Prediabetes and Adolescence—Trends, Causes, Effects, and Screening

2016 ◽  
Vol 12 (02) ◽  
pp. 94 ◽  
Author(s):  
Charikleia Stefanaki ◽  
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Homeostasis ◽  
Dietary Habits ◽  
Early Recognition ◽  
Adult Life ◽  
Lifestyle Changes ◽  
Oral Glucose ◽  
Oral Glucose Tolerance Testing ◽  
Diabetes Onset

I ntermediate hyperglycemia, or prediabetes, is increasing worldwide, affecting people of all ages, including adolescents. Hormonal, physiological, psychological, and lifestyle changes in adolescence have been associated with disruptions in glucose homeostasis, such as decreased insulin sensitivity, insulin resistance, or the combination of both. As a rule, glucose homeostasis is ameliorated, in normal subjects, when puberty is completed. However, in susceptible individuals, like obese adolescents, or adolescents with a strong genetic background, there is a progression to type 2 diabetes onset. Thus, susceptible adolescents should be screened for prediabetes, using fasting plasma glucose, and glycated hemoglobin (HbA1c), and oral glucose tolerance testing. Prediabetic adolescents should be counseled for a healthy lifestyle including healthy dietary habits, increased physical activity, and/or stress management. Other pathological conditions should be adequately treated. Early recognition of prediabetes in adolescence will prevent type 2 diabetes onset, decreasing the diabetes-associated health burden in adult life. This review aims to revise the associations and elucidate on the gaps between prediabetes and adolescence, via a comprehensive review of the current medical literature.

scholarly journals Vertical Sleeve Gastrectomy Improves Glucose and Lipid Metabolism and Delays Diabetes Onset in UCD-T2DM Rats

Endocrinology ◽  
2012 ◽  
Vol 153 (8) ◽  
pp. 3620-3632 ◽  
Author(s):  
Bethany P. Cummings ◽  
Ahmed Bettaieb ◽  
James L. Graham ◽  
Kimber L. Stanhope ◽  
Mark Kowala ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Tolerance ◽  
University Of California ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Vertical Sleeve Gastrectomy ◽  
Diabetes Onset ◽  
Oral Glucose Tolerance Tests ◽  
Glucose Tolerance Tests

Vertical sleeve gastrectomy (VSG) has gained interest as a low morbidity bariatric surgery, which is effective in producing weight loss and causing type 2 diabetes resolution. However, the efficacy of VSG to prevent the onset of type 2 diabetes has not been previously investigated. VSG or sham surgery was performed on 2-month-old prediabetic male University of California Davis-type 2 diabetes mellitus rats. Sham-operated animals were either sham-operated ad libitum fed (S-AL) or were weight-matched to VSG-operated animals (S-WM). Diabetes onset was determined by weekly nonfasting blood glucose measurements. Animals underwent oral glucose tolerance tests at 1 and 4 months after surgery and indirect calorimetry at 1.5 months after surgery. VSG surgery significantly delayed diabetes onset compared with both S-AL and S-WM animals. VSG-operated animals ate 23% less and weighed 20% less than S-AL. Energy expenditure did not differ between VSG-operated animals and controls. Results from the oral glucose tolerance tests demonstrate improved glucose tolerance and islet function in VSG-operated animals compared with S-AL and S-WM. Nutrient-stimulated glucagon-like peptide (GLP)-1, GLP-2, and peptide YY excursions were greater in VSG-operated animals. VSG surgery resulted in decreased fasting plasma insulin, ghrelin and lipid concentrations, and markedly higher fasting plasma adiponectin and bile acid concentrations, independent of body weight. Increases of circulating bile acid concentrations were due to selective increases of taurine-conjugated bile acids. Thus, VSG delays type 2 diabetes onset in the University of California Davis-type 2 diabetes mellitus rat, independent of body weight. This is potentially mediated by increases of circulating bile acids, adiponectin, and nutrient-stimulated GLP-1 secretion and decreased circulating ghrelin concentrations.

scholarly journals Gut Microbiome of Indonesian Adults Associated with Obesity and Type 2 Diabetes: A Cross-Sectional Study in an Asian City, Yogyakarta

