Variability, mean, and baseline values of metabolic parameters in predicting the risk of type 2 diabetes

2022 ◽  
Author(s):  
Duong Duc Pham ◽  
Jaekyung Song ◽  
Yunwan Jeon ◽  
Ibrahimi Hajar ◽  
Chae Hun Leem
Keyword(s):  
Type 2 Diabetes ◽  
Density Lipoprotein ◽  
Tolerance Test ◽  
Metabolic Parameters ◽  
Sensitivity Analyses ◽  
Oral Glucose ◽  
Average Value ◽  
Hazard Ratios

Abstract Context Impact of baseline and alteration of metabolic parameters (MPs), including plasma glucose (PGs) testing, insulin resistance surrogates, and lipid profile and their mutual interactions on the development of type 2 diabetes (T2DM) has not been investigated systematically. Objective To access the association of the past variability (V), past mean (M), and the baseline (B) values of various MPs and their mutual interaction with the risk of T2DM. Design Longitudinal analysis from the Korean Genome and Epidemiology Study. Setting Community-based Participants 3829 non-diabetic participants with completed MPs measurements during three biannually visits were followed up over the next 10 years. Outcomes Incidence of T2DM during the follow up. Results Among predictors, PG concentrations measured during the oral glucose tolerance test were the most prominent T2DM determinants, in which the M of the average value of fasting PG, 1-h, and 2-h PGs had the strongest discriminative power (hazard ratios and 95% CI for an increment of SD: 3.00 (2.5–3.26), AUC: 0.82). The M values of MPs were superior to their B and V values in predicting T2DM, especially among post-load PGs. Various mutual interactions between indices and among MPs were found. The most consistent interactants were the M values of high-density lipoprotein cholesterol and the M and V values of fasting PG. The findings were similar in normal tolerance glucose participants and were confirmed by sensitivity analyses. Conclusion The post-load PGs, past alteration of measurements, and mutual interactions among indices of MPs are important risk factors for T2DM development.

scholarly journals Metformin use is associated with a lower risk of uterine leiomyoma in female type 2 diabetes patients

2019 ◽  
Vol 10 ◽  
pp. 204201881989515 ◽  
Author(s):  
Chin-Hsiao Tseng
Keyword(s):  
Type 2 Diabetes ◽  
Lower Risk ◽  
Uterine Leiomyoma ◽  
Sensitivity Analyses ◽  
Matched Pair ◽  
Diagnostic Code ◽  
Hazard Ratios ◽  
Diabetes Patients

Background: Whether metformin may reduce the risk of uterine leiomyoma in type 2 diabetes patients has not been investigated. This retrospective cohort study compared the risk of uterine leiomyoma in ever versus never users of metformin. Methods: Female patients with new-onset type 2 diabetes during 1999–2005 were enrolled from the reimbursement database of Taiwan’s National Health Insurance and followed up from 1 January 2006 until 31 December 2011. Analyses were conducted in a propensity score (PS) matched-pair cohort of 10,998 ever users and 10,998 never users of metformin. Hazard ratios were estimated by Cox regression incorporated with the inverse probability of treatment weighting using the PS. Results: A total of 321 never users and 162 ever users developed uterine leiomyoma during follow up, with respective incidence of 704.65 and 329.82 per 100,000 person-years. The overall hazard ratio was 0.467 (95% confidence interval: 0.387–0.564). The hazard ratios for the first (<23.3 months), second (23.3–53.1 months), and third (>53.1 months) tertiles of cumulative duration were 0.881 (0.685–1.132), 0.485 (0.367–0.642), and 0.198 (0.134–0.291), respectively; and were 0.751 (0.576–0.980), 0.477 (0.360–0.632), and 0.277 (0.198–0.386), respectively, for the first (<655,000 mg), second 655,000–1,725,500 mg), and third (>1,725,500) tertiles of cumulative dose. Sensitivity analyses after excluding users of sulfonylurea, users of estrogen, users of insulin, users of incretin-based therapies during follow up, patients with irregular drug refills, patients who discontinued the use of metformin, patients who received metformin prescription less than four times, or redefining uterine leiomyoma by using ‘diagnostic code’ plus ‘procedure codes’ consistently supported a lower risk of uterine leiomyoma in ever users of metformin. Conclusion: Metformin use is associated with a lower risk of uterine leiomyoma.

