scholarly journals Effects of Metronidazole as an Adjunct to Non-Surgical Periodontal Therapy on Insulin Resistance in Type 2 Diabetics

Antibiotics ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1400
Author(s):  
Ambrina Qureshi ◽  
Zeba Haque ◽  
Hina Qureshi ◽  
Waqas Ahmed Farooqui
Keyword(s):  
Insulin Resistance ◽  
Repeated Measures ◽  
P Value ◽  
Model Assessment ◽  
Short Term ◽  
Type 2 Diabetics ◽  
The Difference ◽  
Post Hoc

Treating periodontitis with metronidazole (MET) as an adjunct to scaling root planing (SRP) is suggested to have inconsistent effects on insulin resistance (IR) in type 2 diabetes mellitus (T2DM). This paper will present the effects of MET, in addition to SRP, on the homeostatis model assessment of IR (HOMA-IR). A three-arm clinical trial was conducted and analyses were performed on T2DM participants with periodontitis (n = 74) who completed follow-up visits at 3 and 6 months after the intervention. The observed between-group and within-group mean changes in IR were found using ANOVA with repeated measures, followed by a post-hoc analysis, and a p-value of ≤0.05 was considered significant. Between-group analyses showed no difference in the HOMA-IR at 3 months, but at 6 months the difference was significant (p = 0.046). Within-group analyses showed that the HOMA-IR was significantly reduced in both test groups (p ≤ 0.05) over the period of time. Adjunct use of MET may result in a sudden short-term lowering of the HOMA-IR level within 3 months that may not be retained over 6 months when compared to the sustained lowering of the HOMA-IR levels in T2DM when intervened with SRP without MET.

scholarly journals Glycolysis/gluconeogenesis- and tricarboxylic acid cycle–related metabolites, Mediterranean diet, and type 2 diabetes

2020 ◽  
Vol 111 (4) ◽  
pp. 835-844 ◽  
Author(s):  
Marta Guasch-Ferré ◽  
José L Santos ◽  
Miguel A Martínez-González ◽  
Clary B Clish ◽  
Cristina Razquin ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Relative Risk ◽  
Mediterranean Diet ◽  
Tca Cycle ◽  
Tricarboxylic Acid ◽  
Model Assessment ◽  
Weighted Score

ABSTRACT Background Glycolysis/gluconeogenesis and tricarboxylic acid (TCA) cycle metabolites have been associated with type 2 diabetes (T2D). However, the associations of these metabolites with T2D incidence and the potential effect of dietary interventions remain unclear. Objectives We aimed to evaluate the association of baseline and 1-y changes in glycolysis/gluconeogenesis and TCA cycle metabolites with insulin resistance and T2D incidence, and the potential modifying effect of Mediterranean diet (MedDiet) interventions. Methods We included 251 incident T2D cases and 638 noncases in a nested case-cohort study within the PREDIMED Study during median follow-up of 3.8 y. Participants were allocated to MedDiet + extra-virgin olive oil, MedDiet + nuts, or control diet. Plasma metabolites were measured using a targeted approach by LC–tandem MS. We tested the associations of baseline and 1-y changes in glycolysis/gluconeogenesis and TCA cycle metabolites with subsequent T2D risk using weighted Cox regression models and adjusting for potential confounders. We designed a weighted score combining all these metabolites and applying the leave-one-out cross-validation approach. Results Baseline circulating concentrations of hexose monophosphate, pyruvate, lactate, alanine, glycerol-3 phosphate, and isocitrate were significantly associated with higher T2D risk (17–44% higher risk for each 1-SD increment). The weighted score including all metabolites was associated with a 30% (95% CI: 1.12, 1.51) higher relative risk of T2D for each 1-SD increment. Baseline lactate and alanine were associated with baseline and 1-y changes of homeostasis model assessment of insulin resistance. One-year increases in most metabolites and in the weighted score were associated with higher relative risk of T2D after 1 y of follow-up. Lower risks were observed in the MedDiet groups than in the control group although no significant interactions were found after adjusting for multiple comparisons. Conclusions We identified a panel of glycolysis/gluconeogenesis-related metabolites that was significantly associated with T2D risk in a Mediterranean population at high cardiovascular disease risk. A MedDiet could counteract the detrimental effects of these metabolites. This trial was registered at controlled-trials.com as ISRCTN35739639.

scholarly journals "Teaching:Individual" to Increase Adherence to Therapeutic Regimen in People with Hypertension and Type-2 Diabetes: Randomized Controlled Trial ENURSIN