2021 ◽  
Vol 9 (5) ◽  
pp. 897
Author(s):  
Phatthanaphong Therdtatha ◽  
Yayi Song ◽  
Masaru Tanaka ◽  
Mariyatun Mariyatun ◽  
Maisaroh Almunifah ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bile Acids ◽  
Gut Microbiome ◽  
Dietary Habits ◽  
Lifestyle Changes ◽  
Farnesoid X Receptor ◽  
Triangular Distribution ◽  
Obese People ◽  
Obesity And Diabetes

Indonesia is a developing country facing the national problem of the growing obesity and diabetes in its population due to recent drastic dietary and lifestyle changes. To understand the link between the gut microbiome, diet, and health of Indonesian people, fecal microbiomes and metabolomes of 75 Indonesian adults in Yogyakarta City, including obese people (n = 21), type 2 diabetes (T2D) patients (n = 25), and the controls (n = 29) were characterized together with their dietary and medical records. Variations of microbiomes showed a triangular distribution in the principal component analysis, driven by three dominant bacterial genera, namely Bacteroides, Prevotella, and Romboutsia. The Romboutsia-driven microbiome, characterized by low bacterial diversity and high primary bile acids, was associated with fat-driven obesity. The Bacteroides-driven microbiome, which counteracted Prevotella but was associated with Ruminococcaceae concomitantly increased with high-carbohydrate diets, showed positive correlation with T2D indices but negative correlation with body mass index. Notably, Bacteroides fragilis was increased in T2D patients with a decrease in fecal conjugated bile acids, particularly tauroursodeoxycholic acid (TUDCA), a farnesoid X receptor (FXR) antagonist with anti-diabetic activity, while these features disappeared in patients administered metformin. These results indicate that the gut microbiome status of Indonesian adults is differently associated with obesity and T2D under their varied dietary habits.

scholarly journals A Pathophysiology of Type 2 Diabetes Unrelated to Metabolic Syndrome

2021 ◽  
Author(s):  
Marietta Rottenkolber ◽  
Christina Gar ◽  
Cornelia Then ◽  
Lorena Wanger ◽  
Vanessa Sacco ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Cardiopulmonary Exercise Testing ◽  
Liver Fat ◽  
Oral Glucose ◽  
Healthy Controls ◽  
Antibody Testing ◽  
Oral Glucose Tolerance Testing ◽  
Incident Cases

Abstract Objective Clinically, type 2 diabetes mellitus (T2DM) is heterogeneous, but the prevailing pathophysiologic hypothesis nevertheless contends that components of metabolic syndrome are central to all cases of T2DM. Here, we reevaluated this hypothesis. Research Design and Methods We conducted a cross-sectional analysis of 138 women from the monocenter, post gestational diabetes study PPSDiab, 73 of which had incident prediabetes or T2DM. Additionally, we examined all the 412 incident cases of T2DM in phases 3-9 of the Whitehall II Study in comparison to healthy controls. Our analysis included a medical history, anthropometrics, oral glucose tolerance testing, and laboratory chemistry in both studies. Additional analyses from the PPSDiab Study consisted of cardiopulmonary exercise testing, magnetic resonance imaging, auto-antibody testing, and the exclusion of glucokinase maturity-onset diabetes of the young. Results We found that 33 (45%) of the women with prediabetes or T2DM in the PPSDiab Study displayed no components of metabolic syndrome. They reached no point for metabolic syndrome in the NCEP ATP3 score other than hyperglycemia and, moreover, had levels of liver fat content, plasma triglycerides, hdl cholesterol, c-reactive protein, and blood pressure that were comparable to healthy controls. In the Whitehall II Study, 62 (15%) of the incident T2DM cases fulfilled the same criteria. In both studies, these cases without metabolic syndrome revealed insulin resistance and inadequately low insulin secretion. Conclusions Our results contradict the hypothesis that components of metabolic syndrome are central to all cases of T2DM. Instead, they suggest the common occurrence of a second, unrelated pathophysiology.

scholarly journals Carbohydrate Intake Prior to Oral Glucose Tolerance Testing

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Klara R Klein ◽  
Christopher P Walker ◽  
Amber L McFerren ◽  
Halie Huffman ◽  
Flavio Frohlich ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Tolerance ◽  
Research Participant ◽  
Carbohydrate Intake ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Oral Glucose Tolerance Testing ◽  
Glucose Levels