P5006Metformin reduces the risk of hospitalization for heart failure in type 2 diabetes patients: a retrospective cohort analysis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C H Tseng
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Cohort Analysis ◽  
Sensitivity Analyses ◽  
Matched Pair ◽  
Hazard Ratios ◽  
Reimbursement Database ◽  
Diabetes Patients

Abstract Background A beneficial effect of metformin on heart failure requires confirmation. Purpose To investigate whether metformin might affect the risk of heart failure hospitalization in type 2 diabetes patients. Methods Patients with new-onset type 2 diabetes during 1999–2005 were enrolled from the reimbursement database of Taiwan's National Health Insurance and followed until December 31, 2011. Analyses were conducted in a propensity score (PS) matched-pair cohort (42,367 ever users and 42,367 never users) and hazard ratios were estimated by Cox's hazard regression analysis incorporated with the inverse probability of treatment weighting using the PS. Results A total of 1,592 never users and 987 ever users were hospitalized for heart failure for the first time during follow-up, with a respective incidence of 843.34 and 499.18 per 100,000 person-years. The overall hazard ratio was 0.588 (95% confidence interval: 0.543–0.637), and the hazard ratios for the first (<29.13 months), second (29.13–61.63 months), and third (>61.63 months) tertiles of cumulative duration were 1.018 (0.914–1.135), 0.575 (0.511–0.647), and 0.340 (0.297–0.390), respectively. Sensitivity analyses conducted in an unmatched cohort before and after excluding patients who received an irregular refill of metformin or who were treated with incretin-based therapies during follow-up consistently supported such a protective effect of metformin on heart failure. Conclusion Metformin use is associated with a lower risk of hospitalization for heart failure. Acknowledgement/Funding The study was partly supported by the Ministry of Science and Technology (MOST 107-2221-E-002-129-MY3) of Taiwan.

scholarly journals Serum Uromodulin Is Associated With But Does Not Predict Type 2 Diabetes in Elderly KORA F4/FF4 Study Participants

2019 ◽  
Vol 104 (9) ◽  
pp. 3795-3802 ◽  
Author(s):  
Cornelia Then ◽  
Holger Then ◽  
Christa Meisinger ◽  
Margit Heier ◽  
Annette Peters ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Tolerance ◽  
Tolerance Test ◽  
Population Based ◽  
Oral Glucose ◽  
Linear Regression Models ◽  
Glucose Tolerance Status ◽  
Study Participants

AbstractAimsSerum uromodulin has recently emerged as promising biomarker for kidney function and was suggested to be associated with type 2 diabetes (T2D) in patients with coronary heart disease. Here, we analyzed the association of serum uromodulin with T2D in the population-based KORA F4/FF4 study.MethodsIn 1119 participants of the KORA F4 study aged 62 to 81 years, serum uromodulin was measured, and the association of serum uromodulin with T2D was assessed using logistic and linear regression models stratified for sex. After a mean follow-up time of 6.5 years, 635 participants where re-evaluated. Glucose tolerance status was determined by oral glucose tolerance test at baseline and at the follow-up examination except in cases of known T2D.ResultsSerum uromodulin was inversely associated with T2D in the crude analysis and after adjustment for age and body mass index in men (P < 0.001) and in women (P < 0.05). After further adjustment for estimated glomerular filtration rate, serum uromodulin was significantly inversely associated with T2D in men (P < 0.001) but not in women. Serum uromodulin was not associated with prediabetes after multivariate adjustment and did not predict T2D in men or in women after the follow-up time of 6.5 ± 0.3 years.ConclusionsIn participants of the KORA F4 study, serum uromodulin is independently associated with T2D in men but is not a predictor of future development of T2D.

scholarly journals Vitamin D and Incidence of Prediabetes or Type 2 Diabetes: A Four-Year Follow-Up Community-Based Study

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yun Gao ◽  
Tianpeng Zheng ◽  
Xingwu Ran ◽  
Yan Ren ◽  
Tao Chen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Community Based ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

