scholarly journals Diabetes Type 2 in the Berlin Aging Study II: Prevalence, Incidence and Severity Over up to Ten Years of Follow-up

2021 ◽  
Author(s):  
Johanne Spieker ◽  
Valentin Max Vetter ◽  
Dominik Spira ◽  
Elisabeth Steinhagen-Thiessen ◽  
Vera Regitz-Zagrosek ◽  
...  
Keyword(s):  
Sex Differences ◽  
Older People ◽  
Operating Characteristics ◽  
Antidiabetic Medication ◽  
Diagnostic Laboratory ◽  
Laboratory Parameters ◽  
Aging Study ◽  
Incident Cases

Abstract Aim: To describe the prevalence, incidence, and severity of diabetes mellitus type 2 (T2D) and antidiabetic medication in older people and to assess the prognostic value of diagnostic laboratory parameters.Methods: Baseline data of 1,671 participants of the Berlin Aging Study II (68.8 ±3.7 years) and follow-up data assessed 7.4 ±1.5 years later were analysed. T2D was diagnosed based on self-report, antidiabetic medication use, laboratory parameters. T2D severity was determined by the diabetes complications severity index (DCSI). Prognostic capacity of laboratory parameters was evaluated by Receiver Operating Characteristics (ROC) and Areas Under the Curve (AUCs).Results: The proportion of participants with T2D increased from 12.9% (37.3% women) at baseline to 17.1% (41.1% women) with 74 incident cases and 22.2% not being aware of the disease at follow-up. More than half of the 41 newly identified incident T2D cases were diagnosed solely by the 2h-plasma glucose test (OGTT) and diagnosis based on OGTT as the only criterion among incident cases was found more frequently in women (p=0.028). The OGTT assessed at baseline predicted incident T2D less accurate in men (AUC: 0.671, 95% CI 0.570-0.771) when compared to women (AUC: 0.7893, 95% CI 0.7036-0.8751). No sex differences were detected with respect to antidiabetic medication used and T2D severity. Conclusions: A comprehensive picture of T2D with respect to prevalence, incidence, and severity in older people is provided. Clinically relevant sex differences in the capacity of the commonly used T2D diagnostic laboratory parameters to predict incident T2D on average 7.4 years later were detected.

scholarly journals Vitamin Intake and Loss of Muscle Mass in Older People with Type 2 Diabetes: A Prospective Study of the KAMOGAWA-DM Cohort

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2335
Author(s):  
Fuyuko Takahashi ◽  
Yoshitaka Hashimoto ◽  
Ayumi Kaji ◽  
Ryosuke Sakai ◽  
Yuka Kawate ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Older People ◽  
Vitamin B12 ◽  
Muscle Mass ◽  
Vitamin B1 ◽  
Vitamin D Intake ◽  
Glucagon Like Peptide 1

The aim of this prospective cohort study was to examine the relationships between the intakes of various vitamins and the loss of muscle mass in older people with type 2 diabetes (T2DM). The change in skeletal muscle mass index (SMI, kg/m2) (kg/m2/year) was defined as follows: (SMI at baseline (kg/m2) − SMI at follow-up (kg/m2))/follow-up period (year). The rate of SMI reduction (%) was calculated as follows (the change in SMI (kg/m2/year)/SMI at baseline (kg/m2)) × 100. The rate of SMI reduction ≥ 1.2% was considered as the loss of muscle mass. Among 197 people with T2DM, 47.2% of them experienced the loss of muscle mass at the 13.7 ± 5.2 month follow-up. Vitamin B1 (0.8 ± 0.3 vs. 0.8 ± 0.3 mg/day, p = 0.031), vitamin B12 (11.2 ± 8.3 vs. 13.4 ± 7.5 μg/day, p = 0.049), and vitamin D (16.5 ± 12.2 vs. 21.6 ± 13.0 μg/day, p = 0.004) intakes in people with the loss of muscle mass were significantly lower than those without. Vitamin D intake was related to the loss of muscle mass after adjusting for sex, age, exercise, alcohol, smoking, body mass index, SMI, glucagon-like peptide-1 agonist, sodium glucose cotransporter-2 inhibitor, insulin, HbA1c, creatinine, energy intake, and protein intake (adjusted odds ratio 0.93, 95% confidence interval: 0.88–0.97, p = 0.003). This study showed that vitamin D intake was related to the loss of muscle mass in older people with T2DM. Vitamin B12 intake tended to be related to the loss of muscle mass, although vitamin A, vitamin B2, vitamin B6, vitamin C, and vitamin E intake were not related.

