Impact of malnutrition on systemic immune and metabolic profiles in type 2 diabetes

Abstract Background While obesity and overweight status are firmly established risk factors for Type 2 diabetes mellitus (T2DM), a substantial proportion of diabetic individuals, especially in Africa and Asia, are often underweight or normal weight. However, very little is known about the immunological and metabolic profiles of these individuals. Methods This study aimed to assess the relationship between malnutrition and Type 2 diabetes mellitus (T2DM). We examined a variety of analytes associated with the immunological and metabolic profiles of T2DM individuals with low (< 18.5 kg/m2) or normal (18.5–24.9 kg/m2) body mass index (BMI). To this end, we measured plasma levels of HbA1c, glucose, insulin, glucagon, adipocytokines and Type 1, Type 2, Type 17, pro-inflammatory and regulatory cytokines in T2DM individuals with low BMI (LBMI) or normal BMI (NBMI) with small sample size n = 44 in each group. Results LBMI individuals exhibited significantly higher levels of HbA1c, random blood glucose, insulin and glucagon compared to NBMI individuals. Similarly, LBMI individuals exhibited significantly higher levels of adiponectin and adipsin and significantly lower levels of leptin in comparison to NBMI individuals. LBMI individuals also exhibited significantly lower levels of the Type 1, Type 2, Type 17, pro-inflammatory and regulatory cytokines in comparison to NBMI individuals. Finally, while the metabolic parameters exhibited a significant negative correlation with BMI, the immunological parameters exhibited a significant positive correlation with BMI. Conclusions Malnutrition is associated with a significant modulation of glycemic, hormonal and cytokine parameters in T2DM. Hence, the biochemical and immunological profiles of T2DM is significantly influenced by BMI.

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Erroneous reduction of HbA1c levels in patients with type 2 diabetes mellitus on dapsone treatment for Hansen’s disease - a single-center retrospective cohort study

Indian Journal of Dermatology Venereology and Leprology ◽

10.25259/ijdvl_527_18 ◽

2021 ◽

Vol 0 ◽

pp. 1-4

Author(s):

G. S. Basavaraj ◽

Riddhi Das Gupta ◽

Bhavesh Patel ◽

Felix Jebasingh ◽

Anu Anna George ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Small Sample Size ◽

Small Sample ◽

Hansen's Disease ◽

Glucose Levels ◽

Hansen’S Disease ◽

Hba1c Levels

Background: Dapsone treatment may reduce HbA1c levels in patients with diabetes. Aims: To assess the prevalence and characteristics of dapsone associated reduction of HbA1c in patients with Hansen’s disease. Methods: A retrospective data review of outpatient and inpatient charts of consecutive patients with Hansen’s disease and type 2 diabetes mellitus was conducted over two years from January 2014 to January 2016 at the Department of Dermatology, CMC Vellore, India. Results: Of the 245 patients with a confirmed diagnosis of Hansen’s disease who were on oral dapsone 100 mg/day as part of their treatment regimen, 49 patients had diabetes and were eligible for the study as per predetermined inclusion criteria. Of these, 35 subjects (71%) had an HbA1c discordantly lower than the corresponding mean plasma glucose levels. Patients with discordant HbA1c levels were more likely to be male and to have a higher RBC mean corpuscular volume (MCV). A greater reduction in HbA1c levels was seen during the initial 3 months of therapy of dapsone treatment. Limitations: The small sample size and retrospective design were limitations of this study. Also, we did not analyze the role of methemoglobinemia or the utility of alternative measures of glycemic control in these patients. Conclusion: We describe a high prevalence of dapsone associated inappropriate HbA1c lowering in type 2 diabetes mellitus patients. This may have serious implications for the management of diabetes in patients on therapy with dapsone.

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Lack of Evidence Linking Infant Feeding Regimen and Type 1 or Type 2 Diabetes Mellitus

PEDIATRICS ◽

10.1542/peds.137.supplement_3.237a ◽

2016 ◽

Vol 137 (Supplement 3) ◽

pp. 237A-237A

Author(s):

Robin S. Feldman ◽

Michael Falk ◽

Kathy A. Grako ◽

Dawn A. Groenke ◽

Allison Cooke ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Infant Feeding ◽

Feeding Regimen

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Faculty Opinions recommendation of Exocrine pancreatic insufficiency in type 1 and type 2 diabetes mellitus: do we need to treat it? A systematic review.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.733293123.793567383 ◽

2019 ◽

Author(s):

Chris Forsmark

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Pancreatic Insufficiency ◽

Exocrine Pancreatic Insufficiency

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958: Congenital malformation rates in a contemporary cohort with type 1 and type 2 diabetes mellitus

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2019.11.969 ◽

2020 ◽

Vol 222 (1) ◽

pp. S595

Author(s):

Robert Martin ◽

Elaine Duryea ◽

Anne Ambia ◽

Angela R. Seasely ◽

Donald D. McIntire ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Congenital Malformation

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Hunger sensation in patients with compensated and uncompensated type 1 and type 2 Diabetes Mellitus

International Journal of Eating Disorders ◽

10.1002/(sici)1098-108x(199607)20:1<85::aid-eat10>3.0.co;2-i ◽

1996 ◽

Vol 20 (1) ◽

pp. 85-98 ◽

Cited By ~ 5

Author(s):

Pietro Cugini ◽

Giuseppe Fatati ◽

Anna Paggi ◽

Stefano Coaccioli ◽

Francesca Paci ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Hunger Sensation

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Insulin Dose Adjustment Following Bariatric Surgery, a Review of Available Literature

Journal of Diabetes Science and Technology ◽

10.1177/19322968211028886 ◽

2021 ◽

pp. 193229682110288

Author(s):

Lynn E. Kassel ◽

Jessica J. Berei ◽

Jamie M. Pitlick ◽

Joel E. Rand

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Bariatric Surgery ◽

Type 2 Diabetes Mellitus ◽

Dose Adjustment ◽

Insulin Dose ◽

Appraisal Tool

Bariatric surgery is a known and effective treatment for type 2 diabetes mellitus. Patients with type 1 diabetes mellitus and exogenous insulin-requiring type 2 diabetes mellitus require adjusted insulin dosing after surgery to avoid hypoglycemia. This review describes insulin dose adjustments following a variety of bariatric procedures. After searching the available literature and assessing for eligibility, 8 articles were included. The Johns Hopkins Research Evidence Appraisal Tool for literature appraisal was used. The results of this review reveal insulin dose adjustment varies based upon surgical procedure type and time of follow-up from the procedure.

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