Abstract With the emergence of glycated hemoglobin as a diagnostic test for diabetes, oral glucose tolerance tests (OGTTs) have become rare in endocrinology practice. As they have moved out of favor, the importance of patient instructions on preparation prior to OGTT has faded from memory. Decades-old literature, well-known to endocrinologists a generation ago, emphasized the importance of carbohydrate intake prior to OGTT. In this expert endocrine consult, we discuss an OGTT performed in a research setting without adequate carbohydrate intake at the evening meal prior to the OGTT. The resultant elevated plasma glucose levels at 1-hour and 2-hours mimicked the loss of first-phase insulin release seen in early type 1 and type 2 diabetes. With clinical concern that the research participant had evolving type 1 or type 2 diabetes, the volunteer was subjected to additional testing and experienced anxiety. Repeat OGTT was normal after adequate carbohydrate intake (>150 grams/day and >50 grams the evening prior to overnight fast for the study). The physiology of this phenomenon is explored and is likely mediated through beta cell adaptation and alteration in peripheral glucose uptake in response to nutrient exposure. The learnings of decades ago have clearly faded, and this literature should be revisited to ensure that OGTT results are not compromised when ordered for clinical or research purposes.

scholarly journals High-Fat Diet Accelerates Pathological Progression and Intestinal Inflammation in a Type 2 Diabetes Rodent Model

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A446-A446
Author(s):  
Austin Reilly ◽  
Hongxia Ren
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Pathway Analysis ◽  
Glucose Homeostasis ◽  
High Fat Diet ◽  
Intestinal Inflammation ◽  
Oral Glucose ◽  
Gi Tract ◽  
High Fat

Abstract Insulin signaling lowers postprandial glucose by stimulating cell surface translocation of the insulin sensitive glucose transporter 4 (GLUT4). In order to better understand how insulin resistance contributes to the pathophysiological progression of type 2 diabetes, we generated human GLUT4 promoter-driven insulin receptor knockout (GIRKO) mice and characterized their metabolic features relative to control mice. Although the role of insulin resistance in diabetes is beyond dispute, our previous studies showed that GIRKO mice fed normal chow diet (NCD) had an unexpectedly low rate of frank diabetes despite severe insulin resistance in muscle, fat, and brain. In the current study, we first sought to determine whether GIRKO mice would respond to high-fat diet (HFD) challenge with worsened glycemic outcome compared to control mice on HFD. Secondly, we sought to determine whether HFD-induced pathologies in GIRKO mice were caused by adaptations in the gastrointestinal (GI) tract and microbiome. We discovered that after beginning the HFD-feeding regimen, GIRKO mice rapidly developed hyperinsulinemia and hyperglycemia without excessive adiposity gain. Furthermore, GIRKO mice displayed dyslipidemia via increased hepatic lipid accumulation and serum lipid content. We used indirect calorimetry to characterize the metabolic features of single-housed mice. HFD-fed GIRKO mice had comparatively lower respiratory exchange ratio (RER), indicating relatively greater lipid metabolism compared to control mice on HFD. Despite having increased circulating incretins, GIRKO mice had impaired oral glucose tolerance and limited glucose-lowering benefit from Exendin-4 (Ex-4) injections. Since HFD promotes inflammation in the gastrointestinal (GI) tract, we performed gene expression analysis and pathway analysis of duodenal mRNAs to investigate whether inflammatory response, glucose transport, and lipid transport were altered in HFD-fed GIRKO mice. Among the top pathways discovered in pathway analysis were those involved with inflammatory signaling, carbohydrate transport, and xenobiotic metabolism, which supports that HFD-fed GIRKO mice have increased GI tract inflammation which may promote impaired glucose homeostasis. In conclusion, our studies suggest that HFD increased intestinal inflammation and exacerbated insulin resistance, which catalyzed the pathological progression of diabetes. Future studies are necessary to identify the molecular and cellular signaling pathways which culminate in frank diabetes, which may lead to therapeutic targets for regulating glucose homeostasis in the context of insulin resistance.

scholarly journals New Insights on the Interactions Between Insulin Clearance and the Main Glucose Homeostasis Mechanisms

2021 ◽  
Author(s):  
Roberto Bizzotto ◽  
Domenico Tricò ◽  
Andrea Natali ◽  
Amalia Gastaldelli ◽  
Elza Muscelli ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Glucose Homeostasis ◽  
Insulin Clearance ◽  
Oral Glucose ◽  
Β Cell ◽  
Euglycemic Clamp ◽  
Glucose Ingestion ◽  
Per Se

