scholarly journals Sex Differences in Glutathione Peroxidase Activity and Central Obesity in Patients with Type 2 Diabetes at High Risk of Cardio-Renal Disease

Antioxidants ◽  
2019 ◽  
Vol 8 (12) ◽  
pp. 629 ◽  
Author(s):  
Mia Steyn ◽  
Karima Zitouni ◽  
Frank J Kelly ◽  
Paul Cook ◽  
Kenneth A Earle
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Waist Circumference ◽  
Glutathione Peroxidase ◽  
Renal Disease ◽  
Selenium Concentration ◽  
Fat Deposits ◽  
Central Fat ◽  
The Relationship

Women with type 2 diabetes (T2DM) have an increased susceptibility of developing cardio-renal disease compared to men, the reasons and the mechanisms of this vulnerability are unclear. Since oxidative stress plays a key role in the development of cardio-renal disease, we investigated the relationship between sex, plasma antioxidants status (glutathione peroxidase (GPx-3 activity), vitamin E and selenium), and adiposity in patients with T2DM at high risk of cardio-renal disease. Women compared to men had higher GPx-3 activity (p = 0.02), bio-impedance (p ≤ 0.0001), and an increase in waist circumference in relation to recommended cut off-points (p = 0.0001). Waist circumference and BMI were negatively correlated with GPx-3 activity (p ≤ 0.05 and p ≤ 0.01, respectively) and selenium concentration (p ≤ 0.01 and p ≤ 0.02, respectively). In multiple regression analysis, waist circumference and sex were independent predictors of GPx-3 activity (p ≤ 0.05 and p ≤ 0.05, respectively). The data suggest that increased central fat deposits are associated with reduced plasma antioxidants which could contribute to the future risk of cardio-renal disease. The increased GPx-3 activity in women could represent a preserved response to the disproportionate increase in visceral fat. Future studies should be aimed at evaluating if the modulation of GPx-3 activity reduces cardio-renal risk in men and women with T2DM.

scholarly journals Choice of HbA1c threshold for identifying individuals at high risk of type 2 diabetes and implications for diabetes prevention programmes: a cohort study

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Lauren R. Rodgers ◽  
Anita V. Hill ◽  
John M. Dennis ◽  
Zoe Craig ◽  
Benedict May ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Predictive Value ◽  
Absolute Risk ◽  
Parametric Survival Model ◽  
Prevention Programmes ◽  
Parametric Survival ◽  
The Impact ◽  
The Relationship

Abstract Background Type 2 diabetes (T2D) is common and increasing in prevalence. It is possible to prevent or delay T2D using lifestyle intervention programmes. Entry to these programmes is usually determined by a measure of glycaemia in the ‘intermediate’ range. This paper investigated the relationship between HbA1c and future diabetes risk and determined the impact of varying thresholds to identify those at high risk of developing T2D. Methods We studied 4227 participants without diabetes aged ≥ 40 years recruited to the Exeter 10,000 population cohort in South West England. HbA1c was measured at study recruitment with repeat HbA1c available as part of usual care. Absolute risk of developing diabetes within 5 years, defined by HbA1c ≥ 48 mmol/mol (6.5%), according to baseline HbA1c, was assessed by a flexible parametric survival model. Results The overall absolute 5-year risk (95% CI) of developing T2D in the cohort was 4.2% (3.6, 4.8%). This rose to 7.1% (6.1, 8.2%) in the 56% (n = 2358/4224) of participants classified ‘high-risk’ with HbA1c ≥ 39 mmol/mol (5.7%; ADA criteria). Under IEC criteria, HbA1c ≥ 42 mmol/mol (6.0%), 22% (n = 929/4277) of the cohort was classified high-risk with 5-year risk 14.9% (12.6, 17.2%). Those with the highest HbA1c values (44–47 mmol/mol [6.2–6.4%]) had much higher 5-year risk, 26.4% (22.0, 30.5%) compared with 2.1% (1.5, 2.6%) for 39–41 mmol/mol (5.7–5.9%) and 7.0% (5.4, 8.6%) for 42–43 mmol/mol (6.0–6.1%). Changing the entry criterion to prevention programmes from 39 to 42 mmol/mol (5.7–6.0%) reduced the proportion classified high-risk by 61%, and increased the positive predictive value (PPV) from 5.8 to 12.4% with negligible impact on the negative predictive value (NPV), 99.6% to 99.1%. Increasing the threshold further, to 44 mmol/mol (6.2%), reduced those classified high-risk by 59%, and markedly increased the PPV from 12.4 to 23.2% and had little impact on the NPV (99.1% to 98.5%). Conclusions A large proportion of people are identified as high-risk using current thresholds. Increasing the risk threshold markedly reduces the number of people that would be classified as high-risk and entered into prevention programmes, although this must be balanced against cases missed. Raising the entry threshold would allow limited intervention opportunities to be focused on those most likely to develop T2D.

