scholarly journals Antipsychotics and glucose metabolism: how brain and body collide

2019 ◽  
Vol 316 (1) ◽  
pp. E1-E15 ◽  
Author(s):  
Chantel Kowalchuk ◽  
Laura N. Castellani ◽  
Araba Chintoh ◽  
Gary Remington ◽  
Adria Giacca ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Gain ◽  
Glucose Metabolism ◽  
First Generation ◽  
Clinical Evidence ◽  
Mental Illnesses ◽  
Therapeutic Effects ◽  
Direct Effects ◽  
Increased Risk

Since the serendipitous discovery of the first antipsychotic (AP) drug in the 1950s, APs remain the cornerstone of treatment for schizophrenia. A shift over the past two decades away from first-generation, conventional APs to so-called “atypical” (or 2nd/3rd generation) APs parallels acknowledgment of serious metabolic side-effects associated in particular with these newer agents. As will be reviewed, AP drugs and type 2 diabetes are now inextricably linked, contributing to the three- to fivefold increased risk of type 2 diabetes observed in schizophrenia. However, this association is not straightforward. Biological and lifestyle-related illness factors contribute to the association between type 2 diabetes and metabolic disease independently of AP treatment. In addition, APs have a well-established weight gain propensity which could also account for elevated risk of insulin resistance and type 2 diabetes. However, compelling preclinical and clinical evidence now suggests that these drugs can rapidly and directly influence pathways of glucose metabolism independently of weight gain and even in absence of psychiatric illness. Mechanisms of these direct effects remain poorly elucidated but may involve central and peripheral antagonism of neurotransmitters implicated not only in the therapeutic effects of APs but also in glucose homeostasis, possibly via effects on the autonomic nervous system. The clinical relevance of studying “direct” effects of these drugs on glucose metabolism is underscored by the widespread use of these medications, both on and off label, for a growing number of mental illnesses, extending safety concerns well beyond schizophrenia.

scholarly journals Potential of Creatine in Glucose Management and Diabetes

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 570
Author(s):  
Marina Yazigi Solis ◽  
Guilherme Giannini Artioli ◽  
Bruno Gualano
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glucose Metabolism ◽  
Exercise Training ◽  
Creatine Supplementation ◽  
Small Scale ◽  
Therapeutic Effects ◽  
Glucose Management

Creatine is one of the most popular supplements worldwide, and it is frequently used by both athletic and non-athletic populations to improve power, strength, muscle mass and performance. A growing body of evidence has been identified potential therapeutic effects of creatine in a wide variety of clinical conditions, such as cancer, muscle dystrophy and neurodegenerative disorders. Evidence has suggested that creatine supplementation alone, and mainly in combination with exercise training, may improve glucose metabolism in health individuals and insulin-resistant individuals, such as in those with type 2 diabetes mellitus. Creatine itself may stimulate insulin secretion in vitro, improve muscle glycogen stores and ameliorate hyperglycemia in animals. In addition, exercise induces numerous metabolic benefits, including increases in insulin-independent muscle glucose uptake and insulin sensitivity. It has been speculated that creatine supplementation combined with exercise training could result in additional improvements in glucose metabolism when compared with each intervention separately. The possible mechanism underlying the effects of combined exercise and creatine supplementation is an enhanced glucose transport into muscle cell by type 4 glucose transporter (GLUT-4) translocation to sarcolemma. Although preliminary findings from small-scale trials involving patients with type 2 diabetes mellitus are promising, the efficacy of creatine for improving glycemic control is yet to be confirmed. In this review, we aim to explore the possible therapeutic role of creatine supplementation on glucose management and as a potential anti-diabetic intervention, summarizing the current knowledge and highlighting the research gaps.