<i>Objective</i> Endogenous insulin clearance (EIC) is physiologically reduced at increasing insulin secretion rate (ISR). Computing EIC at the prevailing ISR does not distinguish the effects of hypersecretion from those of other mechanisms of glucose homeostasis. We aimed to measure EIC in standardized ISR conditions (i.e., at fixed ISR levels) and to analyze its associations with relevant physiologic factors. <p><i>Research Design and Methods</i> We estimated standardized EIC (EIC<sub>ISR</sub>) by mathematical modelling in 9 different studies with insulin and glucose infusions (N=2067). EIC<sub>ISR</sub> association with various traits was analyzed by stepwise multivariable regression, in studies with euglycemic clamp and OGTT (N=1410). We also tested whether oral glucose ingestion, as opposed to intravenous infusion, has an independent effect on EIC (N=1555).</p> <p><i>Results</i> Insulin sensitivity (as M/I from the euglycemic clamp) is the strongest determinant of EIC<sub>ISR</sub>, ~4 times more influential than insulin-resistance related hypersecretion. EIC<sub>ISR</sub> independently associates positively with M/I, fasting and mean OGTT glucose or type 2 diabetes, and β-cell glucose sensitivity, and negatively with African American or Hispanic race, female sex, and female age. With oral glucose ingestion, an ISR-independent ~10% EIC reduction is necessary to explain the observed insulin concentration profiles.</p> <p><i>Conclusions</i> Based on EIC<sub>ISR</sub>, we posit the existence of two adaptive processes involving insulin clearance: the first reduces EIC<sub>ISR</sub> with insulin resistance (not with higher BMI <i>per se</i>) and is more relevant than the concomitant hypersecretion; the second reduces EIC<sub>ISR</sub> with β-cell dysfunction. These processes are dysregulated in type 2 diabetes. Finally, oral glucose ingestion <i>per se</i> reduces insulin clearance.<br> </p>

scholarly journals Does supplementation with carnosine improve cardiometabolic health and cognitive function in patients with pre-diabetes and type 2 diabetes? study protocol for a randomised, double-blind, placebo-controlled trial

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017691 ◽  
Author(s):  
Estifanos Baye ◽  
Kirthi Menon ◽  
Maximilian PJ de Courten ◽  
Arul Earnest ◽  
James Cameron ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cognitive Function ◽  
Glucose Tolerance ◽  
Dietary Habits ◽  
Controlled Trial ◽  
Cardiometabolic Health ◽  
Control Group ◽  
Activity Measurement ◽  
Oral Glucose

IntroductionCarnosine, an over-the-counter food supplement, has a promising potential for the prevention and treatment of chronic diseases such as type 2 diabetes (T2DM), cardiovascular and neurodegenerative diseases through its anti-inflammatory, antiglycation, antioxidative and chelating effects. We have previously shown that supplementation with carnosine preserves insulin sensitivity and secretion in non-diabetic overweight and obese individuals. The effect of carnosine on cardiometabolic risk and related cognitive outcomes in patients with pre-diabetes and T2DM has thus far not been studied. We therefore aim to investigate whether supplementation with carnosine improves cardiometabolic health and cognitive function in patients with pre-diabetes and T2DM.Methods and analysisWe will employ a parallel design randomised controlled trial. Fifty participants with pre-diabetes (impaired fasting glycaemia and impaired glucose tolerance) and T2DM (with HbA1c level < 8%) aged between 18 to 70 years will be randomly assigned to the intervention or control group. At baseline, participants will undergo a medical review and series of tests including anthropometric measurements (body mass index, a dual X-ray absorptiometry and peripheral quantitative computed tomography scan), an oral glucose tolerance test, cardiovascular measurements (central blood pressure, endothelial function and arterial stiffness), cognitive function, physical activity measurement, heart rate variability and liver fibroscan as well as questionnaires to assess dietary habits, sleep quality, depression and quality of life. The intervention group will receive 2 g of carnosine daily in two divided doses while the control group will receive identical placebo capsules for 14 weeks. All baseline measurements will be repeated at the end of the intervention. The change in glycaemic, cardiovascular and cognitive parameters as well as other measures will be compared between the groups.Ethics and disseminationThis study is approved by the Human Research Ethics Committee of Monash Health and Monash University, Australia. The findings will be disseminated via peer-reviewed publications and conference presentations.Trial registrationNCT02917928; Pre-results.