Aim. To examine whether the baseline 25-hydroxyvitamin D [25(OH)D] level was predictive of the onset of prediabetes or type 2 diabetes (T2DM) in the Chinese population. Methods. This was a 4-year follow-up study that was conducted in the Chengdu region of China as part of the China National Diabetes and Metabolic Disorders Study. The study included 490 participants that were free of prediabetes and type 2 diabetes mellitus (T2DM) at baseline and had complete data by follow-up examinations. Glucose, insulin, and 25(OH)D levels were measured at baseline and at 4 years later. Prediabetes and T2DM were defined by results obtained from an oral glucose tolerance test. Results. Over a 4-year follow-up, 95 (48.5‰) developed prediabetes and 31 (15.8‰) individuals developed diabetes. Low 25(OH)D status was significantly associated with the risk of developing prediabetes [OR 3.01 (95% CI: 1.50–6.06), P=0.002] and T2DM [OR 5.61 (95% CI: 1.73–18.27), P=0.004] after adjustment for multiple potential confounders. In a multiple linear regression analysis, low baseline levels of 25(OH)D were an independent predictor of increased insulin resistance over a 4-year period (P<0.05). Conclusions. The current prospective study suggests that low 25(OH)D levels might have contributed to the incidence of prediabetes or T2DM in Chinese individuals. This trial is registered with TR-CCH-ChiCTR-OCS-09000361.

scholarly journals Impaired succinate response to a mixed meal in obesity and type 2 diabetes is normalized after metabolic surgery

2020 ◽  
Author(s):  
Brenno Astiarraga ◽  
Laia Martínez ◽  
Victoria Ceperuelo-Mallafré ◽  
Gemma Llauradó ◽  
Margarida Terrón-Puig ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Surgery ◽  
Healthy Subjects ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Glucose Sensing ◽  
Oral Glucose ◽  
One Year

<div><b><i>Objective</i></b> To explore the meal response of circulating succinate in patients with obesity and type 2 diabetes undergoing bariatric surgery, and to examine the role of gastrointestinal glucose sensing in succinate dynamics in healthy subjects. <b><i><br></i></b></div><div><b><i>Research Design and</i></b> <b><i>Methods</i></b> Cohort I comprised 45 patients with morbid obesity and type 2 diabetes (BMI 39.4±1.9 kg/m<sup>2</sup>) undergoing metabolic surgery. Cohort II was a confirmatory cohort of 13 patients (BMI 39.3±1.4 kg/m<sup>2</sup>) undergoing gastric bypass surgery. Cohort III comprised 15 healthy subjects (BMI 26.4±0.5 kg/m<sup>2</sup>). Cohorts I and II completed a 2-hour meal tolerance test (MTT) before the intervention and at one-year of follow-up, and cohort II also completed a 3-hour lipid test (LT). Cohort III underwent a 3-hour oral glucose tolerance test (OGTT) and an isoglycemic variable glucose infusion (ISO) study. </div> <p><b><i>Results</i></b><i> </i>In cohort I, succinate response to MTT at follow-up was greater than before the intervention (p<0.0001). This response was confirmed in cohort II with a greater increase after one year of surgery (p=0.009). By contrast, LT did not elicit a succinate response. Changes in succinate response were associated with changes in the area under the curve of glucose (r=0.417, p<0.0001) and insulin (r=0.204, p=0.002). In cohort III, glycemia <i>per se</i> stimulated a plasma succinate response (p=0.0004), but its response was greater in the OGTT (p=0.02; OGTT <i>versus</i> ISO). </p> <p><b><i>Conclusions</i></b><b> </b>The<b> </b>meal-related response of circulating succinate in patients with obesity and type 2 diabetes is recovered after metabolic surgery.</p>

scholarly journals Discovery of biomarkers for glycaemic deterioration before and after the onset of type 2 diabetes: an overview of the data from the epidemiological studies within the IMI DIRECT Consortium

2018 ◽  
Author(s):  
Robert W. Koivula ◽  
Ian M. Forgie ◽  
Azra Kurbasic ◽  
Ana Viñuela ◽  
Alison Heggie ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Adipose Tissue ◽  
Fasting Glucose ◽  
Tolerance Test ◽  
Glucose Regulation ◽  
Oral Glucose ◽  
Diabetes Research ◽  
Normal Glucose