scholarly journals Circulating metabolites and the risk of type 2 diabetes: a prospective study of 11,896 young adults from four Finnish cohorts

Diabetologia ◽  
2019 ◽  
Vol 62 (12) ◽  
pp. 2298-2309 ◽  
Author(s):  
Ari V. Ahola-Olli ◽  
Linda Mustelin ◽  
Maria Kalimeri ◽  
Johannes Kettunen ◽  
Jari Jokelainen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Young Adults ◽  
Fasting Glucose ◽  
Diabetes Risk ◽  
Increased Risk ◽  
Metabolic Biomarkers ◽  
Incident Cases ◽  
Future Diabetes

Abstract Aims/hypothesis Metabolomics technologies have identified numerous blood biomarkers for type 2 diabetes risk in case−control studies of middle-aged and older individuals. We aimed to validate existing and identify novel metabolic biomarkers predictive of future diabetes in large cohorts of young adults. Methods NMR metabolomics was used to quantify 229 circulating metabolic measures in 11,896 individuals from four Finnish observational cohorts (baseline age 24–45 years). Associations between baseline metabolites and risk of developing diabetes during 8–15 years of follow-up (392 incident cases) were adjusted for sex, age, BMI and fasting glucose. Prospective metabolite associations were also tested with fasting glucose, 2 h glucose and HOMA-IR at follow-up. Results Out of 229 metabolic measures, 113 were associated with incident type 2 diabetes in meta-analysis of the four cohorts (ORs per 1 SD: 0.59–1.50; p< 0.0009). Among the strongest biomarkers of diabetes risk were branched-chain and aromatic amino acids (OR 1.31–1.33) and triacylglycerol within VLDL particles (OR 1.33–1.50), as well as linoleic n-6 fatty acid (OR 0.75) and non-esterified cholesterol in large HDL particles (OR 0.59). The metabolic biomarkers were more strongly associated with deterioration in post-load glucose and insulin resistance than with future fasting hyperglycaemia. A multi-metabolite score comprised of phenylalanine, non-esterified cholesterol in large HDL and the ratio of cholesteryl ester to total lipid in large VLDL was associated with future diabetes risk (OR 10.1 comparing individuals in upper vs lower fifth of the multi-metabolite score) in one of the cohorts (mean age 31 years). Conclusions/interpretation Metabolic biomarkers across multiple molecular pathways are already predictive of the long-term risk of diabetes in young adults. Comprehensive metabolic profiling may help to target preventive interventions for young asymptomatic individuals at increased risk.

scholarly journals Changes in secondhand smoke exposure levels and risk of type 2 diabetes in middle age: the Korean Genome and Epidemiology Study (KoGES)

2019 ◽  
Vol 7 (1) ◽  
pp. e000859 ◽  
Author(s):  
Jooeun Jeon ◽  
Keum Ji Jung ◽  
Heejin Kimm ◽  
Sun Ha Jee
Keyword(s):  
Type 2 Diabetes ◽  
Secondhand Smoke ◽  
Middle Age ◽  
Exposure Level ◽  
Epidemiology Study ◽  
Shs Exposure ◽  
Exposure Levels ◽  
Incident Cases

ObjectivesSecondhand smoke (SHS) was known as one of the risk factors for type 2 diabetes. So far, some studies revealed the association of SHS exposure and type 2 diabetes, however, no studies to show the relationship of cumulative SHS exposure with type 2 diabetes exist. Therefore, the objectives of this study were to identify subgroups of participants who share similar trajectories in SHS exposure levels in middle age by using latent class growth modeling, and determine the independent association of these SHS exposure level trajectories with risk of incident type 2 diabetes.MethodsIn Korean Genome and Epidemiology Study (2001–2014), 2079 participants aged 40 years and above who received biennially health check-up to follow-up and with available information of SHS exposure were selected. Four distinct trajectory groups (low-stable, moderate to low, moderate, and high to low) were identified for SHS exposure levels using trajectory modeling methods. Multivariable Cox proportional hazards model was used to examine the association of trajectories with risk of type 2 diabetes.ResultsDuring 24 083.3 person-years of follow-up (mean follow-up duration, 11.6 years), 200 incident cases of type 2 diabetes and 640 incident cases of impaired fasting glucose (IFG) were identified. In multivariable Cox model, ‘High to low’ trajectory was significantly associated with risk of type 2 diabetes (OR 1.9; 95% CI 1.3 to 2.8) compared with ‘Low-stable’. For IFG, all trajectories had significantly 30%–30% higher risk of type 2 diabetes compared with the ‘Low-stable’ trajectory.ConclusionsChanges in SHS exposure levels have been shown to associate with subsequent type 2 diabetes risk. Reversing high exposure level of SHS in middle-aged adulthood may still lead to worse progressions of type 2 diabetes than remaining stable exposure level.