2019 ◽  
Author(s):  
Dora Inés Parra ◽  
Sandra Lucrecia Romero Guevara ◽  
Lyda Zoraya Rojas Sánchez
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Repeated Measures ◽  
Correlation Matrix ◽  
Educational Interventions ◽  
Therapeutic Regimen ◽  
Multifaceted Approach ◽  
The Difference

Abstract Background. Educational interventions with multifaceted approach have proven effective to improve adherence to the therapeutic regimen in people with chronic diseases. This study sought to evaluate the efficacy of the nursing intervention “Teaching: Individual” compared with usual care to increase adherence to therapeutic regimen and to analyze the impact of nursing interventions to decrease systolic blood pressure (SBP) and glycosylated hemoglobin (HbA1c) levels in people with hypertension and/or type-2 diabetes mellitus. Methods. This was a two-arm parallel randomized clinical trial in 200 patients from primary care programs with arterial hypertension and type-2 diabetes. The intervention was designed with a multifaceted approach and conducted individually in six sessions. For statistical analysis of SBP, a linear marginal model was used with an exchangeable correlation matrix for repeated measures, and for treatment adherence as well as generalized HbA1c estimating equations repeated measures were used with an unstructured correlation matrix, using all available data. All analyses were conducted in STATA software version 15.0. Values of p <0.05 were considered statistically significant. Results. After six months the follow up score adherence to the therapeutic regimen was higher in the “Teaching: Individual” group compared with the usual care group with a difference in the median of 0.87 points (95% CI: 0.30 to 1.44). The difference in the median of SBP between the groups was -3.79 mmHg (95% CI: -6.85 to -0.73), in favor of the group intervened. The difference in the median of HbA1c was -0.16% (95% CI: -0.41 to 0.09). The effect was not maintained at 12 months of follow up in none of the variables of interest. Conclusions. As well as in other contexts, this study determined that educational interventions with multifaceted approach leaded by nursing are effective in improving therapeutic adherence and control of tension figures in users of primary care programs with high blood pressure and type-2 diabetes. Trial Registration: ENURSIN was registered in ClinicalTrials.gov (NCT02758275) on 27 April 2016, protocol number 01. Keywords: Nursing Process; Diabetes Mellitus, Type 2; Hypertension, Patient Education as a Topic, Blood Pressure Monitoring, Ambulatory; Treatment Adherence and Compliance; Glycated Hemoglobin A.

scholarly journals A Follow-up Study on BMI-SDS and Insulin Resistance in Overweight and Obese Children at Risk for Type 2 Diabetes Mellitus

2015 ◽  
Vol 2 ◽  
pp. 2333794X1456845 ◽  
Author(s):  
Soulmaz Fazeli Farsani ◽  
Marloes P. van der Aa ◽  
Catherijne A. J. Knibbe ◽  
Anthonius de Boer ◽  
Marja M. J. van der Vorst
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
At Risk ◽  
Type 2 Diabetes Mellitus ◽  
Model Assessment ◽  
Children At Risk ◽  
The Mean

Objectives. To evaluate body mass index standard deviation score (BMI-SDS), insulin sensitivity, and progression to type 2 diabetes mellitus (T2DM) in children at risk for T2DM approximately 3 years after being diagnosed with overweight/obesity and insulin resistance (measured by Homeostasis Model Assessment of Insulin Resistance [HOMA-IR]). Methods. Out of 86 invited children, 44 (mean age 15.4 ± 3.6 years) participated. Medical history, physical examination, and laboratory workup were performed. Results. While the mean BMI-SDS significantly increased from 2.9 to 3.4, the mean HOMA-IR significantly decreased from 5.5 to 4.6 (baseline vs follow-up visit). Change in HOMA-IR was only due to a decrease in mean fasting plasma insulin (24.1 vs 21.1, P = .073). Conclusions. Although increase in BMI-SDS in these children is worrisome, the American Diabetes Association recommended screening interval of 3 years for children at risk for T2DM is not too long based on the fact that none of our study participants developed T2DM.

scholarly journals Flaxseed oil supplementation manipulates correlations between serum individual mol % free fatty acid levels and insulin resistance in type 2 diabetics. Insulin resistance and percent remaining pancreatic β-cell function are unaffected

2016 ◽  
Vol 50 (4) ◽  
pp. 183-193 ◽  
Author(s):  
DE Barre ◽  
KA Mizier-Barre ◽  
O Griscti ◽  
K Hafez
Keyword(s):  
Insulin Resistance ◽  
Cell Function ◽  
Flaxseed Oil ◽  
Total Serum ◽  
Safflower Oil ◽  
Model Assessment ◽  
Β Cell ◽  
Type 2 Diabetics ◽  
Β Cell Function