Abstract/SummaryBackground and aims:Understanding the aetiology, clinical presentation and prognosis of type 2 diabetes (T2D) and optimizing its treatment might be facilitated by biomarkers that help predict a person’s susceptibility to the risk factors that cause diabetes or its complications, or response to treatment. The IMI DIRECT (Diabetes Research on Patient Stratification) Study is a European Union (EU) Innovative Medicines Initiative (IMI) project that seeks to test these hypotheses in two recently established epidemiological cohorts. Here, we describe the characteristics of these cohorts at baseline and at the first main follow-up examination (18-months).Materials and methods:From a sampling-frame of 24,682 European-ancestry adults in whom detailed health information was available, participants at varying risk of glycaemic deterioration were identified using a risk prediction algorithm and enrolled into a prospective cohort study (n=2127) undertaken at four study centres across Europe (Cohort 1: prediabetes). We also recruited people from clinical registries with recently diagnosed T2D (n=789) into a second cohort study (Cohort 2: diabetes). The two cohorts were studied in parallel with matched protocols. Endogenous insulin secretion and insulin sensitivity were modelled from frequently sampled 75g oral glucose tolerance (OGTT) in Cohort 1 and with mixed-meal tolerance tests (MMTT) in Cohort 2. Additional metabolic biochemistry was determined using blood samples taken when fasted and during the tolerance tests. Body composition was assessed using MRI and lifestyle measures through self-report and objective methods.Results:Using ADA-2011 glycaemic categories, 33% (n=693) of Cohort 1 (prediabetes) had normal glucose regulation (NGR), and 67% (n=1419) had impaired glucose regulation (IGR). 76% of the cohort was male, age=62(6.2) years; BMI=27.9(4.0) kg/m2; fasting glucose=5.7(0.6) mmol/l; 2-hr glucose=5.9(1.6) mmol/l [mean(SD)]. At follow-up, 18.6(1.4) months after baseline, fasting glucose=5.8(0.6) mmol/l; 2-hr OGTT glucose=6.1(1.7) mmol/l [mean(SD)]. In Cohort 2 (diabetes): 65% (n=508) were lifestyle treated (LS) and 35% (n=271) were lifestyle + metformin treated (LS+MET). 58% of the cohort was male, age=62(8.1) years; BMI=30.5(5.0) kg/m2; fasting glucose=7.2(1.4)mmol/l; 2-hr glucose=8.6(2.8) mmol/l [mean(SD)]. At follow-up, 18.2(0.6) months after baseline, fasting glucose=7.8(1.8) mmol/l; 2-hr MMTT glucose=9.5(3.3) mmol/l [mean(SD)].Conclusion:The epidemiological IMI DIRECT cohorts are the most intensely characterised prospective studies of glycaemic deterioration to date. Data from these cohorts help illustrate the heterogeneous characteristics of people at risk of or with T2D, highlighting the rationale for biomarker stratification of the disease - the primary objective of the IMI DIRECT consortium.Abbreviations:ASATAbdominal subcutaneous adipose tissueDIRECTDiabetes Research on Patient StratificationEUEuropean UnionMMTTMixed-meal tolerance testMRIMagnetic resonance imaginghpfVMHigh-pass filtered vector magnitudeIAATIntra-abdominal adipose tissueIGRImpaired glucose regulationIMIInnovative Medicines InitiativeMEmultiechoNGRNormal glucose regulationOGTTOral glucose tolerance testPAPhysical activityTAATTotal abdominal adipose tissueT2DType 2 Diabetes

scholarly journals Mechanisms of Antidiabetic Activity of Methanolic Extract of Punica granatum Leaves in Nicotinamide/Streptozotocin-Induced Type 2 Diabetes in Rats

Plants ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 1609
Author(s):  
Shinu Pottathil ◽  
Parminder Nain ◽  
Mohamed A. Morsy ◽  
Jaspreet Kaur ◽  
Bandar E. Al-Dhubiab ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Methanolic Extract ◽  
Density Lipoprotein ◽  
Punica Granatum ◽  
Tolerance Test ◽  
Daily Basis ◽  
Diabetic Rats ◽  
Antidiabetic Activity ◽  
Oral Glucose