The Relationship between Plasma alpha-Tocopherol Concentration and Vitamin E Intake in Patients with Type 2 Diabetes Mellitus

2011 ◽  
Vol 81 (1) ◽  
pp. 12-20 ◽  
Author(s):  
Vanessa K. Illison ◽  
Patricia H.C. Rondó ◽  
Andréia M. de Oliveira ◽  
Francisco H. D’Abronzo ◽  
Katia F. Campos
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Vitamin E ◽  
Waist Circumference ◽  
Total Cholesterol ◽  
Alpha Tocopherol ◽  
Tocopherol Concentration ◽  
The Relationship

Type 2 diabetes mellitus (DM2) predisposes to an increased production of free radicals and a probable reduction in plasma antioxidants, including vitamin E. This cross-sectional study investigated the relationship between plasma alpha-Tocopherol concentration and vitamin E intake in 58 Brazilians with DM2. Plasma alpha-Tocopherol was determined by high-performance liquid chromatography. The intake of vitamin E-rich foods was assessed by a food frequency questionnaire. Total cholesterol and fractions were measured by colorimetric enzymatic methods. Data on demographic and socioeconomic factors, life habits, and anthropometry were obtained by a questionnaire and physical examination. The association between plasma alpha-Tocopherol and vitamin E intake was assessed by multiple linear regression analysis. The following variables were included in the regression model: alpha-Tocopherol, vitamin E intake, total cholesterol and fractions, body mass index, waist circumference, gender, age, education, occupation, income, smoking, alcohol intake, and blood pressure. There was no association between alpha-Tocopherol and vitamin E intake, but there were significant associations between alpha-Tocopherol and total cholesterol (p < 0.001) and waist circumference (p = 0.003). There were 36.2 % diabetics with low alpha-Tocopherol concentrations (< 12 µmol/L) and 32.7 % with a low alpha-Tocopherol/total cholesterol ratio (< 2.2). Further large, epidemiological, longitudinal studies, including measurements of gamma-tocopherol in blood, should be conducted to confirm our results.

scholarly journals Peer-Supported Diabetes Prevention Program for Turkish- and Arabic-Speaking Communities in Australia

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Nabil Sulaiman ◽  
Elaine Hadj ◽  
Amal Hussein ◽  
Doris Young
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
High Risk ◽  
Waist Circumference ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Lifestyle Behaviour ◽  
Arabic Speaking

In Australia, type 2 diabetes and prediabetes are more prevalent in culturally and linguistically diverse (CALD) communities than mainstream Australians. Purpose. To develop, implement, and evaluate culturally sensitive peer-supported diabetes education program for the prevention of type 2 diabetes in high-risk middle-aged Turkish- and Arabic-speaking people. Methods. A two-day training program was developed. Ten bilingual peer leaders were recruited from existing health and social networks in Melbourne and were trained by diabetes educators. Each leader recruited 10 high-risk people for developing diabetes. Questionnaires were administered, and height, weight, and waist circumference were measured at baseline and three months after the intervention. The intervention comprised two 2-hour group sessions and 30 minutes reinforcement and support telephone calls. Results. 94 individuals (73% women) completed the program. Three months after the program, the participants’ mean body weight (before = 78.1 kg, after = 77.3; Z score = −3.415, P=0.001) and waist circumference (Z = −2.569, P=0.004) were reduced, their diabetes knowledge was enhanced, and lifestyle behaviours were significantly improved. Conclusions. A short diabetes prevention program delivered by bilingual peers was associated with improved diabetes awareness, changed lifestyle behaviour, and reduction in body weight 3 months after intervention. The findings are encouraging and should stimulate a larger control-designed study.