AbstractObjectives. Elevated total serum free fatty acids (FFAs) concentrations have been suggested, controversially, to enhance insulin resistance and decrease percent remaining β-cell function. However, concentrations of individual serum FFAs have never been published in terms of their relationship (correlation) to homeostatic model assessment-insulin resistance (HOMA-IR) and percent remaining β-cell function (HOMA-%β) in the type 2 diabetics (T2Ds). Alpha-linolenic acid consumption has a negative correlation with the insulin resistance, which in turn is negatively correlated with the remaining β-cell function. The primary objective was to test the hypothesis that there would be different relationship (correlation) between the blood serum individual free FFA mol % levels and HOMA-IR and/or HOMA-%β in T2D. The secondary objective was to test the hypothesis that flaxseed oil, previously being shown to be ineffective in the glycemic control in T2Ds, may alter these correlations in a statistically significant manner as well as HOMA-IR and/or HOMA-%β.Methods. Patients were recruited via a newspaper advertisement and two physicians have been employed. All the patients came to visit one and three months later for a second visit. At the second visit, the subjects were randomly assigned (double blind) to flaxseed or safflower oil treatment for three months, until the third visit.Results. Different statistically significant correlations or trends towards among some serum individual free FFA mol % levels and HOMA-IR and HOMA-%β, pre- and post-flaxseed and safflower oil supplementation were found. However, flaxseed oil had no impact on HOMA-IR or HOMA-%β despite statistically significant alterations in correlations compared to baseline HOMA-IR.Conclusions. The obtained data indicate that high doses of flaxseed oil have no statistically significant effect on HOMA-IR or HOMA-%β in T2Ds, probably due to the additive effects of negative and positive correlations.

scholarly journals Incidence of type 2 diabetes in familial combined hyperlipidemia

2020 ◽  
Vol 8 (1) ◽  
pp. e001107 ◽  
Author(s):  
Martijn C G J Brouwers ◽  
Jacqueline de Graaf ◽  
Nynke Simons ◽  
Steven Meex ◽  
Sophie ten Doeschate ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Fatty Liver ◽  
Visceral Obesity ◽  
High Risk Population ◽  
Model Assessment ◽  
Familial Combined Hyperlipidemia ◽  
Original Cohort

ObjectiveFamilial combined hyperlipidemia (FCHL) is common among survivors of a premature myocardial infarction. FCHL patients are characterized by visceral obesity, fatty liver, and insulin resistance. The aim of the present study was to determine the incidence and determinants of type 2 diabetes (T2D) in a longitudinal cohort of FCHL pedigrees.Research design and methodsFCHL patients, their unaffected relatives and spouses included in our baseline cohort in 1998–2005 (n=596) were re-invited to determine the incidence of self-reported T2D (that was confirmed by medical records), used as the primary outcome measure. The Fatty Liver Index (FLI) and Homeostasis Model Assessment Insulin Resistance (HOMA2-IR) were used as markers of fatty liver and insulin resistance, respectively. A subset of the original cohort underwent ultrasound of the liver, and subcutaneous and visceral fat in 2002–2005 (n=275; ‘ultrasound subcohort’).ResultsFollow-up data (median: 15 years) was acquired for 76%. The incidence rate of T2D was significantly higher in FCHL patients compared with spouses (19.2 per 1000 person-years vs 2.8 per 1000 person-years; HR : 6.3, 95% CI: 2.4 to 16.8), whereas no differences were observed between unaffected relatives and spouses (HR: 0.9, 95% CI: 0.3 to 2.6). Cox’s proportional hazard regression analyses showed that baseline HOMA2-IR and FLI≥60, but not waist circumference, BMI, or the FCHL affected state, were independently associated with incident T2D. Similar results were obtained in the ultrasound subcohort (median follow-up: 11 years), in which baseline HOMA2-IR and fatty liver (assessed by ultrasound) were independently associated with incident T2D.ConclusionThis study further corroborates the suggestion that the liver plays a central role in the pathogenesis of cardiometabolic complications in FCHL. It supports periodical screening for T2D in this high-risk population.

scholarly journals Association between Adiponectin and Insulin Resistance among Sudanese Males with Type 2 Diabetes Mellitus

2021 ◽  
Author(s):  
Eman Ahamed Almakey ◽  
Ahmed Mohamed Makeen ◽  
Osman Khalafalla Saeed ◽  
Khalid Abdelsamea Mohamedahmed
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Serum Adiponectin ◽  
Control Group ◽  
P Value ◽  
Model Assessment ◽  
Positive Effects