scholarly journals May the Mediterranean diet attenuate the risk of type 2 diabetes associated with obesity: the Seguimiento Universidad de Navarra (SUN) cohort

2017 ◽  
Vol 117 (10) ◽  
pp. 1478-1485 ◽  
Author(s):  
Sonia Eguaras ◽  
Maira Bes-Rastrollo ◽  
Miguel Ruiz-Canela ◽  
Silvia Carlos ◽  
Pedro de la Rosa ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Adverse Effects ◽  
Mediterranean Diet ◽  
Weight Changes ◽  
Product Term ◽  
Hazard Ratios ◽  
The Mediterranean ◽  
Incident Cases

AbstractIt is likely that the Mediterranean diet (MedDiet) may mitigate the adverse effects of obesity on the incidence of type 2 diabetes mellitus (T2DM). We assessed this hypothesis in a cohort of 18 225 participants initially free of diabetes (mean age: 38 years, 61 % women). A validated semi-quantitative 136-item FFQ was used to assess dietary intake and to build a 0–9 score of adherence to MedDiet. After a median of 9·5-year follow-up, 136 incident cases of T2DM were confirmed during 173 591 person-years follow-up. When MedDiet adherence was low (≤4 points), the multivariable-adjusted hazard ratios (HR) were 4·07 (95 % CI 1·58, 10·50) for participants with BMI 25–29·99 kg/m2 and 17·70 (95 % CI 6·29, 49·78) kg/m2 for participants with BMI≥30 kg/m2, (v.<25 kg/m2). In the group with better adherence to the MedDiet (>4 points), these multivariable-adjusted HR were 3·13 (95 % CI 1·63, 6·01) and 10·70 (95 % CI 4·98, 22·99) for BMI 25–30 and ≥30 kg/m2, respectively. The P value for the interaction was statistically significant (P=0·002). When we assessed both variables (BMI and MedDiet) as continuous, the P value for their interaction product-term was marginally significant (P=0·051) in fully adjusted models. This effect modification was not explained by weight changes during follow-up. Our results suggest that the MedDiet may attenuate the adverse effects of obesity on the risk of T2DM.

Abstract P224: Sex Differences in the Risk of Stroke and HbA1c among Diabetic Patients

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Gang Hu ◽  
Peter Katzmarzyk ◽  
Ronald Horswell ◽  
Yujie Wang ◽  
Jolene Johnson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Stroke Risk ◽  
Reference Group ◽  
Epidemiological Studies ◽  
Diabetic Patients ◽  
Hospital System ◽  
Incident Cases ◽  
Different Levels

Background: Epidemiological studies have reported that type 2 diabetes is an independent risk factor for stroke, but how much its effect varies by sex is uncertain. Aim: To better understand the relationship between glycemic control and stroke risk in men and women, we studied a large sample of patients with type 2 diabetes with long-term follow up. Methods: We prospectively investigated the sex-specific association of different levels of HbA1c with incident stroke risk among 10,876 male and 19,278 female diabetic patients within the Louisiana State University (LSU) Hospital System. Results: During a mean follow up of 6.7 years, 2,949 incident cases of stroke were identified. The multivariable-adjusted hazard ratios (HRs) of stroke associated with different levels of HbA1c at baseline (<6.0%, 6.0-6.9% [reference group], 7.0-7.9%, 8.0-8.9%, 9.0-9.9%, and ≥10.0%,) were 0.96 (95% confidence interval [CI] 0.80-1.14), 1.00, 1.04 (0.85-1.28), 1.11 (0.89-1.39), 1.10 (0.86-1.41), and 1.22 (0.92-1.35) (P trend =0.66) for males, and 1.03 (0.90-1.18), 1.00, 1.09 (0.94-1.26), 1.19 (1.00-1.42), 1.32 (1.09-1.59), and 1.42 (1.23-1.65) (P trend <0.001) for females, respectively. The graded association of HbA1c during follow-up with stroke risk was observed among female diabetic patients (P trend=0.066). When stratified by race, with glucose-lowering agents or not, this graded association of HbA1c with stroke was still present. When stratified by age, the adjusted HRs were significantly higher in women older than 55 years compared to younger women. Conclusions: The current study suggests a graded association between HbA1c and the risk of stroke among female patients with type 2 diabetes and poor control of blood sugar has a stronger effect in women older than 55 years.

