scholarly journals Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes

2006 ◽  
Vol 154 (6) ◽  
pp. 899-906 ◽  
Author(s):  
D Kapoor ◽  
E Goodwin ◽  
K S Channer ◽  
T H Jones
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Fasting Blood Glucose ◽  
Glycated Haemoglobin ◽  
Visceral Adiposity ◽  
Testosterone Replacement Therapy ◽  
Fasting Insulin ◽  
Testosterone Therapy

Objective: Low levels of testosterone in men have been shown to be associated with type 2 diabetes, visceral adiposity, dyslipidaemia and metabolic syndrome. We investigated the effect of testosterone treatment on insulin resistance and glycaemic control in hypogonadal men with type 2 diabetes. Design: This was a double-blind placebo-controlled crossover study in 24 hypogonadal men (10 treated with insulin) over the age of 30 years with type 2 diabetes. Methods: Patients were treated with i.m. testosterone 200 mg every 2 weeks or placebo for 3 months in random order, followed by a washout period of 1 month before the alternate treatment phase. The primary outcomes were changes in fasting insulin sensitivity (as measured by homeostatic model index (HOMA) in those not on insulin), fasting blood glucose and glycated haemoglobin. The secondary outcomes were changes in body composition, fasting lipids and blood pressure. Statistical analysis was performed on the delta values, with the treatment effect of placebo compared against the treatment effect of testosterone. Results: Testosterone therapy reduced the HOMA index (−1.73 ± 0.67, P = 0.02, n = 14), indicating an improved fasting insulin sensitivity. Glycated haemoglobin was also reduced (−0.37 ± 0.17%, P = 0.03), as was the fasting blood glucose (−1.58 ± 0.68 mmol/l, P = 0.03). Testosterone treatment resulted in a reduction in visceral adiposity as assessed by waist circumference (−1.63 ± 0.71 cm, P = 0.03) and waist/hip ratio (−0.03 ± 0.01, P = 0.01). Total cholesterol decreased with testosterone therapy (−0.4 ± 0.17 mmol/l, P = 0.03) but no effect on blood pressure was observed. Conclusions: Testosterone replacement therapy reduces insulin resistance and improves glycaemic control in hypogonadal men with type 2 diabetes. Improvements in glycaemic control, insulin resistance, cholesterol and visceral adiposity together represent an overall reduction in cardiovascular risk.

scholarly journals KORELASI INDEKS 20/(C-PEPTIDE PUASA×GLUKOSA DARAH PUASA) DENGAN HOMA-IR UNTUK MENILAI RESISTENSI INSULIN DIABETES MELITUS TIPE 2

2016 ◽  
Vol 38 (4) ◽  
pp. 155
Author(s):  
Elsi Kelana ◽  
Ellyza Nasrul ◽  
Rismawati Yaswir ◽  
Desywar Desywar
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Insulin Secretion ◽  
Blood Glucose ◽  
Pearson Correlation ◽  
Fasting Blood Glucose ◽  
Biological Response ◽  
Fasting Insulin ◽  
C Peptide

