Physical Activity is Strongly Inversely Related To Post-Challenge Plasma Glucose and Glycemic Spikes in a Risk Population for Type 2 Diabetes

Folia Medica ◽  
2013 ◽  
Vol 55 (2) ◽  
pp. 33-42 ◽  
Author(s):  
Theodora Temelkova-Kurktschiev ◽  
Tsvetan Stefanov ◽  
Carsta Koehler ◽  
Elena Henkel ◽  
Frank Schaper ◽  
...  

ABSTRACT AIM: To examine the relationship between physical activity (PA) and various cardiometabolic risk factors during an oral glucose tolerance test (OGTT), including glycemic spikes (PGS) in individuals at risk for type 2 diabetes. SUBJECTS AND METHODS: A total of 949 middle-aged subjects from the Risk factors in Impaired Glucose Tolerance for Atherosclerosis and Diabetes (RIAD) trial aged 40-70 years were included in the present cross-sectional analysis. Standard 75 g OGTT was performed and blood was collected every 30 min for 2 hours for measurements of plasma glucose (PG) and other cardiometabolic risk factors. PA was assessed using interviewer-administered questionnaire. RESULTS: Post-challenge PGS and maximal PG (PGmax) during OGTT were significantly lower in individuals with high PA vs. individuals with low PA even after body mass index (BMI) adjustment (p = 0.026 and p = 0.035, respectively). In univariate analysis post-challenge PG 30, 60, 90, and 120 minutes, PGS and PGmax during OGTT were significantly inversely correlated to PA. This correlation was attenuated but remained significant after adjustment for BMI. Fasting PG and glycosylated hemoglobin were not correlated to PA. Significantly higher fasting and post-challenge insulin levels were found among subjects with low vs. subjects with medium (p < 0.05) and high PA (p < 0.05). Post-challenge C-peptide and proinsulin levels were significantly lower in participants with high vs. participants with low PA (p < 0.05 for all). The relationship between 2-h PG and PA was observed also in lean subjects and in subjects with normal fasting glucose. In multivariate analysis PA was a significant independent determinant of 2-h PG. CONCLUSION: We found a strong inverse relationship between PA and various post-challenge cardiometabolic parameters during OGTT, including glycemic spikes, in a population at risk for diabetes. This relationship was only partially dependent on BMI.

2014 ◽  
Vol 171 (4) ◽  
pp. 443-449 ◽  
Author(s):  
Se Eun Park ◽  
Nam Seok Lee ◽  
Ji Woo Park ◽  
Eun-Jung Rhee ◽  
Won-Young Lee ◽  
...  

ObjectiveSerum concentrations of retinol-binding protein 4 (RBP4) are elevated in type 2 diabetes and associated with the severity of insulin resistance; however, there are few data about the relationship between urinary RBP4 levels and metabolic parameters. We assessed urinary RBP4 as a new biomarker by establishing its relationship with clinical parameters associated with insulin resistance and urinary albumin excretion.Design and methodsWe measured RBP4 in the serum and urine of 689 subjects with diverse glucose tolerance status. We also evaluated the relationship between urinary RBP4 and cardiometabolic risk factors, including insulin resistance, high-sensitivity C-reactive protein (hsCRP), arterial stiffness, and microalbuminuria.ResultsUrinary RBP4 levels were higher in insulin-resistant subjects with prediabetes or type 2 diabetes than in subjects with normal glucose tolerance (NGT) (type 2 diabetes>prediabetes>NGT; allP<0.001). Urinary RBP4 correlated strongly with homeostasis model assessments of insulin resistance (HOMA-IR), fasting glucose, triglycerides, blood pressure, hsCRP, arterial stiffness, estimated glomerular filtration rate, and urinary albumin-to-creatinine ratio (allP<0.01). HOMA-IR and arterial stiffness were found to be independent determinants of urinary RBP4 concentration. Furthermore, urinary RBP4 was highly predictive of microalbuminuria (odds ratio 2.6, 95% CI 1.6–4.2), even after adjustment for other metabolic parameters. The area under the ROC curve for urinary RBP4 to detect the presence of microalbuminuria was 0.80±0.02 (95% CI 0.76–0.84) and the cut-off value was 157.01 μg/gCr.ConclusionsUrinary RBP4 concentrations were elevated in patients with dysregulation of glucose metabolism and were related to various cardiometabolic risk factors including insulin resistance, inflammation, and microalbuminuria.


