scholarly journals Immunological and Pathophysiological Outcomes of Helminth Infections and Type 2 Diabetes Comorbidity Studies in Humans and Experimental Animals—A Scoping Review

2021 ◽  
Vol 11 (17) ◽  
pp. 8079
Author(s):  
Ekuyikeno Silas ◽  
Siyanda Ndlovu ◽  
Selaelo Ivy Tshilwane ◽  
Samson Mukaratirwa

Animal and human studies have demonstrated that helminth infections are associated with a decreased prevalence of type 2 diabetes mellitus (T2DM). Lack of exposure to helminth infections has been postulated to be one mechanism to explain the markedly increased prevalence of T2DM in developed countries. However, there is still paucity of information regarding the immunological interactions between helminth infections and T2DM. The study aimed at reviewing peer-reviewed articles on host immune and pathophysiological outcomes from human and laboratory animal studies of helminth infections and T2DM comorbidity. A literature search was carried out in Google Scholar, PubMed, and EBSCOhost databases using the following keywords; immune responses OR immune modulation of helminth infections OR parasites infections AND Type 2 diabetes comorbidity in humans AND experimental/laboratory animals. Results showed that helminth infections provided some degree of protection from the pathology associated with T2DM by modulating the surrounding cytokine and chemokine milieu in humans and animals. Whilst there is some evidence regarding the protective effects of helminth infections to T2DM in cases of comorbidity, there is paucity of research in both laboratory animals and humans, with reference to the immunological and pathophysiological mechanisms which occur during comorbidity, and these constitute gaps for future research.

2018 ◽  
Vol 69 (4) ◽  
pp. 697-704 ◽  
Author(s):  
Anuradha Rajamanickam ◽  
Saravanan Munisankar ◽  
Yukthi Bhootra ◽  
Chandrakumar Dolla ◽  
Kannan Thiruvengadam ◽  
...  

Abstract Background Human and animal studies have demonstrated that helminth infections are associated with a decreased prevalence of type 2 diabetes mellitus (T2DM). However, very little is known about their biochemical and immunological interactions. Methods To assess the relationship between a soil-transmitted helminth, Strongyloides stercoralis (Ss), and T2DM, we examined analytes associated with glycemic control, metabolic processes, and T-cell–driven inflammation at the time of Ss diagnosis and 6 months after definitive anthelmintic treatment. We measured plasma levels of hemoglobin A1c, glucose, insulin, glucagon, adipocytokines, and T-helper (TH) 1-, 2-, and 17- associated cytokines in patients with T2DM with (INF group) or without (UN group) Ss infection. In INF individuals, we again assessed the levels of these analytes 6 months following anthelmintic treatment. Results Compared to UN individuals, INF individuals exhibited significantly diminished levels of insulin and glucagon that increased significantly following therapy. Similarly, INF individuals exhibited significantly diminished levels of adiponectin and adipsin that reversed following therapy. INF individuals also exhibited significantly decreased levels of the TH1- and TH17- associated cytokines in comparison to UN individuals; again, anthelmintic therapy augmented these levels. As expected, INF individuals had elevated levels of TH2-associated and regulatory cytokines that normalized following definitive therapy. Multivariate analysis revealed that these changes were independent of age, sex, body mass index, and liver and renal function. Conclusions Strongyloides stercoralis infection is associated with a significant modulation of glycemic, hormonal, and cytokine parameters in T2DM and its reversal following anthelmintic therapy. Hence, Ss infection has a protective effect on diabetes-related parameters.


2011 ◽  
pp. 5-10
Author(s):  
Huu Dang Tran

The incretins are peptide hormones secreted from the gut in response to food. They increase the secretion of insulin. The incretin response is reduced in patients with type 2 diabetes so drugs acting on incretins may improve glycaemic control. Incretins are metabolised by dipeptidyl peptidase, so selectively inhibiting this enzyme increases the concentration of circulating incretins. A similar effect results from giving an incretin analogue that cannot be cleaved by dipeptidyl peptidase. Studies have identified other actions including improvement in pancreatic β cell glucose sensitivity and, in animal studies, promotion of pancreatic β cell proliferation and reduction in β cell apoptosis.


Author(s):  
Emina Hadziabdic ◽  
Sara Pettersson ◽  
Helén Marklund ◽  
Katarina Hjelm