scholarly journals Atherogenic Index in Type 2 Diabetes and Its Relationship with Chronic Microvascular Complications

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Zhen Li ◽  
Qi Huang ◽  
Li Sun ◽  
Tengfei Bao ◽  
Zhe Dai
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
High Risk ◽  
Waist Circumference ◽  
Microvascular Complications ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Atherogenic Index ◽  
Lipid Lowering

Objective. This study was designed to investigate risk factors related to atherogenic index of plasma (AIP), as well as the relationship between AIP and chronic microvascular complications in patients with type 2 diabetes (T2DM). Methods. This study included 2523 patients with T2DM who had not been treated with lipid-lowering drugs and were admitted to the Department of Endocrinology at Zhongnan Hospital, Wuhan University, during the period from January 2015 to February 2018. Anthropometric indicators were measured after overnight fasting. Low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglyceride (TG) were detected by enzymatic analysis. Standard 75 g oral glucose tolerance testing was performed to measure 0 and 2 hr plasma levels of glucose and insulin. Insulin sensitivity was assessed with HOMA-IR. Results. Increase in AIP was associated with an increased risk for hypertension (P<0.05), HbA1c (P<0.05), HOMA-IR (P<0.05), UA (P<0.05), and decreased eGFR levels (P<0.05). Furthermore, AIP values directly correlated with BMI (r=0.182, P<0.001), waist circumference (r=0.129, P<0.001), blood glucose index (FBG (r=0.153, P<0.001), PPBG (r=0.117, P<0.001), and HbA1c (r=0.074, P<0.001)), insulin resistance (HOMA-IR; r=0.112, P<0.001), and uric acid (UA, r=0.177, P<0.001). Multiple logistic regression analysis showed that waist circumference, HOMA-IR, FBG, systolic blood pressure, and UA were independent risk factors for AIP (all P<0.05). The prevalence of diabetic neuropathy and metabolic syndrome was significantly higher among patients with higher AIP. Conclusion. AIP represents a clinically convenient indicator for the detection of T2DM with high risk of complications and associated diseases and thus is a good predictor and indicator for follow-up monitoring in the treatment of patients with high-risk type 2 diabetes.

scholarly journals The Relationship between Hypertriglyceridemic Waist Phenotype and Early Diabetic Nephropathy in Type 2 Diabetes

2017 ◽  
Vol 7 (4) ◽  
pp. 295-300 ◽  
Author(s):  
Chun-Ming Ma ◽  
Rui Wang ◽  
Xiao-Li Liu ◽  
Na Lu ◽  
Qiang Lu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Nephropathy ◽  
Waist Circumference ◽  
Glycosylated Hemoglobin ◽  
Serum Triglyceride ◽  
Hypertriglyceridemic Waist ◽  
The Relationship ◽  
Early Diabetic Nephropathy ◽  
Diabetes Patients

Background/Aims: The aim of this study was to explore the relationship between hypertriglyceridemic waist (HW) phenotype and early diabetic nephropathy in type 2 diabetes. Methods: A cross-sectional study was conducted on 538 type 2 diabetes patients in Qinhuangdao. The HW phenotype was defined as serum triglyceride concentrations ≥1.7 mmol/L and waist circumference ≥90 cm (males) and ≥85 cm (females). Results: The prevalence of the HW phenotype was 34.9%. The prevalence of early diabetic nephropathy was 10.6% in type 2 diabetes patients with normal waist circumference and triglycerides and 24.5% in type 2 diabetes patients with HW phenotype. After adjustment for sex, age, body mass index, hypertension, history of diabetes, and glycosylated hemoglobin A1c, the prevalence of early diabetic nephropathy among type 2 diabetes patients with the HW phenotype was 2.81 (95% confidence interval 1.36-5.80, p = 0.005) times higher than that among type 2 diabetes patients with normal waist circumference and triglycerides. Conclusion: There was a significant correlation between HW phenotype and early diabetic nephropathy in type 2 diabetes.