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 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 Exercise prevents whole-body type 2 diabetes risk factors better than estradiol replacement in rats

2021 ◽  
Author(s):  
Luke J. Fritsch ◽  
Skylar J. McCaulley ◽  
Colton R. Johnson ◽  
Nicholaus J. Lawson ◽  
Brittany K. Gorres-Martens
Keyword(s):  
Type 2 Diabetes ◽  
Weight Gain ◽  
Protein Expression ◽  
Molecular Mechanisms ◽  
Body Weight Gain ◽  
Serum Insulin ◽  
Whole Body ◽  
Body Type ◽  
Increased Risk

Introduction: The absence of estrogens in postmenopausal women is linked to an increased risk of type 2 diabetes (T2D), and estradiol replacement can decrease this risk. Notably, exercise can also treat and prevent T2D. This study seeks to understand the molecular mechanisms by which estradiol and exercise induce their beneficial effects via assessing whole-body and cellular changes. Methods: Female Wistar rats were ovariectomized and fed a high-fat diet for 10 weeks and divided into the following 4 experimental groups: 1) no treatment (control), 2) exercise (Ex), 3) estradiol replacement, and 4) Ex+estradiol. Results: Both Ex and estradiol decreased the total body weight gain. However, only exercise effectively reduced the white adipose tissue (WAT) weight gain, food intake, blood glucose levels and serum insulin levels. At the molecular level, exercise increased the non-insulin stimulated pAkt levels in the WAT. In the liver, estradiol increased the protein expression of ACC and FAS, and estradiol decreased the hepatic protein expression of LPL. In the WAT, estradiol and exercise increased the protein expression of ATGL. Conclusion: Exercise provides better protection against T2D when considering whole body measurements, which may be due to increased non-insulin stimulated pAkt in the WAT. However, at the cellular level, several molecular changes in fat metabolism and fat storage occurred in the liver and WAT with estradiol treatment.

scholarly journals The Correlation between Dietary Selenium Intake and Type 2 Diabetes: A Cross-Sectional Population-Based Study on North Chinese Adults

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Sultan Mehmood Siddiqi ◽  
Changhao Sun ◽  
Xiaoyan Wu ◽  
Imranullah Shah ◽  
Anam Mehmood
Keyword(s):  
Type 2 Diabetes ◽  
Logistic Regression ◽  
Glucose Metabolism ◽  
Linear Trend ◽  
Multivariate Logistic Regression Analysis ◽  
Cluster Sampling ◽  
Chinese Adults ◽  
Anthropometric Measures ◽  
Increased Risk

The relationship between selenium (Se) and type 2 diabetes (T2D) remains controversial. In previous animal and cell studies, Se was found to be insulin mimic and antidiabetic, whereas recent epidemiological and interventional trials have shown an unexpected association between high Se intake and increased risk of T2D. The present study aimed to investigate the significance of dietary Se and T2D in North Chinese adults. A large sample of the population was enrolled through cluster sampling in Northern China (N=8824). Information on basic characteristics, anthropometric measures, and dietary Se intake was collected from each subject for analysis. Multivariable logistic regression was used to investigate the association between dietary Se and T2D through adjusted odds ratio (OR) and the corresponding 95% confidence interval (CI). The average nutritional Se intake was 52.43 μg/day, and the prevalence of T2D was 20.4% in the studied population. The OR for developing T2D was 1.66 (95% CI: 1.38, 1.99; P for linear trend <0.005), comparing the highest to the lowest quintile of energy-adjusted Se intake in multivariate logistic regression analysis. The mediation analysis discovered that glucose metabolism (indicated by FBG and HbA1c) mediated this association. In conclusion, our research adds further support to the role of high dietary Se in the incidence of T2D. The results also suggested that this association was mediated by glucose metabolism.

scholarly journals The Measurement of Insulin Clearance

2020 ◽  
Author(s):  
Francesca Piccinini ◽  
Richard N. Bergman
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Metabolism ◽  
Animal Models ◽  
Measurement Methods ◽  
Insulin Clearance ◽  
Molar Ratio ◽  
Fundamental Aspect ◽  
C Peptide ◽  
Increased Risk