Abstract Background Adiponectin is associated with improved systemic insulin sensitivity and profound positive effects in adipose tissue, such as increasing mitochondrial density in adipocytes, reducing adipocyte size, and effective esterification of free fatty acids on lipid storage The factor performs forward transcriptional regulation. Diabetes and its complications are considered to be one of the main causes of morbidity and mortality worldwide. Objectives The aim of this study was to correlate serum levels of adiponectin with insulin resistance in Sudanese males' type 2 diabetes mellitus. Methodology: A case-control community-based study carried out among 126 patients with T2DM as cases group (mean ages 45.2 ± 5.4 years); and 126 normal healthy individuals as controls group (mean ages 44.7 ± 5.4 years as) in Aldaraga Diabetic Center, Wad Medani, Gezira State, Sudan. About Five mL of fasting venous blood was obtained from all participants. HbA1c, FPG, FPI, serum Adiponectin, and (HOMA)-IR were analyzed. SPSS (v 20.0) was used for data analysis. Results The mean of serum adiponectin in the cases group (3.03 ± 0.90µg/ml) was lower than the control group (6.02 ± 4.24µg/ml) giving highly significant differences -between them (P = value ≤ 0.000). HbA1c and Homeostasis Model Assessment of Insulin Resistance index (HOMA-IR) differed significantly between the two groups (P-value ≤ 0.000). Serum adiponectin concentrations correlated significantly negative with HOMA IR (r = -0.149, P-value = 0.002). Conclusion We concluded that low plasma adiponectin level was predictive of future development of Insulin resistance in Sudanese males.

scholarly journals Homeostasis Model Assessment Is a Reliable Indicator of Insulin Resistance During Follow-up of Patients With Type 2 Diabetes

Diabetes Care ◽  
2001 ◽  
Vol 24 (2) ◽  
pp. 362-365 ◽  
Author(s):  
A. Katsuki ◽  
Y. Sumida ◽  
E. C. Gabazza ◽  
S. Murashima ◽  
M. Furuta ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Reliable Indicator ◽  
Model Assessment ◽  
Homeostasis Model Assessment

scholarly journals The Effect of Laparoscopic Gastric Bypass Surgery on Insulin Resistance and Glycosylated Hemoglobin A1c: a 2-Year Follow-up Study

2020 ◽  
Vol 30 (9) ◽  
pp. 3489-3495
Author(s):  
Erik Stenberg ◽  
Eva Rask ◽  
Eva Szabo ◽  
Ingmar Näslund ◽  
Johan Ottosson
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Gastric Bypass ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Glycosylated Hemoglobin ◽  
Model Assessment ◽  
Fasting Insulin

Abstract Background Bariatric surgery improves insulin sensitivity and secretion in patients with type 2 diabetes, but the effect on patients with prediabetes or even normal glucose tolerance deserves further consideration. Methods Cohort study including patients operated with laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) between November 2012 and June 2017 at the Örebro University Hospital (n = 813) with follow-up of 742 patients 2 years after surgery. Fasting insulin, glucose, glycosylated hemoglobin (HbA1c), and homeostatic model assessment of insulin resistance (HOMA-IR) were analyzed at baseline and 2 years after surgery for patients with overt type 2 diabetes, prediabetes, or non-diabetes. Results Fasting insulin levels improved for all groups (diabetics baseline 25.5 mIU/L, IQR 17.5–38.0, 2 years 7.6 mIU/L, IQR 5.4–11.1, p < 0.001; prediabetics baseline 25.0 mIU/L, IQR 17.5–35.0, 2 years 6.7mIU/L, IQR 5.3–8.8, p < 0.001; non-diabetics baseline 20.0 mIU/L, IQR 14.0–30.0, 2 years 6.4 mIU/L, IQR 5.0–8.5, p < 0.001). HbA1c improved in all groups (diabetics baseline 56 mmol/mol, IQR 49–74 [7.3%, IQP 6.6–8.9], 2 years 38 mmol/mol, IQR 36–47 [5.6%, IQR 5.4–6.4], p < 0.001; prediabetics baseline 40 mmol/mol, IQR 39–42 [5.8%, IQR5.7–6.0], 2 years 36 mmol/mol, IQR 34–38 [5.5%, IQR 5.3–5.6], p < 0.001; non-diabetics baseline 35 mmol/mol, IQR 33–37 [5.4%, IQR 5.2–5.5]; 2 years 34 mmol/mol, IQR 31–36 [5.3%, IQR 5.0–5.4], p < 0.001). HOMA-IR improved in all groups (diabetics baseline 9.3 mmol/mol, IQR 5.4–12.9, 2 years 1.9 mmol/mol, IQR 1.4–2.7, p < 0.001; prediabetics baseline 7.0 mmol/mol, IQR 4.3–9.9, 2 years 1.6 mmol/mol, IQR 1.2–2.1, p < 0.001; non-diabetics 4.9 mmol/mol, IQR 3.4–7.3, 2 years 1.4 mmol/mol, IQR 1.1–1.9, p < 0.001). Conclusion Insulin homeostasis and glucometabolic control improve in all patients after LRYGB, not only in diabetics but also in prediabetics and non-diabetic obese patients, and this improvement is sustained 2 years after surgery.