scholarly journals Dietary polyphenol intake and risk of type 2 diabetes in the Polish arm of the Health, Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) study

2017 ◽  
Vol 118 (1) ◽  
pp. 60-68 ◽  
Author(s):  
Giuseppe Grosso ◽  
Urszula Stepaniak ◽  
Agnieszka Micek ◽  
Magdalena Kozela ◽  
Denes Stefler ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Eastern Europe ◽  
Psychosocial Factors ◽  
Phenolic Acids ◽  
Continuous Variable ◽  
Dietary Polyphenols ◽  
Polyphenol Intake ◽  
Incident Cases

AbstractThis study aimed to test the association between dietary content of total and individual classes of polyphenols and incident cases of type 2 diabetes in Polish adults participating to the Health, Alcohol and Psychosocial factors In Eastern Europe study. At baseline, diet by 148-item FFQ and health information were collected from 5806 participants free of diabetes. Self-reported incident type 2 diabetes was ascertained at 2–4-year follow-up visit. OR and 95 % CI of type 2 diabetes comparing the various categories of polyphenol intake to the lowest one (reference category) and as 1sdincrease modelled as continuous variable were calculated by performing age-, energy-, and multivariate-adjusted logistic regression models. During the follow-up, 456 incident cases of type 2 diabetes occurred. When comparing extreme quartiles, intake of total polyphenol was inversely associated with the risk of type 2 diabetes (OR 0·43; 95 % CI 0·30, 0·61); 1sdincrease was associated with a reduced risk of diabetes (OR 0·68; 95 % CI 0·59, 0·79). Among the main classes of polyphenols, flavonoids, phenolic acids, and stilbenes were independent contributors to this association. Both subclasses of phenolic acids were associated with decreased risk of type 2 diabetes, whereas among subclasses of flavonoids, high intake of flavanols, flavanones, flavones and anthocyanins was significantly associated with decreased risk of type 2 diabetes. Total dietary polyphenols and some classes of dietary polyphenols were associated with lower risk of type 2 diabetes.

scholarly journals Prospective study of coffee and tea consumption in relation to risk of type 2 diabetes mellitus among men and women: The Whitehall II study

2008 ◽  
Vol 100 (5) ◽  
pp. 1046-1053 ◽  
Author(s):  
Mark Hamer ◽  
Daniel R. Witte ◽  
Annhild Mosdøl ◽  
Michael G. Marmot ◽  
Eric J. Brunner
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Inverse Association ◽  
Tea Consumption ◽  
Coffee Intake ◽  
Decaffeinated Coffee ◽  
Incident Cases

At least fourteen cohort studies have documented an inverse association between coffee consumption and risk of type 2 diabetes. We examined the prospective association between coffee and tea consumption and the risk of type 2 diabetes mellitus among British men (n 4055) and women (n 1768) from the Whitehall II cohort. During 11·7 years follow-up there were a total of 387 incident cases of diabetes confirmed by self-report of doctor's diagnosis or glucose tolerance tests. Despite an inverse association between coffee intake and 2 h post-load glucose concentration at the baseline assessment, combined caffeinated and decaffeinated coffee (hazard ratio (HR) 0·80; 95 % CI 0·54, 1·18) or only decaffeinated coffee intake (HR 0·65; 95 % CI 0·36, 1·16) was not significantly associated with diabetes risk at follow-up after adjustment for possible confounders. There was an association between tea intake and diabetes (HR 0·66; 95 % CI 0·61, 1·22; P < 0·05) after adjustment for age, gender, ethnicity and social status, which was not robust to further adjustments. There was, however, an association between combined intake of tea and coffee (two or more cups per day of both beverage) and diabetes (HR 0·68; 95 % CI 0·46, 0·99; P < 0·05) after full adjustment. In conclusion, relatively moderate intake (more than three cups per day) of coffee and tea were not prospectively associated with incidence of type 2 diabetes although there was evidence of a combined effect. The limited range of exposure and beverage consumption according to socio-economic class may explain these conflicting findings.

