scholarly journals Ghrelin deficiency in patients with type 2 diabetes: the relationships with obesity, adipose tissue dysfunction and glucose variability

2019 ◽  
Vol 91 (10) ◽  
pp. 28-33
Author(s):  
V V Klimontov ◽  
D M Bulumbaeva ◽  
O N Fazullina ◽  
N B Orlov ◽  
V I Konenkov
Keyword(s):  
Type 2 Diabetes ◽  
Body Composition ◽  
Adipose Tissue ◽  
Glucose Monitoring ◽  
Peptide Hormone ◽  
Serum Levels ◽  
Glucose Variability ◽  
Endocrine Function ◽  
Fasting Serum

Aim. Ghrelin, a peptide hormone mostly produced by stomach, plays an important role in regulation of feeding behavior, energy balance and glucose homeostasis. The aim: to determine the relationships between fasting serum levels of ghrelin, body composition, adipose tissue endocrine function and glucose variability (GV) in type 2 diabetic subjects with and without obesity. Materials and methods. We observed 124 individuals with type 2 diabetes, including 42 non - obese subjects and 82 patients with obesity. Thirty non - obese healthy subjects were acted as control. The concentrations of ghrelin, leptin, resistin, and visfatin in the fasting serum were determined by Multiplex analysis. Body composition was assessed with DEXA. The 24-hour and nocturnal GV parameters were derived from continuous glucose monitoring. Results and discussion. Ghrelin levels in patients with diabetes were decreased significantly as compared to control (p

scholarly journals Peroxisome Proliferator-Activated Receptor γ and Adipose Tissue—Understanding Obesity-Related Changes in Regulation of Lipid and Glucose Metabolism

2006 ◽  
Vol 92 (2) ◽  
pp. 386-395 ◽  
Author(s):  
Arya M. Sharma ◽  
Bart Staels
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Adipose Tissue ◽  
Fatty Acid ◽  
Endocrine Function ◽  
Low Grade ◽  
Peroxisome Proliferator ◽  
Peroxisome Proliferator Activated Receptor

Abstract Context: Adipose tissue is a metabolically dynamic organ, serving as a buffer to control fatty acid flux and a regulator of endocrine function. In obese subjects, and those with type 2 diabetes or the metabolic syndrome, adipose tissue function is altered (i.e. adipocytes display morphological differences alongside aberrant endocrine and metabolic function and low-grade inflammation). Evidence Acquisition: Articles on the role of peroxisome proliferator-activated receptor γ (PPARγ) in adipose tissue of healthy individuals and those with obesity, metabolic syndrome, or type 2 diabetes were sourced using MEDLINE (1990–2006). Evidence Synthesis: Articles were assessed to provide a comprehensive overview of how PPARγ-activating ligands improve adipose tissue function, and how this links to improvements in insulin resistance and the progression to type 2 diabetes and atherosclerosis. Conclusions: PPARγ is highly expressed in adipose tissue, where its activation with thiazolidinediones alters fat topography and adipocyte phenotype and up-regulates genes involved in fatty acid metabolism and triglyceride storage. Furthermore, PPARγ activation is associated with potentially beneficial effects on the expression and secretion of a range of factors, including adiponectin, resistin, IL-6, TNFα, plasminogen activator inhibitor-1, monocyte chemoattractant protein-1, and angiotensinogen, as well as a reduction in plasma nonesterified fatty acid supply. The effects of PPARγ also extend to macrophages, where they suppress production of inflammatory mediators. As such, PPARγ activation appears to have a beneficial effect on the relationship between the macrophage and adipocyte that is distorted in obesity. Thus, PPARγ-activating ligands improve adipose tissue function and may have a role in preventing progression of insulin resistance to diabetes and endothelial dysfunction to atherosclerosis.

scholarly journals Adipose tissue and body composition in women six years after gestational diabetes: factors associated with development of type 2 diabetes

