Legacy of a 10-Year Multidomain Lifestyle Intervention on the Cognitive Trajectories of Individuals with Overweight/Obesity and Type 2 Diabetes Mellitus

2021 ◽  
pp. 1-13
Author(s):  
Kathleen M. Hayden ◽  
Rebecca H. Neiberg ◽  
Joni K. Evans ◽  
José A. Luchsinger ◽  
Owen Carmichael ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Lifestyle Intervention ◽  
Baseline Body Mass Index ◽  
Subgroup Analyses ◽  
History Of ◽  
Stroop Color Word Test ◽  
The Impact

<b><i>Introduction:</i></b> Weight loss and increased physical activity interventions are commonly recommended for individuals with type 2 diabetes (T2D) and overweight or obesity. We examined the impact of randomization to an intensive lifestyle intervention (ILI) on trajectories of cognitive function over 10 years in a cohort of participants in a randomized clinical trial who had T2D and overweight/obesity at baseline. <b><i>Methods:</i></b> Participants aged 45–76 years were enrolled in 2001–2004 and were randomized to the ILI or a diabetes support and education (DSE) condition. Cognitive function was assessed in 3,938 participants at up to 4 time points 8–18 years after randomization. General linear mixed effects models examined cognitive trajectories over time. Subgroup analyses focused on sex, individuals with baseline body mass index &#x3e;30, those carrying the <i>APOE</i> ε4 allele, and those with a baseline history of cardiovascular disease (CVD). <b><i>Results:</i></b> Overall, there were no differences in the rate of cognitive decline by intervention arm. Subgroup analyses showed that participants who had a baseline history of CVD and were randomized to the ILI arm of the study performed significantly worse on the Stroop Color Word Test than those in the DSE arm. <b><i>Discussion/Conclusions:</i></b> The ILI did not result in preserved cognitive function or slower rates of cognitive decline in this cohort of individuals who had T2D and were overweight or obese at baseline.

scholarly journals Finerenone Reduces Risk of Incident Heart Failure in Patients With Chronic Kidney Disease and Type 2 Diabetes: Analyses from the FIGARO-DKD Trial

Circulation ◽  
2021 ◽  
Author(s):  
Gerasimos Filippatos ◽  
Stefan D. Anker ◽  
Rajiv Agarwal ◽  
Luis M. Ruilope ◽  
Peter Rossing ◽  
...  
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Lower Risk ◽  
Cardiovascular Death ◽  
History Of ◽  
The Impact ◽  
New Onset

Background: Chronic kidney disease (CKD) and type 2 diabetes (T2D) are independently associated with heart failure (HF), a leading cause of morbidity and mortality. In the FIDELIO-DKD and FIGARO DKD trials, finerenone (a selective, nonsteroidal mineralocorticoid receptor antagonist) improved cardiovascular outcomes in patients with albuminuric CKD and T2D. These prespecified analyses from FIGARO-DKD assessed the impact of finerenone on clinically important HF outcomes. Methods: Patients with T2D and albuminuric CKD (urine albumin-to-creatinine ratio [UACR] ≥30 to <300 mg/g and estimated glomerular filtration rate [eGFR] ≥25 to ≤90 ml/min/1.73 m 2 , or UACR ≥300 to ≤5000 mg/g and eGFR ≥60 ml/min/1.73 m 2 ,), without symptomatic HF with reduced ejection fraction, were randomized to finerenone or placebo. Time-to-first event outcomes included: new-onset HF (first hospitalization for HF [HHF] in patients without a history of HF at baseline); cardiovascular death or first HHF; HF-related death or first HHF; first HHF; cardiovascular death or total (first or recurrent) HHF; HF-related death or total HHF; and total HHF. Outcomes were evaluated in the overall population and in prespecified subgroups categorized by baseline HF history (as reported by the investigators). Results: Overall, 7352 patients were included in these analyses; 571 (7.8%) had a history of HF at baseline. New-onset HF was significantly reduced with finerenone versus placebo (1.9% versus 2.8%; hazard ratio [HR], 0.68 [95% CI 0.50-0.93]; P =0.0162). In the overall population, the incidences of all HF outcomes analyzed were significantly lower with finerenone than placebo, including a 18% lower risk of cardiovascular death or first HHF (HR, 0.82 [95% CI 0.70-0.95]; P =0.011), a 29% lower risk of first HHF (HR, 0.71 [95% CI 0.56-0.90]; P =0.0043) and a 30% lower rate of total HHF (rate ratio, 0.70 [95% CI, 0.52- 0.94]). The effects of finerenone on improving HF outcomes were not modified by a history of HF. The incidence of treatment-emergent adverse events was balanced between treatment groups. Conclusions: The results from these FIGARO-DKD analyses demonstrate that finerenone reduces new-onset HF and improves other HF outcomes in patients with CKD and T2D, irrespective of a history of HF.