2019 ◽  
Vol 16 (12) ◽  
pp. 1105-1112 ◽  
Author(s):  
Nele Huys ◽  
Vicky Van Stappen ◽  
Samyah Shadid ◽  
Marieke De Craemer ◽  
Odysseas Androutsos ◽  
...  

Background: This study aimed to investigate whether the relationship between psychosocial and perceived environmental factors and physical activity (PA) in adults at risk for type 2 diabetes is influenced by educational level. Methods: Based on the Finnish Diabetes Risk Score questionnaire, this study selected 164 adults (Mage: 38 (5.34) y, 13.4% men) at type 2 diabetes risk from 11 low socioeconomic neighborhoods in Flanders (Belgium). Participants filled out questionnaires on psychosocial and perceived environmental factors and wore an ActiGraph accelerometer for 5 consecutive days. Statistical analyses were performed using analysis of covariance in SPSS. Results: Educational level significantly influenced the association between perception of body weight and light PA (P = .01) and total PA (P = .03) on weekend days. Educational level did not influence the associations between other psychosocial and perceived environmental factors (ie, perceived social influence; environmental, time and attitudinal barriers, perceived self-efficacy; knowledge and fatalism) and PA. Conclusions: Educational level did not influence the relationship between most psychosocial and perceived environmental factors and PA in this sample of adults at type 2 diabetes risk. This suggests that addressing different psychosocial and perceived environmental correlates in lower and higher educated participants might not be necessary. However, more research in this specific population is needed.


Author(s):  
Robert P. Hoffman ◽  
Melanie M. Copenhaver ◽  
Danlei Zhou ◽  
Chack-Yung Yu

Abstract Objectives In obese adults the shape of the glucose response curve during an oral glucose tolerance test (OGTT) predicts future type 2 diabetes. Patients with an incessant increase or monophasic curves have increased risk compared to those with biphasic curves. Since type 2 diabetes is associated with increased cardiometabolic risk, we studied whether differences in OGTT response curve are associated with differences in cardiometabolic risk factors in healthy adolescents across a wide body mass index (BMI) range. Methods Sixty-nine (33F/36M), white adolescents (age: 15.2 ± 1.7 years; BMI: 21.5 ± 4.7 kg/m2; mean ± SD) were studied. Risk factors measured included percent body fat, blood pressure, lipids, augmentation index, reactive hyperemia, endothelin 1, plasminogen activator 1, inflammatory markers (interleukin 6, c-reactive protein), insulin secretion, insulin sensitivity (Matusda index), and disposition index (DI). Results Thirty-two subjects had biphasic responses; 35 subjects had monophasic responses and two females had incessant increases. Sex did not affect the frequency of responses. Glucose area under the curve during OGTT was greater in those with a mono vs. biphasic curves (p=0.01). Disposition index was markedly lower in subjects with a monophasic curve than in those with a biphasic curve (3.6 [2.3–5.0] vs. 5.8 [3.8–7.6], median [25th, 75th%] p=0.003). Triglyceride to high-density lipoprotein cholesterol (HDL) ratio was higher in subjects with a monophasic curve (p=0.046). Conclusions The decreased disposition index indicates that in healthy adolescents a monophasic response to OGTT is due to decreased insulin secretion relative to the degree of insulin resistance present. This was not associated with differences in most other cardiometabolic risk markers. Trial registration Clinical Trials.gov, NCT02821104.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Margareta Hellgren ◽  
Ulf Lindblad ◽  
Bledar Daka