Adipocyte ◽  
2018 ◽  
Vol 7 (4) ◽  
pp. 229-237 ◽  
Author(s):  
Henrik Svensson ◽  
Louise Wetterling ◽  
Ulrika Andersson-Hall ◽  
Eva Jennische ◽  
Staffan Edén ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Composition ◽  
Adipose Tissue ◽  
Gestational Diabetes ◽  
Factors Associated

Acute-phase serum proteins and adipocytokines in women with type 2 diabetes mellitus: Relationships with body composition and blood glucose fluctuations

2016 ◽  
Vol 88 (10) ◽  
pp. 35-41 ◽  
Author(s):  
V V Klimontov ◽  
N V Tyan ◽  
O N Fazullina ◽  
N E Myakina ◽  
N B Orlov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Body Composition ◽  
Adipose Tissue ◽  
Serum Concentrations ◽  
Tnf Α ◽  
Hs Crp ◽  
Pai 1

Aim. To estimate the relationships between the serum concentrations of acute-phase proteins (APPs) and adipocytokines, body composition (BC), and blood glucose (BG) fluctuations in women with type 2 diabetes mellitus (T2DM). Subjects and methods. A total of 165 women with T2DM and 22 with a normal body mass index (BMI) at the age of 40 to 70 years were examined. The concentrations of high-sensitivity C-reactive protein (hs-CRP) and acid α1-glycoprotein (α1-AGP) were determined by ELISA. The levels of interleukins 6, 8, and 18 (IL-6, IL-8, IL-18), tumor necrosis factor-α (TNF-α), and plasminogen activator inhibitor type 1 (PAI-1) were measured by a multiplex analysis. Dual energy X-ray absorptiometry was used to estimate BC parameters. BG fluctuations were estimated via continuous glucose monitoring. Results. The levels of hs-CRP, α1-AGP, IL-6, IL-8, IL-18, TNF-α, and PAI-1 were significantly higher in the obese women with T2DM than those in the control group. In the diabetic normal weight women, only hs-CRP, α1-AGP, and IL-8 concentrations exceeded those in the controls. The level of hs-CRP (other than α1-AGP) correlated positively with BMI, the mass of adipose tissue, body trunk (android), and gynoid fats. A multivariate regression analysis showed that adipose tissue mass and trunk fat proportion were independent predictors of hs-CRP levels. The concentrations of IL-6, IL-8, IL-18, PAI-1, and TNF-α correlated positively with waist-to-hip ratio, but demonstrated no associations with BMI and BC. Only the serum α1-AGP level showed a positive association with mean BG and its variability parameters. Conclusion. In the women with T2DM, the serum concentrations of APPs and adipocytokines correlate differently with the mass of adipose tissue, its distribution, and BG fluctuations. The findings indicate the multifactorial genesis of chronic inflammation in these patients.

scholarly journals Chemerin Exacerbates Glucose Intolerance in Mouse Models of Obesity and Diabetes

Endocrinology ◽  
2010 ◽  
Vol 151 (5) ◽  
pp. 1998-2007 ◽  
Author(s):  
Matthew C. Ernst ◽  
Mark Issa ◽  
Kerry B. Goralski ◽  
Christopher J. Sinal
Keyword(s):  
Type 2 Diabetes ◽  
Adipose Tissue ◽  
Glucose Metabolism ◽  
Mouse Models ◽  
Glucose Intolerance ◽  
Serum Insulin ◽  
Serum Levels ◽  
Established Risk Factor ◽  
Obesity And Diabetes