scholarly journals Association of endothelial dysfunction with incident prediabetes, type 2 diabetes and related traits: the KORA F4/FF4 study

2020 ◽  
Vol 8 (1) ◽  
pp. e001321
Author(s):  
Marie-Theres Huemer ◽  
Cornelia Huth ◽  
Florian Schederecker ◽  
Stefanie J Klug ◽  
Christa Meisinger ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Fasting Glucose ◽  
Model Assessment ◽  
Fasting Insulin ◽  
Homeostasis Model Assessment

IntroductionPeripheral arterial tonometry (PAT) is an operator-independent and non-invasive measurement method to assess microvascular endothelial function in the fingertips. PAT-derived measures of endothelial function were associated with type 2 diabetes in cross-sectional studies. However, longitudinal studies are lacking. The study aims to investigate the association of two PAT-derived endothelial function parameters reactive hyperemia index (RHI) and mean baseline amplitude (MBA) with follow-up glucose and insulin parameters and the development of (pre)diabetes and type 2 diabetes.Research design and methodsThe study included 673 participants initially without diabetes (328 men and 345 women) aged 52–71 years from the prospective population-based Cooperative Health Research in the Region of Augsburg F4/FF4 cohort study conducted in Southern Germany (baseline examination F4: 2006–2008; follow-up FF4: 2013–2014). An oral glucose tolerance test was performed at baseline and follow-up to define type 2 diabetes, prediabetes, fasting glucose, fasting insulin, 2-hour glucose, homeostasis model assessment of insulin resistance (HOMA-IR), homeostasis model assessment of beta-cell function and hemoglobin A1c.ResultsIn multivariable adjusted logistic/linear regression models, a 1 SD increase in baseline RHI was inversely associated with incident type 2 diabetes (OR 0.69 (95% CI 0.48 to 0.97)) as well as with fasting insulin (β −0.069 (95% CI −0.131 to −0.007)) and HOMA-IR (β −0.072 (95% CI −0.133 to −0.010)) at follow-up in participants with initial normoglycemia. A 1 SD increase in baseline MBA was positively associated with incident (pre)diabetes (OR 1.62 (95% CI 1.25 to 2.11)) and fasting glucose (β 0.096 (95% CI 0.047 to 0.146)) at follow-up in participants with initial normoglycemia.ConclusionsMicrovascular endothelial dysfunction seems to be involved in the development of early derangements in glucose metabolism and insulin resistance and could thereby trigger the development of prediabetes and type 2 diabetes.

scholarly journals Study of prevalence of metabolic syndrome in obese children in Konaseema region of India

2020 ◽  
Vol 7 (12) ◽  
pp. 2321
Author(s):  
R. Pratyush ◽  
K. Narayan Rao
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Overweight And Obesity ◽  
P Value ◽  
Model Assessment ◽  
Overweight Children ◽  
Cross Sectional ◽  
Homeostatic Model Assessment ◽  
Overweight Or Obesity

Background: The rising prevalence of overweight and obesity is associated with development of growing number of early complications in children and adolescents among that type 2 diabetes mellitus and metabolic syndrome (MS) is common. Present study has been designed to identify the prevalence of MS in children with overweight risk, overweight or obesity and to compare anthropometric and biochemical parameters in patients with metabolic syndrome and without MS.Methods: This is a cross sectional descriptive study conducted in the department of paediatrics where 120 patients with obesity were enrolled for this study and various metabolic parameters were compared.Results: In our study the prevalence of metabolic syndrome was 30% among obese and overweight children. Fasting insulin (18.65±13.64 mg/dl versus 16.48±10.32 mg/dl) was significantly higher in patients with MS than without MS (p is less than 0.05). Homeostatic model assessment of insulin resistance (HOMA-IR) was 5.84±1.43 in MS group and 4.54±1.34 in without MS group. The p value was 0.00. The glycocylated haemoglobin was significantly higher in MS group than without MS group (5.84±0.78 versus 4.54±0.34).Conclusions: From our study we can conclude that metabolic syndrome is a common problem in children with overweight and obesity in our region. Insulin resistance and metabolic abnormality were more common in children with MS.

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