Background and Aims: Individuals with prediabetes, impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT), have approximately 50% risk to develop type 2 diabetes mellitus (T2DM) within ten years. This paper examines risk factors for development of T2DM in individuals with prediabetes. Materials and Methods: A total of 2816 individuals were randomly selected and completed a careful physical examination and an oral glucose tolerance test. IFG and IGT was defined according to WHO. A representative sample of 1327 individuals were re-examined in a follow-up study after ten years. This study focuses on the participants who were diagnosed with prediabetes, IFG (n=67) and/or IGT (n=89) at baseline and who were re-examined at follow-up. Insulin resistance was estimated by HOMA-ir (Homeostatic Model Assessment for Insulin Resistance). Differences between the participants with prediabetes who developed T2DM and those who did not, were analyzed with general linear models and adjusted for age, sex and BMI. The risk to progress to T2DM in ten years was explored using binary logistic regression, adding the risk-factors one after another. Results: Of the 156 individuals with prediabetes 28% progressed to T2DM. Individuals who developed T2DM had higher BMI (α=3.2kg/m 2 , P<0.001), higher HbA1c (α=0.2 mmol/mol, P=0.047), higher C-reactive protein (α=3.3 mmol/L, P=0.040) and also significantly higher HOMAir (α=2.8, P<0.001) at base-line. The risk to develop T2DM increased in a step-wise manner in individuals with prediabetes when successively adding the risk-factors. Having a BMI ≥30kg/m 2 , a known family history for T2DM, HbA1c ≥37mmol/mol, HOMAir ≥2.8 and a low level of physical activity increased the risk to develop T2DM 5.6 times. Table 1. Conclusion: In individuals with prediabetes, those with additional risk-factors like obesity, HbA1c and HOMAir above mean values, family history for T2DM and a low level of physical activity require extra attention and intensive lifestyle interventions should be initiated.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Di Wang ◽  
Xiaoran Liu ◽  
Liang Sun ◽  
Zhenghua Niu ◽  
Shuangshuang Chen ◽  
...  

Abstract Objectives To determine the effect of peanut consumption, as part of the diet on cardiometabolic risk factors and Metabolic Syndrome (MetS) in a Chinese population at risk for developing type 2 diabetes. Methods We recruited 224 participants (men and women, ages 46 ± 10 y, BMI 28.0 ± 3.1 kg/m2) with central obesity plus at least one additional MetS risk factor. In this randomized, parallel-arm, controlled study, participants were supplemented with either lightly salted peanuts, 2oz (56 g) per day or a calorie-matched control snack (refined grains) for 12 weeks. Peanuts and control snacks were consumed between meals. Anthropometric and metabolic measurements were assessed at baseline, week 6 and week 12. We used paired Student's t-tests to examine within-treatment differences and multivariable linear regression for between-treatment differences with the models adjusted for age, sex and baseline BMI (with the exception of analysis on waist circumference [WC], body weight and BMI). Multivariate logistic regression was used to calculate the reversion rate of MetS. Results The peanut group and the control group had similar energy intake (peanut: 1872 ± 433 kcal, control: 1906 ± 400 kcal). There were no differences observed between the two groups on WC, body weight, and BMI. Compared to baseline, the peanut group had small but significant reductions in WC (–0.88 ± 0.32 cm, P = 0.006), body weight (–0.41 ± 0.16 kg, P = 0.01), and BMI (–0.14 ± 0.06 kg/m2, P = 0.01) at week 12. Both groups decreased fasting glucose levels (peanut: 0.32 ± 0.06 mmol/L, P < 0.001; control: 0.28 ± 0.05 mmol/L, P < 0.001) and increased HDL-C levels (peanut: 0.05 ± 0.02 mmol/L, P = 0.001; control: 0.05 ± 0.02 mmol/L, P = 0.002) after 12 weeks. The peanut group decreased triglycerides by −0.34 ± 0.13 mmol/L (P = 0.009) at week 6. There were no effects on LDL-C, total cholesterol or blood pressure. The peanut group had a greater reversion rate of MetS compared to the control group at week 6 (31.7% vs. 17.9%, P = 0.04, Figure 1), which attenuated at week 12 (P = 0.10). Conclusions Adding 2oz of peanuts per day to the diet for 12 weeks did not promote weight gain among Chinese adults at risk for type 2 diabetes. Consumption of peanuts may help ameliorate MetS, suggesting that peanuts may be a healthful snack option relative to refined grains. Funding Sources This study was supported by the Chinese Academy of Sciences (Grant/Award Number: KJZD-EW-G20-02), and an in kind donation from the Peanut Institute. The finding source had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Supporting Tables, Images and/or Graphs


Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 772-P
Author(s):  
MARIKO HIGA ◽  
AYANA HASHIMOTO ◽  
MOE HAYASAKA ◽  
MAI HIJIKATA ◽  
AYAMI UEDA ◽  
...  

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