The current study aimed to establish the mechanisms of antidiabetic activity of methanolic extract of Punica granatum leaves (MEPGL) in nicotinamide/streptozotocin-induced type 2 diabetes in rats. Phytochemical screening, HPLC analysis, and acute toxicity study of MEPGL were carried out. Various concentrations of MEPGL (100, 200, 400, and 600 mg/kg) were administered orally to diabetic rats for 45 days on a daily basis. The antidiabetic effect of MEPGL was examined by measuring blood glucose, plasma insulin, and glycated hemoglobin (HbA1c) levels, as well as with an oral glucose tolerance test. The antioxidant effect of MEPGL was determined by analyzing hepatic and renal antioxidant markers, namely superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), reduced glutathione (GSH), and lipid peroxidation. The other biochemical markers alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), urea, and creatinine, as well as total cholesterol, triglycerides, and high-density lipoprotein (HDL) were also studied. Type 2 diabetes significantly altered these parameters, while oral administration of the MEPGL significantly ameliorated them. Moreover, the pancreatic histopathological changes were attenuated with MEPGL treatment. In a nutshell, oral MEPGL administration in diabetic rats showed antidiabetic activity due to its antioxidant activity, most probably due to the gallic acid, ellagic acid, and apigenin found in MEPGL.

scholarly journals Association of risk variants for type 2 diabetes and hyperglycemia with gestational diabetes

2013 ◽  
Vol 169 (3) ◽  
pp. 291-297 ◽  
Author(s):  
Hanna Huopio ◽  
Henna Cederberg ◽  
Jagadish Vangipurapu ◽  
Heidi Hakkarainen ◽  
Mirja Pääkkönen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Secretion ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Nucleotide Polymorphisms ◽  
Risk Variants

ObjectiveThe aim of this study was to investigate the association of risk variants for type 2 diabetes (T2D) and hyperglycemia with gestational diabetes (GDM).Design and methodsFive hundred and thirty-three Finnish women who were diagnosed with GDM and 407 controls with normal glucose tolerance during the pregnancy were genotyped for 69 single-nucleotide polymorphisms (SNPs) which have been previously verified as susceptibility risk variants for T2D and hyperglycemia. All participants underwent an oral glucose tolerance test at the follow-up study after the index pregnancy.ResultsRisk variants rs10830963 and rs1387153 ofMTNR1Bwere significantly associated with GDM (odds ratio (OR)=1.62 (95% CI 1.34–1.96),P=4.5×10−7and 1.38 (1.14–1.66),P=7.6×10−4respectively). Both SNPs ofMTNR1Bwere also significantly associated with elevated fasting glucose level and reduced insulin secretion at follow-up. Additionally, risk variants rs9939609 ofFTO, rs2796441 ofTLE1, rs560887 ofG6PC2, rs780094 ofGCKR, rs7903146 ofTCF7L2and rs11708067 ofADCY5showed nominally significant associations with GDM (OR range from 1.25 to 1.30).ConclusionsOur study suggests that GDM and T2D share a similar genetic background. Our findings also provide further evidence that risk variants ofMTNR1Bare associated with GDM by increasing fasting plasma glucose and decreasing insulin secretion.

scholarly journals Incidence of type 2 diabetes in Mexico. Results of The Mexico City Diabetes  Study after 18 years of follow-up

2014 ◽  
Vol 56 (1) ◽  
pp. 11 ◽  
Author(s):  
Clicerio González-Villalpando ◽  
Claudio Alberto Dávila-Cervantes ◽  
Mireya Zamora-Macorra ◽  
Belem Trejo-Valdivia ◽  
María Elena González-Villalpando
Keyword(s):  
Type 2 Diabetes ◽  
Tolerance Test ◽  
Population Based ◽  
Mexican Population ◽  
Oral Glucose ◽  
The Mean ◽  
Incident Cases

 Objective. To estimate the incidence of type 2 diabetes (T2D) in Mexican population. Materials and methods. Population based prospective study. At baseline (1990), the population at risk (1939 non-diabetic adults 35-64 years) was evaluated with oral glucose tolerance test. Subsequent similar evaluations were done (1994, 1998, 2008). American Diabetes Association diagnostic criteria were applied. Re­sults. The period of observation was 27842 person-years, the cumulative incidence of T2D was 14.4 and 13.7 per 1000 person-years for men and women, respectively. Incidence was 15.8, 15.7 and 12.7 per 1 000 person-years for the second (1994), third (1998) and fourth (2008) follow-up phases, respectively. The mean age at diagnosis was 44 years for prevalent cases and 56 years for incident cases. Conclu­sions. This is the first estimate of long-term incidence of T2D in Mexican population. The incidence is among the highest reported worldwide. It remained with few changes throughout the study period.

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