Prevalence of type 2 diabetes and associated risk factors among Saharawi refugees in Algeria

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Henjum ◽  
M K R Kjollesdal ◽  
M O Flaaten ◽  
E Andersen ◽  
V T Hjellset ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
High Risk ◽  
Waist Circumference ◽  
Overweight And Obesity ◽  
Refugee Camps ◽  
High Blood Glucose ◽  
Effective Manner ◽  
Associated Risk Factors

Abstract Background The Saharawi refugees have been living in refugee camps in the Algerian desert since 1975 and are dependent on food aid. A double burden of malnutrition by the coexistence of undernutrition among children and overweight and obesity among adults has been observed in the Saharawi refugee camps. Limited knowledge about the prevalence of type 2 diabetes (T2D) and associated risk factors exists in this population. The aim of this study was, therefore, to address this gap in the literature. Methods A cross-sectional survey was carried out in five Saharawi refugee camps in Algeria in 2014. A total of 180 women and 175 men were included. HbA1c was used to assess the prevalence of T2D and prediabetes. The Finnish Diabetes Risk Score (FINDRISC) was used to estimate the risk of developing T2D. Multiple logistic regressions were performed to assess risk factors associated with T2D and prediabetes. Results Median (min, max) HbA1c among the Saharawi refugees was 35 (4, 135) mmol/mol. The prevalence of T2D and prediabetes was 7% and 10%, respectively. The prevalence of overweight and obesity combined was 45%, and higher in women than in men. According to FINDRISC, 9% of participants had high risk of developing diabetes and 10% had moderate risk. In adjusted models, significant predictors for T2D were age, waist circumference and having a first-degree relative with T2D. Significant predictors for prediabetes were age, body mass index (BMI), waist circumference and a history of high blood glucose. Conclusions We found moderate prevalence of diabetes and prediabetes and a relatively high prevalence of overweight and obesity among the Saharawi refugees, especially the women. Given the fragility of the Saharawi health care system, screening for diabetes should be conducted in a cost-effective manner and high-risk individuals should receive advice about lifestyle changes (e.g. diet and physical activity). Key messages We found moderate prevalence of diabetes and pre-diabetes among the Saharawi refugees, and a high proportion were classified as overweight or obese. In light of this, the rates of T2D are likely to increase in the near future. The Saharawi health authorities should pay attention to the increased risk of diabetes in this vulnerable population.

scholarly journals The relationship between common mental disorders and incident diabetes among participants in the Kerala Diabetes Prevention Program (K-DPP)

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255217
Author(s):  
Leslie C. M. Johnson ◽  
Allissa Desloge ◽  
Thirunavukkarasu Sathish ◽  
Emily D. Williams ◽  
Pilvikki Absetz ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Severe Depression ◽  
Diabetes Prevention Program ◽  
Depression And Anxiety ◽  
Prevalence Of Depression ◽  
The Relationship

This study aims to describe the prevalence of depression and anxiety among a population sample of people at high risk for type 2 diabetes in Kerala, India, and examine the relationship between depressive symptoms, anxiety, and incident Type 2 Diabetes Mellitus (T2DM) over a two-year period. We used data from the Kerala Diabetes Prevention Program, a cluster-randomized controlled trial for diabetes prevention among 1007 high-risk individuals. The prevalence of depression and anxiety were estimated using the 9-item Patient Health Questionnaire and the Generalized Anxiety Disorder 7-item scale, respectively. We calculated proportions for depression and anxiety and performed generalized estimating equations (GEE) to examine the relationship between baseline mental health status and incident T2DM. The prevalence of depression and anxiety at baseline were 7.5% and 5.5%, respectively. Compared with those reporting none/low symptoms, the odds ratio for incident diabetes was 1.07 (95% CI 0.54–2.12) for participants with moderate to severe depression and 0.73 (95% CI 0.23–2.28) for participants with moderate to severe anxiety, after adjusting for potential confounders. Our findings suggest that the prevalence of depression and anxiety were higher than those previously reported in the general population in India. However, among this sample of community-based adults at high risk of developing T2DM, the presence of moderate to severe depression and/or anxiety symptoms was not significantly associated with the risk of developing T2DM. Trial registration: Australia and New Zealand Clinical Trials Registry ACTRN12611000262909. Registered 10 March 2011.

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