AbstrakResistensi insulin merupakan penurunan respons biologis jaringan terhadap insulin dalam kadar normal. Pada DM tipe 2 terjadi resistensi dan gangguan sekresi insulin. Terdapat indeks baru 20/(C-peptide puasa x glukosa darah puasa) untuk menilai resistensi sekaligus gangguan sekresi insulin. Penelitian bertujuan membuktikan korelasi indeks 20/(C-peptide puasa x glukosa darah puasa) dengan HOMA-IR untuk menilai resistensi insulin pada DM tipe 2 di RSUP. Dr. M. Djamil Padang. Dengan menggunakan sampel darah dari pasien, kadar glukosa darah puasa, insulin puasa dan C-peptide puasa ditentukan. Data yang diperoleh kemudian dianalisis menggunakan korelasi Pearson. Hasil penelitian menunjukkan rerata kadar glukosa puasa 9,83 (3,53) mmol/L [177 (63,54) mg/dL], insulin puasa 10,58 (3,61) μU/L, dan C-peptide puasa 0,97 (0,29) nmol/L dan terdapat korelasi yang sangat kuat dan bermakna secara statistik (p<0,0001) antara indeks 20/(C-peptide puasa x glukosa darah puasa) dengan HOMA-IR (r= -0,838). Dapat disimpulkan bahwa indeks 20/(C-peptide puasa x glukosa darah puasa) dan HOMA–IR berkorelasi kuat untuk menilai resistensi insulin pada DM tipe 2 di RSUP. Dr. M. Djamil Padang.AbstractInsulin resistance is a decrease of biological response of the tissues to the normal level of insulin. In type 2 diabetes, there is resistance and impaired of insulin secretion. There is a new index available to assess resistance and impaired of insulin secretion all at once, with the formula 20/(fasting C-peptide x fasting blood glucose). This study aimed to prove the correlation of this new index to the HOMA-IR (Homeostasis model assesment of insulin resistance) in type 2 diabetes at Dr.M.Djamil Padang hospital. Level of fasting glucose, fasting insulin and fasting C-peptide of blood were measured, followed by statistical data analysis using Pearson correlation test.The result showed the mean of fasting blood glucose, fasting insulin and fasting C-peptide were 9.83 (3.53) mmol/L[177 (63.54) mg/dl], 10.58 (3.61) μU/L, and 0.97 (0.29) nmol/L respectively.There was a strong and statistically significant correlation (p<0.0001) found between the new index and the HOMA-IR ( r= -0.838). To be concluded, the index 20/(fasting C-peptide x fasting blood glucose) and HOMA-IR was strongly correlated to assess insulin resistance in type 2 diabetes at Dr. M. Djamil Padang hospital.

scholarly journals Visceral Adiposity Index is associated with Insulin Resistance, impaired Insulin Secretion, and β-cell dysfunction in subjects at risk for Type 2 Diabetes

2021 ◽  
pp. 100013
Author(s):  
Froylan David Martínez-Sánchez ◽  
Valerie Paola Vargas-Abonce ◽  
Andrea Rocha-Haro ◽  
Romina Flores-Cardenas ◽  
Milagros Fernández-Barrio ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
At Risk ◽  
Insulin Secretion ◽  
Visceral Adiposity ◽  
Visceral Adiposity Index ◽  
Β Cell ◽  
Cell Dysfunction ◽  
Impaired Insulin

scholarly journals The Effects of Almonds on Gut Microbiota, Glycometabolism, and Inflammatory Markers in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3377
Author(s):  
Omorogieva Ojo ◽  
Xiao-Hua Wang ◽  
Osarhumwese Osaretin Ojo ◽  
Amanda Rodrigues Amorim Adegboye
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Gut Microbiota ◽  
Inflammatory Markers ◽  
Meta Analysis ◽  
Fasting Blood Glucose ◽  
Glycated Haemoglobin ◽  
Postprandial Blood Glucose

The use of nutritional interventions for managing diabetes is one of the effective strategies aimed at reducing the global prevalence of the condition, which is on the rise. Almonds are the most consumed tree nut and they are known to be rich sources of protein, monounsaturated fatty acids, essential minerals, and dietary fibre. Therefore, the aim of this review was to evaluate the effects of almonds on gut microbiota, glycometabolism, and inflammatory parameters in patients with type 2 diabetes. Methods: This systematic review and meta-analysis was carried out according to the preferred reporting items for systematic review and meta-analysis (PRISMA). EBSCOhost, which encompasses the Health Sciences Research Databases; Google Scholar; EMBASE; and the reference lists of articles were searched based on population, intervention, control, outcome, and study (PICOS) framework. Searches were carried out from database inception until 1 August 2021 based on medical subject headings (MesH) and synonyms. The meta-analysis was carried out with the Review Manager (RevMan) 5.3 software. Results: Nine randomised studies were included in the systematic review and eight were used for the meta-analysis. The results would suggest that almond-based diets have significant effects in promoting the growth of short-chain fatty acid (SCFA)-producing gut microbiota. Furthermore, the meta-analysis showed that almond-based diets were effective in significantly lowering (p < 0.05) glycated haemoglobin (HbA1c) levels and body mass index (BMI) in patients with type 2 diabetes. However, it was also found that the effects of almonds were not significant (p > 0.05) in relation to fasting blood glucose, 2 h postprandial blood glucose, inflammatory markers (C-reactive protein and Tumour necrosis factor α, TNF-α), glucagon-like peptide-1 (GLP-1), homeostatic model assessment of insulin resistance (HOMA–IR), and fasting insulin. The biological mechanisms responsible for the outcomes observed in this review in relation to reduction in HbA1c and BMI may be based on the nutrient composition of almonds and the biological effects, including the high fibre content and the low glycaemic index profile. Conclusion: The findings of this systematic review and meta-analysis have shown that almond-based diets may be effective in promoting short-chain fatty acid-producing bacteria and lowering glycated haemoglobin and body mass index in patients with type 2 diabetes compared with control. However, the effects of almonds were not significant (p > 0.05) with respect to fasting blood glucose, 2 h postprandial blood glucose, inflammatory markers (C-reactive protein and TNF-α), GLP-1, HOMA–IR, and fasting insulin.