Obesity, characterized by an excess of adipose tissue, is an established risk factor for cardiovascular disease and type 2 diabetes. Different mechanisms linking obesity with these comorbidities have been postulated but remain poorly understood. Adipose tissue secretes a number of hormone-like compounds, termed adipokines, that are important for the maintenance of normal glucose metabolism. Alterations in the secretion of adipokines with obesity are believed to contribute to the undesirable changes in glucose metabolism that ultimately result in the development of type 2 diabetes. In the present study, we have shown that serum levels of the novel adipokine chemerin are significantly elevated in mouse models of obesity/diabetes. The expression of chemerin and its receptors, chemokine-like receptor 1, chemokine (C-C motif) receptor-like 2, and G protein-coupled receptor 1 are altered in white adipose, skeletal muscle, and liver tissue of obese/diabetic mice. Administration of exogenous chemerin exacerbates glucose intolerance, lowers serum insulin levels, and decreases tissue glucose uptake in obese/diabetic but not normoglycemic mice. Collectively, these data indicate that chemerin influences glucose homeostasis and may contribute to the metabolic derangements characteristic of obesity and type 2 diabetes.

scholarly journals Nocturnal Hypoglycemia in Type 2 Diabetes

2018 ◽  
Vol 25 (1) ◽  
pp. 99-103
Author(s):  
Simona Clus ◽  
Gabriela Crețeanu ◽  
Amorin Popa
Keyword(s):  
Type 2 Diabetes ◽  
Disease Duration ◽  
Clinical Manifestations ◽  
Glucose Monitoring ◽  
Glucose Variability ◽  
Ambulatory Setting ◽  
Pharmacological Interventions ◽  
Nocturnal Hypoglycemia

Abstract Background and aims: It is known that the majority of critical unacknowledged hypoglycemia has an increased incidence in patients with type 1 diabetes (T1DM) with a long evolution. The aim of this research is to evaluate the variability of glucose level and hypoglycemic events in patients with type 2 diabetes (T2DM) having pharmacological interventions with hypoglycemic risk. These events are sometimes asymptomatic also in T2DM: frequently in elderly, patients with autonomic neuropathy, or having a long evolution of disease. Material and method: This analysis includes 72 patients with T2DM, with a relative good metabolic control, and possible glucose fluctuations. Glucose variability was appreciated using continuous glucose monitoring systems (CGMS) used for more than 72 hours in hospital or ambulatory setting. Results: The incidence, duration and severity of hypoglycemia are not correlated with HbA1c value, age, disease duration or treatment. Approximately a quarter of patients had nocturnal hypoglycemia and in 37,5% of events hypoglycemia was prolonged, more 45 minutes. Clinical manifestations in diurnal hypoglycemia were presents in only 40% of the recorded events. Conclusions: The study suggested that CGMS is beneficial for patients with type 2 diabetes, with hypoglycemic risk and complications, to adjusted medication, education and prevention the cardiovascular events.

scholarly journals Glucose Regulation Beyond HbA1c in Type 2 Diabetes Treated With Insulin: Real-World Evidence From the DIALECT-2 Cohort

2021 ◽  
Author(s):  
Niala den Braber ◽  
Miriam M.R. Vollenbroek-Hutten ◽  
Kathryn M. Westerik ◽  
Stephan J.L. Bakker ◽  
Gerjan Navis ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Monitoring ◽  
Glucose Variability ◽  
Glucose Regulation ◽  
Nocturnal Hypoglycemia ◽  
Real World Evidence ◽  
Freestyle Libre ◽  
Time In Range ◽  
Design And Methods