scholarly journals Synthesis, Spectral Characterization, and Biochemical Evaluation of Antidiabetic Properties of a New Zinc-Diosmin Complex Studied in High Fat Diet Fed-Low Dose Streptozotocin Induced Experimental Type 2 Diabetes in Rats

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Veerasamy Gopalakrishnan ◽  
Subramanian Iyyam Pillai ◽  
Sorimuthu Pillai Subramanian
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Homeostasis ◽  
High Fat Diet ◽  
Low Dose ◽  
Diabetic Rats ◽  
Spectral Studies ◽  
Oral Glucose ◽  
High Fat ◽  
Experimental Type

In view of the established antidiabetic properties of zinc, the present study was aimed at evaluating the hypoglycemic properties of a new zinc-diosmin complex in high fat diet fed-low dose streptozotocin induced experimental type 2 diabetes in rats. Zinc-diosmin complex was synthesized and characterized by various spectral studies. The complexation between zinc ions and diosmin was further evidenced by pH-potentiometric titrations and Job’s plot. Diabetic rats were orally treated with zinc-diosmin complex at a concentration of 20 mg/kg b.w./rat/day for 30 days. At the end of the experimental period, the rats were subjected to oral glucose tolerance test. In addition, HOMA-IR and various biochemical parameters related to glucose homeostasis were analyzed. Treatment with zinc-diosmin complex significantly improved the glucose homeostasis in diabetic rats. Treatment with zinc-diosmin complex significantly improved insulin sensitivity, at least in part, through enhancing protein metabolism and alteration in the levels of muscle and liver glycogen. The assay of clinical marker enzymes revealed the nontoxic nature of the complex. Determination of renal tissue markers such as blood urea and serum creatinine indicates the renoprotective nature of the complex. These findings suggest that zinc-diosmin complex is nontoxic and has complimentary potential to develop as an antihyperglycemic agent for the treatment of diabetes mellitus.

scholarly journals Irrational Beliefs, Dietary Habits and 10-Year Incidence of Type 2 Diabetes; the ATTICA Epidemiological Study (2002-2012)

2021 ◽  
Vol 17 (1) ◽  
pp. 38-49
Author(s):  
Christina Vassou ◽  
Mary Yannakoulia ◽  
Ekavi N. Georgousopoulou ◽  
Christina Chrysohoou ◽  
Christos Pitsavos ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Irrational Beliefs ◽  
Dietary Habits ◽  
Depressive Symptomatology ◽  
Hazard Ratio ◽  
Lifestyle Changes ◽  
Diabetes Incidence ◽  
Psychological Disturbance ◽  
Detailed Medical History

OBJECTIVE: The aim of this study was to evaluate the dietary habits and irrational beliefs of apparently healthy individuals in relation to their 10-year diabetes incidence. METHODS: The ATTICA study (2002-2012) is a prospective populationbased cohort study, in which 853 participants (453 men (aged 45 ± 13 years) and 400 women (aged 44 ± 18 years)) without a history of cardiovascular disease (CVD) underwent psychological evaluations. Among other things, participants completed the Irrational Beliefs Inventory (IBI, range 0-88), a brief, self-reported measure consistent with the Ellis model of psychological disturbance. Demographic characteristics, detailed medical history, and dietary and other lifestyle habits were evaluated as well. Diagnosis of diabetes at follow-up examination was based on the criteria of the American Diabetes Association. RESULTS: Mean IBI score was 53 ± 10 in men and 51± 11 in women (p = 0.68). IBI was positively associated with the 10-year type 2 diabetes incidence (hazard ratio: 1.14; 95% CI: 1.04-1.25) in both men and women, and even more distinctly associated with participants with the following characteristics: lower education status, married, overweight, smokers, anxiety and depressive symptomatology, and unhealthy dietary habits. Especially, participants with increased irrational beliefs and low adherence to the Mediterranean diet were 37% more likely to develop type 2 diabetes than those with the reverse status (hazard ratio: 3.70; 95% CI: 2.32-5.88). CONCLUSIONS: These data support the need for lifestyle changes towards healthier nutrition which can be achieved by educating people so that they are equipped to recognize false and unhelpful thoughts and thus to prevent negative psychological and clinical outcomes such as mental health disorders and type 2 diabetes.

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