scholarly journals Increased erythrocyte- and platelet-derived microvesicles in newly diagnosed type 2 diabetes mellitus

2019 ◽  
Vol 16 (5) ◽  
pp. 458-465 ◽  
Author(s):  
Eugenia Gkaliagkousi ◽  
Barbara Nikolaidou ◽  
Eleni Gavriilaki ◽  
Antonios Lazaridis ◽  
Efthalia Yiannaki ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Fasting Blood Glucose ◽  
Glycated Haemoglobin ◽  
Newly Diagnosed ◽  
Advanced Glycation ◽  
Glycation End Products ◽  
End Products

Aim: To investigate the thrombotic microenvironment in early stages of type 2 diabetes mellitus measuring platelet-derived, endothelial-derived and erythrocyte-derived microvesicles. Methods: We recruited 50 newly diagnosed type 2 diabetes mellitus patients who did not receive glucose-lowering treatment except for metformin and 25 matched non-type 2 diabetes mellitus volunteers. Microvesicles were measured with flow cytometry, glycated haemoglobin with high-performance liquid chromatography and advanced glycation end products with enzyme-linked immunosorbent assay. Results: Type 2 diabetes mellitus patients showed significantly higher levels of platelet-derived microvesicles [195/μL (115–409) vs 110/μL (73–150), p = 0.001] and erythrocyte-derived microvesicles [26/μL (9–100) vs 9/μL (4–25), p = 0.007] compared to non-type 2 diabetes mellitus individuals. Platelet-derived microvesicles were positively associated with fasting blood glucose ( p = 0.026) and glycated haemoglobin ( p = 0.002). Erythrocyte-derived microvesicles were also positively associated with fasting blood glucose ( p = 0.018) but not with glycated haemoglobin ( p = 0.193). No significant association was observed between platelet-derived microvesicles ( p = 0.126) or erythrocyte-derived microvesicles ( p = 0.857) and advanced glycation end products. Erythrocyte-derived microvesicles predicted the presence of type 2 diabetes mellitus, independently of platelet-derived microvesicles. Conclusion: In newly diagnosed type 2 diabetes mellitus, ongoing atherothrombosis is evident during the early stages as evidenced by increased microvesicles levels. Furthermore, the association with glycemic profile suggests that microvesicles represent not only a novel mechanism by which hyperglycemia amplifies thrombotic tendency in type 2 diabetes mellitus but also early markers of thrombosis highlighting the need for earlier management of hyperglycemia.

scholarly journals Glycaemic control in type 2 diabetes patients and its predictors: a retrospective database study at a tertiary care diabetes centre in Ningbo, China

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e019697 ◽  
Author(s):  
Jialin Li ◽  
Kaushik Chattopadhyay ◽  
Miao Xu ◽  
Yanshu Chen ◽  
Fangfang Hu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Rural Areas ◽  
Tertiary Care ◽  
Fasting Blood Glucose ◽  
Information Management System ◽  
Cross Sectional ◽  
Poor Glycaemic Control