Abstract Aim: To develop a diabetes education model based on individual beliefs, knowledge and risk awareness, aimed at migrants with type 2 diabetes, living in Sweden. Background: Type 2 diabetes is rapidly increasing globally, particularly affecting migrants living in developed countries. There is ongoing debate about what kind of teaching method gives the best result, but few studies have evaluated different methods for teaching migrants. Previous studies lack a theoretical base and do not proceed from the individuals’ own beliefs about health and illness, underpinned by their knowledge, guiding their health-related behaviour. Methods: A diabetes education model was developed to increase knowledge about diabetes and to influence self-care among migrants with type 2 diabetes. The model was based on literature review, on results from a previous study investigating knowledge about diabetes, on experience from studies of beliefs about health and illness, and on collaboration between researchers in diabetes care and migration and health and staff working in a multi-professional diabetes team. Findings: This is a culturally appropriate diabetes education model proceeding from individual beliefs about health and illness and knowledge, conducted in focus-group discussions in five sessions, led by a diabetes specialist nurse in collaboration with a multi-professional team, and completed within three months. The focus groups should include 4–5 persons and last for about 90 min, in the presence of an interpreter. A thematic interview guide should be used, with broad open-ended questions and descriptions of critical situations/health problems. Discussions of individual beliefs based on knowledge are encouraged. When needed, healthcare staff present at the session answer questions, add information and ensure that basic principles for diabetes care are covered. The diabetes education model is tailored to both individual and cultural aspects and can improve knowledge about type 2 diabetes, among migrants and thus increase self-care behaviour and improve health.


Author(s):  
Nóra Kovács ◽  
Attila Nagy ◽  
Viktor Dombrádi ◽  
Klára Bíró

The prevalence of type 2 diabetes mellitus (T2DM) and the burden of complications are increasing worldwide. Chronic kidney disease (CKD) is one serious complication. Our aim was to investigate the trends and inequalities of the burden of CKD due to T2DM between 1990 and 2019. Data were obtained from the Global Health Data Exchange database. Age-standardized incidence, mortality, and DALYs rates of CKD were used to estimate the disease burden across the Human Development Index (HDI). Joinpoint regression was performed to assess changes in trend, and the Gini coefficient was used to assess health inequality. A higher incidence was observed in more developed countries (p < 0.001), while higher mortality and DALYs rates were experienced in low and middle HDI countries in 2019 (p < 0.001). The trend of incidence has increased since 1990 (AAPC: 0.9–1.5%), while slight decrease was observed in low HDI countries in mortality (APC: −0.1%) and DALYs (APC: −0.2%). The Gini coefficients of CKD incidence decreased from 0.25 in 2006 to 0.23 in 2019. The socioeconomic development was associated with disease burden. Our findings indicate that awareness of complications should be improved in countries with high incidence, and cost-effective preventive, diagnostic, and therapeutic tools are necessary to implement in less developed regions.


2021 ◽  
Vol 22 (15) ◽  
pp. 7797
Author(s):  
Joseph A. M. J. L. Janssen

For many years, the dogma has been that insulin resistance precedes the development of hyperinsulinemia. However, recent data suggest a reverse order and place hyperinsulinemia mechanistically upstream of insulin resistance. Genetic background, consumption of the “modern” Western diet and over-nutrition may increase insulin secretion, decrease insulin pulses and/or reduce hepatic insulin clearance, thereby causing hyperinsulinemia. Hyperinsulinemia disturbs the balance of the insulin–GH–IGF axis and shifts the insulin : GH ratio towards insulin and away from GH. This insulin–GH shift promotes energy storage and lipid synthesis and hinders lipid breakdown, resulting in obesity due to higher fat accumulation and lower energy expenditure. Hyperinsulinemia is an important etiological factor in the development of metabolic syndrome, type 2 diabetes, cardiovascular disease, cancer and premature mortality. It has been further hypothesized that nutritionally driven insulin exposure controls the rate of mammalian aging. Interventions that normalize/reduce plasma insulin concentrations might play a key role in the prevention and treatment of age-related decline, obesity, type 2 diabetes, cardiovascular disease and cancer. Caloric restriction, increasing hepatic insulin clearance and maximizing insulin sensitivity are at present the three main strategies available for managing hyperinsulinemia. This may slow down age-related physiological decline and prevent age-related diseases. Drugs that reduce insulin (hyper) secretion, normalize pulsatile insulin secretion and/or increase hepatic insulin clearance may also have the potential to prevent or delay the progression of hyperinsulinemia-mediated diseases. Future research should focus on new strategies to minimize hyperinsulinemia at an early stage, aiming at successfully preventing and treating hyperinsulinemia-mediated diseases.


Author(s):  
Manouchehr Nakhjavani ◽  
Mehrnaz Imani ◽  
Mehrdad Larry ◽  
Arash Aghajani-Nargesi ◽  
Afsaneh Morteza ◽  
...  

2007 ◽  
Vol 32 (3) ◽  
pp. 549-556 ◽  
Author(s):  
Alison Kirk ◽  
Pierpaolo De Feo

The evidence that physical activity is an effective therapeutic tool in the management of insulin resistance and type 2 diabetes is well documented. Limited research has addressed how best to promote and maintain physical activity in these individuals. This paper explores strategies to enhance compliance to physical activity for patients with insulin resistance. Several evidence-based guidelines and reviews recommend that physical activity interventions are based on a valid theoretical framework. However, there is no evidence-based consensus on the best theory or the combination of theories to use. Motivational tools such as pedometers, wearable sensors measuring energy expenditure, and point of choice prompts appear to be effective at stimulating short-term substantial increases in physical activity, but further strategies to maintain physical activity behaviour change are required. Physical activity consultation has demonstrated effective physical activity promotion over periods of up to 2 years in people with type 2 diabetes. Future research should identify the longer term effects of this intervention and the effectiveness of different methods of delivery. Overall, there needs to be a lot more focus on this area of research. Without this, the abundance of research investigating the effects of physical activity on people with insulin resistance and type 2 diabetes is essentially redundant.