Insulin clearance has recently been highlighted as a fundamental aspect of glucose metabolism, as it has been hypothesized that its impairment could be related to an increased risk of developing type 2 diabetes. This review focuses on methods used to calculate insulin clearance: from the early surrogate indices employing C-peptide to insulin molar ratio, to direct measurement methods used in animal models, to modeling-based techniques to estimate the <i>components </i>of insulin clearance (hepatic versus extra-hepatic). The methods are explored and interpreted by critically highlighting advantages and limitations.

scholarly journals Metabolic and Nutritional Characteristics in Middle-Aged and Elderly Sarcopenia Patients with Type 2 Diabetes

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Qinghua He ◽  
Xiuzhi Wang ◽  
Caizhe Yang ◽  
Xiaoming Zhuang ◽  
Yanfen Yue ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Glucose Metabolism ◽  
Muscle Strength ◽  
Nutritional Status ◽  
Muscle Mass ◽  
Muscle Quality ◽  
Diabetic Patients ◽  
Increased Risk

Sarcopenia is considered to be a new complication of type 2 diabetes (T2DM) leading to increased risk of adverse outcome. We performed a survey to evaluate glucose metabolism and nutritional status in sarcopenia patients with T2DM. Diabetic participants aged ≥50 years were grouped into a probable sarcopenia group with low muscle strength ( n = 405 ) and a nonsarcopenia group with normal muscle strength ( n = 720 ) according to the revised recommendations from EWGSOP2 (2018). Compared to the controls, the probable sarcopenia participants were older and had lower waist-to-hip ratio and BMI, longer diabetes duration, higher fasting plasma glucose level and glycosylated hemoglobin (HbA1c), decreased estimated glomerular filtration rate and lower bone mineral content, lower fatless upper arm circumference, lower appendicular skeletal muscle mass index (ASMI), and muscle quality in both genders. Multivariable logistic regression analysis showed increased age, male, low BMI, and increased HbA1c, combined with diabetic nephropathy and decreased serum albumin levels, were risk factors associated with low muscle strength in diabetes patients. In conclusion, diabetic patients with sarcopenia had worse glucose metabolism and nutritional status, decreased renal function and reduced muscle quality ,and muscle mass with a greater likelihood of osteoporosis, who need an overall health management to improve outcomes. This clinical trial registration is registered with the Chinese Clinical Trial Registry, ChiCTR-EOC-15006901.

Sleep loss: a novel risk factor for insulin resistance and Type 2 diabetes

2005 ◽  
Vol 99 (5) ◽  
pp. 2008-2019 ◽  
Author(s):  
Karine Spiegel ◽  
Kristen Knutson ◽  
Rachel Leproult ◽  
Esra Tasali ◽  
Eve Van Cauter
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Weight Gain ◽  
Glucose Metabolism ◽  
Molecular Mechanisms ◽  
Sleep Loss ◽  
Obesity And Diabetes ◽  
Chronic Sleep

Chronic sleep loss as a consequence of voluntary bedtime restriction is an endemic condition in modern society. Although sleep exerts marked modulatory effects on glucose metabolism, and molecular mechanisms for the interaction between sleeping and feeding have been documented, the potential impact of recurrent sleep curtailment on the risk for diabetes and obesity has only recently been investigated. In laboratory studies of healthy young adults submitted to recurrent partial sleep restriction, marked alterations in glucose metabolism including decreased glucose tolerance and insulin sensitivity have been demonstrated. The neuroendocrine regulation of appetite was also affected as the levels of the anorexigenic hormone leptin were decreased, whereas the levels of the orexigenic factor ghrelin were increased. Importantly, these neuroendocrine abnormalities were correlated with increased hunger and appetite, which may lead to overeating and weight gain. Consistent with these laboratory findings, a growing body of epidemiological evidence supports an association between short sleep duration and the risk for obesity and diabetes. Chronic sleep loss may also be the consequence of pathological conditions such as sleep-disordered breathing. In this increasingly prevalent syndrome, a feedforward cascade of negative events generated by sleep loss, sleep fragmentation, and hypoxia are likely to exacerbate the severity of metabolic disturbances. In conclusion, chronic sleep loss, behavioral or sleep disorder related, may represent a novel risk factor for weight gain, insulin resistance, and Type 2 diabetes.