ObjectivesThe objectives of the study were to assess glycaemic control in patients with type 2 diabetes (T2DM) at a tertiary care diabetes centre in Ningbo, China and to determine factors that independently predict their glycaemic control.DesignRetrospective cross-sectional study using an existing database, the Diabetes Information Management System.SettingTertiary care diabetes centre in Ningbo, China.ParticipantsThe study included adult patients with T2DM, registered and received treatment at the diabetes centre for at least six consecutive months. The study inclusion criteria were satisfied by 1387 patients, from 1 July 2012 to 30 June 2017.Primary outcome measureGlycaemic control (poor was defined as glycated haemoglobin (HbA1c)>=7% or fasting blood glucose (FBG)>7.0 mmol/L).ResultsIn terms of HbA1c and FBG, the 5-year period prevalence of poor glycaemic control was 50.3% and 57.3%, respectively. In terms of HbA1c and FBG, the odds of poor glycaemic control increased with the duration of T2DM (>1 to 2 years: OR 1.84, 95% CI 1.06 to 3.19; >2 to 4 years: 3.32, 1.88 to 5.85 and >4 years: 5.98, 4.09 to 8.75 and >1 to 2 years: 2.10, 1.22 to 3.62; >2 to 4 years: 2.48, 1.42 to 4.34 and >4 years: 3.34, 2.32 to 4.80) and were higher in patients residing in rural areas (1.68, 1.24 to 2.28 and 1.42, 1.06 to 1.91), with hyperlipidaemia (1.57, 1.12 to 2.19 and 1.68, 1.21 to 2.33), on diet, physical activity and oral hypoglycaemic drug (OHD) as part of their T2DM therapeutic regimen (1.80, 1.01 to 3.23 and 2.40, 1.36 to 4.26) and on diet, physical activity, OHD and insulin (2.47, 1.38 to 4.41 and 2.78, 1.58 to 4.92), respectively.ConclusionsMore than half of patients with T2DM at the diabetes centre in Ningbo, China have poor glycaemic control, and the predictors of glycaemic control were identified. The study findings could be taken into consideration in future interventional studies aimed at improving glycaemic control in these patients.

scholarly journals Comparison of Metformin and Repaglinide Monotherapy in the Treatment of New Onset Type 2 Diabetes Mellitus in China

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
J. Ma ◽  
L. Y. Liu ◽  
P. H. Wu ◽  
Y. Liao ◽  
T. Tao ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cell Function ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Glycated Haemoglobin ◽  
Diabetic Patients ◽  
Newly Diagnosed ◽  
Type 2 Diabetic Patients ◽  
New Onset

Objective. This study was designed to compare the effects of metformin and repaglinide on the fasting plasma glucose (FPG) and glycated haemoglobin (HbA1c) in newly diagnosed type 2 diabetes in China.Methods. A total of 107 newly diagnosed type 2 diabetic patients (46 women and 61 men) participated in the study. All patients received 3-month treatment of metformin or repaglinide. Fasting blood glucose and HbA1c were determined at baseline and at the end of the 3-month of treatment.Results. FPG and HbA1c decreased in both metformin and repaglinide groups after 3 months treatment (P<0.01). The reduction of HbA1c was significantly greater in the repaglinide group(P<0.01). Metformin decreases fasting insulin concentration and HOMA-IR(P<0.01), and repaglinide improves HOMA-β  (P<0.01). Triglycerides (TG) were reduced in both groups(P<0.01in metformin group;P<0.05in repaglinide group), but total cholesterol (TC) and low-density lipoprotein (LDL) were decreased only after metformin treatment(P<0.05).Conclusions. Both repaglinide and metformin were effective in glycaemic control in new onset patients with type 2 diabetes in China. Repaglinide had no effect on insulin sensitivity, but it improvedβ-cell function.

scholarly journals Serum concentrations of asprosin in new-onset type 2 diabetes

2020 ◽  
Author(s):  
Shakiba Naiemian ◽  
Mohsen naeemipour ◽  
Mehdi Zarei ◽  
Ali Gohari ◽  
Mohammad Reza Behroozikhah ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Model Assessment ◽  
Serum Concentrations ◽  
Atherosclerotic Risk Factor

