusting for confounders (Diabetes OR:0.06 CI95%:0.02-0.21 p = &lt;0.01; hypertension OR: 0.16 CI 95%: 0.05-0.55 p = &lt;0.01; overweight OR: 0.21 CI 95%: 0.11 - 0.40 p = &lt;0.01). Conclusions The fourth decade of life might be the starting point for metabolic dysregulation. Hence, subject to long-term health and economic burdens, with a potential extension of the metabolic impact on their offspring. Although further research is recommended, this study sets the ball rolling whether preventive action including screening for dysglycaemia and dyslipidaemia should be implemented at a population level from a young age. Key messages Preventive action should start from fourth decade of life. Targeting the fourth decade of life would also ensure a healthier new generation.

scholarly journals Significance of African Diets in Biotherapeutic Modulation of the Gut Microbiome

2021 ◽  
Vol 15 ◽  
pp. 117793222110126
Author(s):  
PO Isibor ◽  
PA Akinduti ◽  
OS Aworunse ◽  
JO Oyewale ◽  
O Oshamika ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Immune Cell ◽  
Inflammatory Responses ◽  
Brown Rice ◽  
Well Being ◽  
Population Characteristics ◽  
Sub Saharan Africa ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Diet plays an essential role in human development and growth, contributing to health and well-being. The socio-economic values, cultural perspectives, and dietary formulation in sub-Saharan Africa can influence gut health and disease prevention. The vast microbial ecosystems in the human gut frequently interrelate to maintain a healthy, well-coordinated cellular and humoral immune signalling to prevent metabolic dysfunction, pathogen dominance, and induction of systemic diseases. The diverse indigenous diets could differentially act as biotherapeutics to modulate microbial abundance and population characteristics. Such modulation could prevent stunted growth, malnutrition, induction of bowel diseases, attenuated immune responses, and mortality, particularly among infants. Understanding the associations between specific indigenous African diets and the predictability of the dynamics of gut bacteria genera promises potential biotherapeutics towards improving the prevention, control, and treatment of microbiome-associated diseases such as cancer, inflammatory bowel disease, obesity, type 2 diabetes, and cardiovascular disease. The dietary influence of many African diets (especially grain-base such as millet, maize, brown rice, sorghum, soya, and tapioca) promotes gut lining integrity, immune tolerance towards the microbiota, and its associated immune and inflammatory responses. A fibre-rich diet is a promising biotherapeutic candidate that could effectively modulate inflammatory mediators’ expression associated with immune cell migration, lymphoid tissue maturation, and signalling pathways. It could also modulate the stimulation of cytokines and chemokines involved in ensuring balance for long-term microbiome programming. The interplay between host and gut microbial digestion is complex; microbes using and competing for dietary and endogenous proteins are often attributable to variances in the comparative abundances of Enterobacteriaceae taxa. Many auto-inducers could initiate the process of quorum sensing and mammalian epinephrine host cell signalling system. It could also downregulate inflammatory signals with microbiota tumour taxa that could trigger colorectal cancer initiation, metabolic type 2 diabetes, and inflammatory bowel diseases. The exploitation of essential biotherapeutic molecules derived from fibre-rich indigenous diet promises food substances for the downregulation of inflammatory signalling that could be harmful to gut microbiota ecological balance and improved immune response modulation.

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