Diabetology ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. 77-94
Author(s):  
Alexander Little ◽  
Kevin Murphy ◽  
Patrick Solverson

The prevalence of diet-induced obesity and type-2 diabetes remains a growing concern in the United States. As best management practices still include improved diet and physical activity, bioactive food components, contained within functional foods, show promise in curbing the cardiometabolic complications associated with excess weight and diabetes. Quinoa is an emerging candidate crop for its versatility in wide-ranging growing conditions as one approach to address food security, but it also contains several components that may serve as a dietary tool for post-industrial countries struggling with the health complications of caloric excess. Preliminary rodent feeding studies demonstrate that components within quinoa, namely, phytosteroids, phenolics, polysaccharides, and peptides, can prevent adiposity, dyslipidemia, and hyperglycemia. Mechanistic activity may involve reduced lipid absorption and adipogenesis, increased energy expenditure and glucose oxidation and corrected gut microbiota. Other intestinal actions may include blocked carbohydrate digestion with enhanced incretin signaling. Evidence in clinical trials is lacking and future research spanning cells to the clinic is needed to further elucidate the interesting preliminary reports reviewed here. Quinoa offers several unique attributes that could be harnessed to improve the dietary management of obesity and diabetes.


2022 ◽  
Vol 8 ◽  
Author(s):  
Fangyu Yan ◽  
Ehab S. Eshak ◽  
Kokoro Shirai ◽  
Jia-Yi Dong ◽  
Isao Muraki ◽  
...  

The evidence on the protective effects of soy foods against type 2 diabetes has been inconsistent. We thought to examine the association between the dietary intakes of soy and the risk of diabetes in a prospective study encompassing 21,925 healthy Japanese men and women aged 40–79 years. A validated self-administered food frequency questionnaire determined the intakes of soy, and their associations with risk of type 2 diabetes were evaluated by the logistic regression analysis. During the 5-year follow-up period, we observed 593 new cases of type 2 diabetes (302 in men and 291 in women). There was no association between dietary intakes of soy foods and the risk of type 2 diabetes among men. Whereas among women, higher tofu intake was inversely associated with risk of type 2 diabetes; the multivariable odds ratios (ORs) of type 2 diabetes were 0.92 (95% CI: 0.69–1.21) for 3–4 times per week and 0.67 (95% CI: 0.49–0.94) for almost daily (p-trend = 0.03) in reference to those consuming tofu less than 3 times per week. Intakes of boiled beans and miso soup were not associated with the risk in both genders. The inverse association tended to be more evident among overweight women and postmenopaused women. In conclusion, the frequency of tofu intake was inversely associated with the risk of type 2 diabetes among women.


2018 ◽  
Vol 31 (7-8) ◽  
pp. 382 ◽  
Author(s):  
Liliana Laranjo ◽  
Vera Dias ◽  
Carla Nunes ◽  
Dagmara Paiva ◽  
Bill Mahoney

Introduction: Management of diabetes mellitus is largely dependent on patients’ active participation in care. The ‘Patient Activation Measure 13’ assesses patients’ knowledge, skills, and confidence in self-care. We aimed to translate, culturally adapt, and validate the ‘Patient Activation Measure 13’ to Portuguese, in people with type 2 diabetes.Material and Methods: The translation and cultural adaptation occurred in six phases. A convenience sample of people with type 2 diabetes was recruited from the waiting rooms of a diabetes outpatient centre in Lisbon, between March and April 2014. The questionnaire was self-administered; medical records were reviewed to obtain glycated haemoglobin levels. Main statistical analyses were based on the Rasch rating scale model.Results: The response rate for the final questionnaire was 76%. Rasch analysis was conducted on 193 respondents. Respondents had a mean age of 67.1 (SD 10.1) years, 42.7% were women, and the mean patient activation measure score (0 - 100) in the sample was 58.5 (SD 10.1). The sample was low to moderate in terms of activation: 40.4% were low in activation (levels 1 and 2), 49.7% were in level 3, and 9.8% were in level 4, the highest level of activation. All items had good fit and the response categories functioned well. Item reliability was 0.97 and person reliability was between 0.77 (real) and 0.83 (model). Discussion: The ‘Patient Activation Measure 13’ was translated and culturally adapted to European Portuguese and validated in people with diabetes, showing good psychometric properties. Future research should aim at evaluating test-retest reliability of the Portuguese ‘Patient Activation Measure 13’, and exploring its ability to measure changes in activation over time.Conclusion: The ‘Patient Activation Measure 13’ is now available in European Portuguese and has good psychometric properties. 


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