scholarly journals Gestational Diabetes Mellitus and the Risks of Overall and Type-Specific Cardiovascular Diseases: A Population- and Sibling-Matched Cohort Study

2021 ◽  
Author(s):  
Yongfu Yu ◽  
Melissa Soohoo ◽  
Henrik Toft Sørensen ◽  
Jiong Li ◽  
Onyebuchi A. Arah
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Cox Regression ◽  
Maternal History ◽  
History Of ◽  
The Impact

<b>OBJECTIVE</b> <p>To evaluate associations between gestational diabetes mellitus (GDM) and various incident cardiovascular disease (CVD) endpoints, considering the effects of mediating role of type 2 diabetes and shared environmental/familial factors.</p> <p><b>RESEARCH DESIGN AND METHODS</b></p> <p>This population-based cohort study included 1002486 parous women in Denmark during 1978-2016. We used Cox regression to (i) examine the associations of GDM with overall and type-specific CVDs using full-cohort and sibling-matched analysis; (ii) quantify the impact of type 2 diabetes after GDM using mediation analysis; and (iii) assess whether these associations were modified by pre-pregnancy obesity or maternal history of CVD.</p> <p><b>RESULTS</b></p> <p>Women with a history of GDM had a 40% increased overall CVD risk (hazard ratio [HR]: 1.40, 95% confidence interval [CI]: 1.35-1.45). Sibling-matched analyses yielded similar results(HR, 1.44; 95%CI, 1.28-1.62). Proportion of association between GDM and overall CVD explained by subsequent type 2 diabetes was 23.3%(15.4%-32.8%). We observed increased risks of specific CVDs, including 65% increased stroke risk and more than two-fold risks for myocardial infarction, heart failure, and peripheral artery disease. The elevated overall risks were more pronounced among women with GDM and pre-pregnancy obesity or maternal history of CVD. </p> <p><b>CONCLUSIONS</b></p> <p>A history of GDM was associated with increased risks of overall and specific CVDs. Increased risks were partly explained by subsequent type 2 diabetes and the need to identify other pathways remains important. Continuous monitoring of women with a history of GDM, especially those with pre-pregnancy obesity or maternal history of CVD, may provide better opportunities to reduce their cardiovascular risk.</p>

scholarly journals Does Intensive Glucose Control Prevent Cognitive Decline in Diabetes? A Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Carlos Peñaherrera-Oviedo ◽  
Daniel Moreno-Zambrano ◽  
Michael Palacios ◽  
María Carolina Duarte-Martinez ◽  
Carlos Cevallos ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Decline ◽  
Glucose Control ◽  
Meta Analysis ◽  
Tight Glucose Control ◽  
Intensive Glucose Control ◽  
Type 2 Diabetics ◽  
The Impact

Diabetes mellitus is associated with cognitive decline and impaired performance in cognitive function tests among type 1 and type 2 diabetics. Even though the use of tight glucose control has been limited by a reported higher mortality, few reports have assessed the impact of treatment intensity on cognitive function. We conducted a meta-analysis to evaluate if an intensive glucose control in diabetes improves cognitive function, in comparison to standard therapy. We included 7 studies that included type 1 or type 2 diabetics and used standardized tests to evaluate various cognitive function domains. Standardized mean differences (SMDs) were calculated for each domain. We found that type 1 diabetics get no cognitive benefit from a tight glucose control, whereas type 2 diabetics get some benefit on processing speed and executive domains but had worse performances in the memory and attention domains, along with a higher incidence of mortality when using intensive glucose control regimes.

scholarly journals Gestational Diabetes Mellitus and the Risks of Overall and Type-Specific Cardiovascular Diseases: A Population- and Sibling-Matched Cohort Study

2021 ◽  
Author(s):  
Yongfu Yu ◽  
Melissa Soohoo ◽  
Henrik Toft Sørensen ◽  
Jiong Li ◽  
Onyebuchi A. Arah
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Cox Regression ◽  
Maternal History ◽  
History Of ◽  
The Impact