scholarly journals Effect of Long-Term Proton Pump Inhibitor Use on Glycemic Control in Patients with Type Two Diabetes Mellitus

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Amy Trang ◽  
Jordan Bushman ◽  
Alexandra Halalau
Keyword(s):  
Glycemic Control ◽  
Proton Pump ◽  
Medical Records ◽  
Antidiabetic Medication ◽  
Baseline Hba1c ◽  
The Difference ◽  
Type Two Diabetes

There have been conflicting results regarding the effect of proton pump inhibitors (PPIs) as an adjunctive therapy to oral antidiabetic medication (OAM) in those with type 2 diabetes (T2DM). PPIs increase gastrin levels, causing a rise in insulin. No studies have evaluated the duration of PPI therapy and its effect on glycemic control. Medical records across 8 hospitals between 2007 and 2016 were reviewed for 14,602 patients with T2DM (not on insulin therapy) taking PPIs. Values of HbA1c (baseline, follow-up, and the difference between the two) in those prescribed with PPIs and years of therapy were compared to HbA1c values of those who had no record of PPI use. Baseline and follow-up HbA1c for patients on PPIs were 6.8 and 7.0, respectively, compared to 7.1 and 7.2 in their untreated counterparts ( p < 0.001 in both comparisons). For both groups, an increase in baseline HbA1c was seen with time. Those on PPI had an increase in HbA1c of 0.16 compared to 0.08 in those not prescribed PPI. Our results show no relationship between the length of PPI therapy and HbA1c reduction.

Abstract 20: Carbohydrate Quality, Measured Using Multiple Carbohydrate Quality Metrics, is Negatively Associated with Risk of Type 2 Diabetes in US Women

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Hala AlEssa ◽  
Shilpa Bhupathiraju ◽  
Vasanti Malik ◽  
Nicole Wedick ◽  
Hannia Campos ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Quality Metrics ◽  
Dietary Factors ◽  
Increased Risk ◽  
Carbohydrate Quality ◽  
Cereal Fiber ◽  
High Starch ◽  
Incident Cases

Background: Carbohydrate quality may be an important determinant of type 2 diabetes (T2D), however, the relationships between various carbohydrate quality metrics and T2D risk have not been systematically investigated. Objective: To prospectively examine the association between carbohydrate, starch, fiber, and different combinations of these nutrients in relation to the risk of T2D in US women. Methods: We prospectively collected information on diet and lifestyle behaviors among 70,041 women from the Nurses Health Study every 2-4 years, after baseline in 1984. These participants were free of diagnosed cardiovascular disease, cancer, or diabetes at baseline. We used Cox proportional hazards regression models to assess the association between dietary factors of interest and incidence of T2D. Results: With 24 years of follow-up we ascertained 6,934 incident cases of T2D during 1,484, 213 person years of follow-up. After adjusting for age, lifestyle and dietary variables, total carbohydrate intake was not associated with T2D (RR=0.98, 95% CI: 0.89 - 1.08, p for trend=0.84), while starch was positively associated with T2D (RR=1.23, 95%CI: 1.12 - 1.35), p for trend <0.0001), comparing the highest to lowest quintile. Total fiber (RR= 0.80, 95%CI: 0.72 - 0.89, p for trend < 0.0001), cereal fiber (RR= 0.71, 95%CI: 0.65 - 0.78, p for trend < 0.0001) and fruit fiber (RR= 0.80, 95%CI: 0.73 - 0.88, p for trend < 0.0001) were all inversely associated with T2D, comparing extreme quintiles. . There was a borderline significant positive association between the ratio of carbohydrate to total fiber intake and risk of T2D (RR= 1.09, 95%CI: 1.00 - 1.20, p for trend = 0.039), and stronger positive associations between the ratios of carbohydrate to cereal fiber (RR= 1.28, 95%CI: 1.17 - 1.39, p for trend < 0.0001), starch to total fiber (RR= 1.12, 95%CI: 1.02 - 1.23, p for trend = 0.030) and starch to cereal fiber (RR= 1.39, 95%CI: 1.27 - 1.53, p for trend < 0.0001) with T2D, comparing extreme quintiles.. Conclusion: Diets with high starch, low fiber and high starch to cereal fiber ratio were associated with increased risk of T2D. Using the starch to cereal fiber ratio of the overall diet is a potentially useful way of assessing carbohydrate quality in relation to T2D.

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