Abstract Background: Asprosin, a newly identified adipokine, is pathologically increased in individuals with insulin resistance. However, the available evidence on the association of asprosin and type 2 diabetes mellitus (T2DM) status is still scarce. Therefore, this study aimed to determine the relationship between serum concentrations of asprosin and T2DM status . Methods: This observational study was performed based on 194 adults (97 newly diagnosed T2DM and 97 healthy individuals). Anthropometric and biochemical variables were determined in all participants . Serum concentrations of asprosin were measured using enzyme-linked immunosorbent assay (ELISA). Results: In patients with T2DM, the serum concentrations of asprosin were significantly higher than the healthy controls (4.18 [IQR: 4.4] vs. 3.5 [IQR: 1.85], P< 0.001). The concentrations of asprosin were significantly correlated with body mass index (BMI) and fasting blood glucose (FBG) in healthy subjects and with BMI, FBG, hemoglobin A1c (HbA1c), homeostatic model assessment of insulin resistance (HOMA-IR), and quantitative insulin check index (QUICKI), triacylglycerol (TAG) and total cholesterol/ high-density lipoprotein cholesterol (TC/HDL-C) ratio in the T2DM group. In fully adjusted model, the odds ratio (OR) of T2DM with serum concentrations of asprosin was approximately 1.547 (95% CI 1.293-1.850, P< 0.001) compared to the control group . Multiple stepwise regression analysis indicated that FBG and HOMA-IR were independently associated with asprosin in T2DM. Conclusion : Our findings indicated that serum concentrations of asprosin are increased in patients with T2DM. Also, asprosin is correlated with insulin resistance and TC/HDL-C ratio (atherosclerotic risk factor of cardiovascular diseases) in patients with T2DM.

scholarly journals Impact of pharmacist-led care on glycaemic control of patients with uncontrolled type 2 diabetes: a randomised controlled trial in Nigeria

2021 ◽  
Vol 19 (3) ◽  
pp. 2402
Author(s):  
Emmanuel A. David ◽  
Rebecca O. Soremekun ◽  
Isaac O. Abah ◽  
Roseline I. Aderemi-Williams
Keyword(s):  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Usual Care ◽  
Usual Care Group ◽  
Intervention Group ◽  
Glycated Haemoglobin ◽  
Care Group ◽  
Laboratory Parameters ◽  
Randomised Controlled

Background: Diabetes mellitus is a chronic, degenerative disease, requiring a multi-dimensional, multi-professional care by healthcare providers and substantial self-care by the patients, to achieve treatment goals. Objective: To evaluate the impact of pharmacist-led care on glycaemic control in patients with uncontrolled Type 2 Diabetes Methods: In a parallel group, single-blind randomised controlled study; type 2 diabetic patients, with greater than 7% glycated haemoglobin (A1C) were randomised into intervention and usual care groups and followed for six months. Glycated haemoglobin analyzer, lipid analyzer and blood pressure monitor/apparatus were used to measure patients’ laboratory parameters at baseline and six months. Intervention group patients received pharmacist-structured care, made up of patient education and phone calls, in addition to usual care. In an intention to treat analysis, Mann-Whitney U test was used to compare median change at six months in the primary (A1C) and secondary outcome measures. Effect size was computed and proportion of patients that reached target laboratory parameters were compared in both arms. Results: All enrolled participants (108) completed the study, 54 in each arm. Mean age was 51 (SD 11.75) and majority were females (68.5%). Participants in the intervention group had significant reduction in A1C of -0.75%, compared with an increase of 0.15% in the usual care group (p<0.001; eta-square= 0.144). The proportion of those that achieved target A1C of <7% at 6 months in the intervention and usual care group was 42.6% vs 20.8% (p=0.02). Furthermore, intervention patients were about 3 times more likely to have better glucose control; A1C<7% (aOR 2.72, 95%CI: 1.14-6.46) compared to usual care group, adjusted for sex, age, and duration of diabetes. Conclusions: Pharmacist-led care significantly improved glycaemic control in patients with uncontrolled T2DM.

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