<b>OBJECTIVE</b> <p>To evaluate associations between gestational diabetes mellitus (GDM) and various incident cardiovascular disease (CVD) endpoints, considering the effects of mediating role of type 2 diabetes and shared environmental/familial factors.</p> <p><b>RESEARCH DESIGN AND METHODS</b></p> <p>This population-based cohort study included 1002486 parous women in Denmark during 1978-2016. We used Cox regression to (i) examine the associations of GDM with overall and type-specific CVDs using full-cohort and sibling-matched analysis; (ii) quantify the impact of type 2 diabetes after GDM using mediation analysis; and (iii) assess whether these associations were modified by pre-pregnancy obesity or maternal history of CVD.</p> <p><b>RESULTS</b></p> <p>Women with a history of GDM had a 40% increased overall CVD risk (hazard ratio [HR]: 1.40, 95% confidence interval [CI]: 1.35-1.45). Sibling-matched analyses yielded similar results(HR, 1.44; 95%CI, 1.28-1.62). Proportion of association between GDM and overall CVD explained by subsequent type 2 diabetes was 23.3%(15.4%-32.8%). We observed increased risks of specific CVDs, including 65% increased stroke risk and more than two-fold risks for myocardial infarction, heart failure, and peripheral artery disease. The elevated overall risks were more pronounced among women with GDM and pre-pregnancy obesity or maternal history of CVD. </p> <p><b>CONCLUSIONS</b></p> <p>A history of GDM was associated with increased risks of overall and specific CVDs. Increased risks were partly explained by subsequent type 2 diabetes and the need to identify other pathways remains important. Continuous monitoring of women with a history of GDM, especially those with pre-pregnancy obesity or maternal history of CVD, may provide better opportunities to reduce their cardiovascular risk.</p>

619-P: The Impact of Type 2 Diabetes Mellitus Risk Perception on Adoption of Preventive Strategies in Women with a History of Gestational Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 619-P
Author(s):  
AMANDA V. VU ◽  
NORMAN TURK ◽  
O. KENRIK DURU ◽  
CAROL MANGIONE ◽  
HEMALI PANCHAL ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Risk Perception ◽  
Gestational Diabetes ◽  
Preventive Strategies ◽  
History Of ◽  
Diabetes Mellitus Risk ◽  
The Impact

scholarly journals The Association Between Plasma Fatty Acid and Cognitive Function Mediated by Inflammation in Patients With Type 2 Diabetes

2021 ◽  
Author(s):  
Jingyi Shen ◽  
Kaifeng Li ◽  
Huiyan Yu ◽  
Bingjie Ding ◽  
Rong Xiao ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Fatty Acids ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Protective Factor ◽  
Chinese Patients ◽  
Enzyme Linked Immunosorbent Assay ◽  
Plasma Fatty Acids ◽  
Patients With Diabetes

Abstract Background High fat diet may lead to systematic inflammation in patients with type 2 diabetes, which eventually result in neuronal damage and cognitive decline. However, there is a paucity of study examined whether inflammation mediated the association between diet fatty acids and cognitive function in type 2 patients with diabetes. Methods We evaluated the cognitive function of 372 Chinese patients with diabetes, using the mini-mental state examination (MMSE) and the montreal cognitive assessment (MoCA). Plasma fatty acids were measured by gas chromatography analysis. Inflammatory cytokines were determined by immune turbidimetric analysis and enzyme-linked immunosorbent assay (ELISA). Data was analyzed using multiple linear regression based on R program and mediation model was established by Mplus. Results In our study, we found the increasing of BMI may lead to cognitive impairment and induce inflammatory response. We also found higher SFAs levels in plasma were linked to cognitive decline, while higher MUFAs intake might be a protective factor for cognitive function. In addition, most PUFAs levels stood out as having increasing trends that were positively correlated to cognitive function scores, but n-6 PUFAs gave opposite results. In our study, we found higher SFAs led to higher proinflammatory factor levels. Apart from that, MUFAs, SCD-16 and SCD-18 were positively related to hs-CRP. Interestingly, we found PUFAs were negatively related to IL-10. Meanwhile, this result also indicated that C18:0 might reduce MoCA language skills scores by regulating plasma IL-10 levels. Conclusions Plasma fatty acids could improve or damage cognitive function by regulating IL-10, which suggested that plasma fatty acids can be evaluated as a potential indicator of cognitive function decline in 2 type diabetes.

The impact of family history of type 2 diabetes on pancreatic β-cell function

2009 ◽  
Vol 86 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Zhi-hong Wang ◽  
Su-Hua Zhang ◽  
Li-lin Gong ◽  
Wei Ren ◽  
Rong Li ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Family History ◽  
Cell Function ◽  
Pancreatic Β Cell ◽  
Β Cell ◽  
Β Cell Function ◽  
History Of ◽  
The Impact
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