OBJECTIVE To investigate glucose variations associated with HbA<sub>1c</sub> in insulin treated patients with type 2 diabetes. <p>RESEARCH DESIGN AND METHODS Patients included in the Diabetes and Lifestyle Cohort Twente (DIALECT)-2 (n=79) were categorized in three HbA<sub>1c</sub> categories: low, intermediate and high (≤ 53; 54–62 and ≥ 63 mmol/mol or ≤ 7, 7.1–7.8, ≥ 7.9%). Blood glucose time in range (TIR), time below range (TBR), time above range (TAR), glucose variability parameters, day and night duration and frequency of TBR and TAR episodes were determined by continuous glucose monitoring (CGM), using the FreeStyle Libre sensor and compared between HbA<sub>1c</sub> categories.</p> <p>RESULTS <a>CGM was performed for a median [interquartile range] of 10 [7-12] days/ patient. </a>TIR was not different for low and intermediate HbA<sub>1c</sub> categories:<sub> </sub>(76.8% [68.3–88.2] vs 76.0% [72.5.0–80.1]), whereas in the low category<sub> </sub>TBR was higher and TAR lower (7.7% [2.4–19.1] vs 0.7% [0.3–6.1], and 8.2% [5.7–17.6] vs 20.4% [11.6–27.0], respectively, <i>p </i>< 0.05). Patients in the highest HbA<sub>1c </sub>category had lower TIR (52.7% [40.9–67.3]) and higher TAR (44.1% [27.8–57.0]) than the other HbA<sub>1c </sub>categories (<i>p</i> < 0.05), but did not have less TBR during the night. All patients had more (0.06 ± 0.06/h vs 0.03 ± 0.03/h, <i>p </i>= 0.002) and longer (88.0 [45.0–195.5] vs 53.4 [34.4–82.8] minutes, <i>p </i>< 0.001) TBR episodes during the night than during the day. </p> <p>CONCLUSIONS In this study, a high HbA<sub>1c</sub> did not reduce the occurrence of nocturnal hypoglycemia and low HbA<sub>1c</sub> was not associated with the highest TIR. Optimal personalization of glycemic control requires the use of newer tools, including CGM-derived parameters. <br> </p>

scholarly journals Reduced Glucose Variability With Glucose-Dependent Versus Glucose-Independent Therapies Despite Similar Glucose Control and Hypoglycemia Rates in a Randomized, Controlled Study of Older Patients With Type 2 Diabetes Mellitus

2018 ◽  
Vol 12 (6) ◽  
pp. 1184-1191
Author(s):  
Richard E. Pratley ◽  
Julio Rosenstock ◽  
Simon R. Heller ◽  
Alan Sinclair ◽  
Robert J. Heine ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Older Patients ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Glucose Variability ◽  
Controlled Study ◽  
Glucagon Like Peptide 1

Background: Few studies have evaluated continuous glucose monitoring (CGM) in older patients with type 2 diabetes mellitus (T2DM) not using injectable therapy. CGM is useful for investigating hypoglycemia and glycemic variability, which is associated with complications in T2DM. Methods: A CGM substudy of Individualized treatMent aPproach for oldER patIents in a randomized trial in type 2 diabetes Mellitus (IMPERIUM)) was conducted. Patients were vulnerable (moderately ill and/or frail) older (≥65 years) individuals with suboptimally controlled T2DM. Strategy A comprised glucose-dependent therapies (n = 26) with a nonsulfonylurea oral antihyperglycemic medication (OAM) and a glucagon-like peptide-1 receptor agonist as the first injectable. Strategy B comprised non-glucose-dependent therapies (n = 21) with sulfonylurea as the preferred OAM and insulin glargine as the first injectable. Primary endpoints were duration and percentage of time spent with blood glucose (BG) ≤70 mg/dL over 24 hours at week 24. Results: Duration and percentage of time spent with hypoglycemia at ≤70 mg/dL were similar for Strategy A and Strategy B; glycemic control improved similarly in both arms (LSM change in HbA1c at week 24; A = −1.2%, B = −1.4%). Duration and percentage time spent with euglycemia and hyperglycemia were also similar in both arms. However, Strategy A was associated with lower within-day (21.1 ± 1.2 vs 25.1 ± 1.4, P = .046) and between-day (5.4 ± 1.0 vs 9.1 ± 1.3, P = .038) BG variability (coefficient of variance [LSM ± SE]) at week 24. Conclusions: This CGM substudy in older patients with T2DM showed lower within- and between-day BG variability with glucose-dependent therapies but similar HbA1c reductions and hypoglycemia duration with glucose-independent strategies.

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