scholarly journals Comparative risk of new-onset diabetes following commencement of antipsychotics in New Zealand: a population-based clustered multiple baseline time series design

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e022984
Author(s):  
Olivia Currie ◽  
Jonathan Williman ◽  
Dee Mangin ◽  
Bianca McKinnon-Gee ◽  
Paul Bridgford
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Weight Gain ◽  
New Zealand ◽  
High Risk ◽  
Second Generation ◽  
Population Based ◽  
Increased Risk

ObjectiveNewer antipsychotics are increasingly prescribed off-label for non-psychotic ailments both in primary and secondary care settings, despite the purported risk of weight gain and development of type 2 diabetes mellitus. This study aims to determine any relationship between the development of clinically significant new-onset type 2 diabetes mellitus and novel antipsychotic use in New Zealand using hypnotic drugs as control.DesignA population-based clustered multiple baseline time series design.SettingRoutinely collected data from a complete national pharmaceutical database in New Zealand between 2005 and 2011.ParticipantsPatients aged 40–60 years in the year 2006 who were ever dispensed antipsychotics (exposure groups—first-generation antipsychotics, second-generation antipsychotics and antipsychotics with low, medium and high risk for weight gain) or hypnotics (control group) between 2006 and 2011.Main outcome measureFirst ever metformin dispensed to patients in each study group between 2006 and 2011 as proxy for development of clinically significant type 2 diabetes mellitus, no longer amendable by lifestyle modifications.ResultsPatients dispensed a second-generation antipsychotic had 1.49 times increased risk (95% CI 1.10 to 2.03, p=0.011) of subsequently commencing metformin. Patients dispensed an antipsychotic with high risk of weight gain also had a 2.41 times increased risk of commencing on metformin (95% CI 1.42 to 4.09, p=0.001).ConclusionsPatients dispensed a second-generation antipsychotic and antipsychotics with high risk of weight gain appear to be at increased risk of being secondarily dispensed metformin. Caution should be taken with novel antipsychotic use for patients with increased baseline risk of type 2 diabetes mellitus.

scholarly journals Maternal hypothyroidism in mice influences glucose metabolism in adult offspring

Diabetologia ◽  
2020 ◽  
Vol 63 (9) ◽  
pp. 1822-1835 ◽  
Author(s):  
Yasmine Kemkem ◽  
Daniela Nasteska ◽  
Anne de Bray ◽  
Paula Bargi-Souza ◽  
Rodrigo A. Peliciari-Garcia ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Metabolism ◽  
Beta Cell ◽  
Endocrine Pancreas ◽  
Adult Offspring ◽  
Deficient Diet ◽  
Altered Glucose ◽  
Increased Risk ◽  
The Impact

Abstract Aims/hypothesis During pregnancy, maternal metabolic disease and hormonal imbalance may alter fetal beta cell development and/or proliferation, thus leading to an increased risk for developing type 2 diabetes in adulthood. Although thyroid hormones play an important role in fetal endocrine pancreas development, the impact of maternal hypothyroidism on glucose homeostasis in adult offspring remains poorly understood. Methods We investigated this using a mouse model of hypothyroidism, induced by administration of an iodine-deficient diet supplemented with propylthiouracil during gestation. Results Here, we show that, when fed normal chow, adult mice born to hypothyroid mothers were more glucose-tolerant due to beta cell hyperproliferation (two- to threefold increase in Ki67-positive beta cells) and increased insulin sensitivity. However, following 8 weeks of high-fat feeding, these offspring gained 20% more body weight, became profoundly hyperinsulinaemic (with a 50% increase in fasting insulin concentration), insulin-resistant and glucose-intolerant compared with controls from euthyroid mothers. Furthermore, altered glucose metabolism was maintained in a second generation of animals. Conclusions/interpretation Therefore, gestational hypothyroidism induces long-term alterations in endocrine pancreas function, which may have implications for type 2 diabetes prevention in affected individuals.

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