Can Chrono-Nutrition Help Prevent Diabetes?

This editorial aimed to put forward a question if chrono-nutrition can help prevent diabetes through optimizing circadian rhythms of glucose metabolism. With the advancing mechanization, eating behavior (timing, sequence, and frequency) has changed. People are now more willing to eat fast foods at suboptimal times of the circadian period. Growing evidence suggests that untimely eating and lack of exercise can interfere with optimal physiological rhythms of glucose and insulin metabolism that can lead to diabetes. Type 2 diabetes mellitus (T2D) is a foremost metabolic disorder worldwide occurring largely due to suboptimal eating timing and lifestyle. Consuming less sugars and carbohydrates during evening and overnight may help optimize human chrono-physiology. Chrono-nutrition via optimizing the timing of meals is a growing science that needs to be well practiced to help prevent or possibly reduce risks of T2D in today’s complicated life.

Influence of the relative insulin deficiency of the mother on the functional state of the central nervous system of the fetus in the third trimester of pregnancy

85 women from the 28-th to the 40-th week of pregnancy were examined.Nineteen women with impaired glucose tolerance in the third trimester of pregnancy formed the control group. Forty women had gestational diabetes and 26 insulin independent diabetes. The data reveal negative influence of relative insulin insufficiency in expectant mothers on formation of the central neural system of the fetus that is displayed in shortening or even absence of quiet state phase, prolongation of the intermediate state, decrease of motor-cardiac reflex. The intensity of these disturbances depends upon the diabetes type and the rate ofits compensation.

Mechanisms of macro-, micro- and ultramicroscopic transformation of bodies in diabetes

The study of structural changes of organs and tissues in the context of diabetes is one of the urgent problems of modern medicine. According to WHO, in all countries of the world the number of patients with diabetes exceeds 175 million. According to an expert estimate of the spread of this disease by 2025 will make about 300 million people. More than 1 million people with diabetes have been officially registered in Ukraine. WHO has recognized the disease as a non-communicable epidemic. The dramatic increase in the prevalence of diabetes requires a detailed study of this problem. It is established that the prevalence of diabetes increases among the population of the countries of the world depending on the region, the level of economic development of the country, gender and age. Thus, according to IDF findings, there is a tendency for the highest prevalence of diabetes among the urban (urban) able-bodied population of developing countries in persons between 40 and 59 years of age, approximately equal in both male and female. The number of patients is increasing, mainly due to patients with type 2 diabetes. Type 2 diabetes (type 2 diabetes mellitus) is a severe progressive chronic disease that is an independent risk factor for heart failure (CH) and cardiovascular complications. In the XXI century. the steady growth of type 2 diabetes and the frequency of its serious consequences is of great concern to the world medical community. It is important that at the time of diagnosis of type 2 diabetes, the prevalence of complications leading to a decline in quality of life, early disability and premature death is already high enough. Despite the presence in the fight against this disease effective drugs, modern technologies, new educational and preventive techniques, mankind loses the fight against diabetes year after year, which leads to disability due to its complications, reducing the life expectancy and quality of life of patients, loss working capacity and premature mortality. Thus, the current prevalence and incidence of diabetes and life-threatening complications suggest that there is a non-communicable diabetes epidemic in the world and in Ukraine in particular. The article represents analysis of work of numerous researchers who studied statistіcal, clinical and morphological aspects of the impact of diabetes on cardiovascular system. Main morphogenetic, morphological and clinical aspects of complications of diabetes, pathologies of microcirculation of patients with diabetes were dedicated, what makes possible to predict and detect on the early stages vascular complications in diabetes and to perform effective prevention and treatment.

High glycemic variability is associated with worse Continuous Glucose Monitoring metrics in children and adolescents with type 1 diabetes

Objective: The primary aim of this study was to quantify the prevalence of children and adolescents with T1D who achieve the recommended target for CV identifying the determining factors to reach this target. The secondary aim was to examine the relationship between CV, the other metrics derived from CGM data and clinical parameters. Method: CGM data were collected from 805 children/adolescents with T1D. Several CGM metrics and patients' characteristics were evaluated. Participants were stratified by CV≤36% and CV>36%. Binary logistic regression analysis was run to identify the determining factors of high CV. Results CV was positively correlated with %TBR<70mg/dL, %TBR<54 mg/dL, %TAR>250 mg/dL, LBGI, HBGI and negatively with %TIR. CV≤36% was found in 31.4% of the subjects. The CV>36% group spent less time in %TIR, more time in hypoglycemia and hyperglycemia with lower proportion of subjects using rtCGM and CSII. Percentage of TBR<70mg/dL and TAR>250mg/dL were significant predictors of CV>36%, whereas age, gender, BMI, duration of diabetes, type of CGM device, type of insulin therapy administration and %TIR were not significant predictors (p<0.001,R2Nagelkerke=0.48). Conclusions: CV identifies children and adolescents with worse glycemic control at higher risk of both hypoglycemia and hyperglycemia.

Estimation of metformin and other sugar reducing therapy influence on the outcomes in patients with acute coronary syndrome and diabetes mellitus type II

Aim. To study the influence of hypoglycemic therapy on hospital and long-term prognosis in patients with acute coronary syndrome (ACS) and diabetes type 2.Methods. The study included 63 patients with ACS and type 2 diabetes. All patients had a clinical examination, assessment of mortality risk and myocardial infarction on GRACE scale (Global Registry of Acute Coronary Events) and TIMI (Thrombolisis In Myocardial Infarction) in-hospital and six months after hospitalization.Results. Metformin is associated with a lower estimated risk of in-hospital mortality and within 6 months after discharge in patients with acute coronary syndrome on the background of type 2 diabetes and with less risk of adverse cardiovascular events within 14 days of their occurrence in patients with unstable angina pectoris on the background of diabetes. High daily doses of metformin have also been associated with a decrease in the estimated risk of in-hospital mortality and within 6 months after discharge in patients with ACS associated with diabetes. The inverse association between the daily dosage of metformin and the presence of angina pectoris in patients with ACS and diabetes type 2 indicates a protective effect of metformin high daily dosages in relation to the risk of complications within six months after the discharge from hospital.Conclusion. One of the important aspects of ACS treatment, along with effective therapy, is the impact on concomitant risk factors, including blood glucose control. The main groups of hypoglycemic drugs have currently been identified; their effect on cardiovascular events, long-term effects and long-term prognosis are being investigated.

Antibiotic Consumption Patterns in European Countries Might Be Associated with the Prevalence of Diabetes Type-1-2 (T1D, T2D)

Several publications have raised the issue that the development of diabetes is preceded by alteration of the microbiome (dysbiosis) and hence, the role of environmental factors, triggering dysbiosis, should be considered. Antibiotics are powerful agents inducing dysbiosis and the authors wanted to explore the possible relationship between the consumption of different major classes of antibiotics and the prevalence of diabetes (type-1, /T1D/, type-2 /T2D/) in thirty European countries. According to our hypothesis, if such association exists, the dominant use of certain major antibiotic classes might be reflected in the prevalence of T1D and T2D in different countries. Comparisons were performed between the prevalence of diabetes (T1D and T2D) estimated for 2019 and featured in the Diabetes Atlas with the average yearly consumption of major antibiotic classes of the previous 10 years (2010-19) extracted from the ECDC yearly reports on antibiotic consumption in Europe. Pearson correlation and variance analysis were used to estimate the possible relationship. Strong, positive (enhancer) associations were found between the prevalence of T1D and the consumption of tetracycline (J01A /p: 0.001/) and the narrow spectrum penicillin (J01CE /p: 0,006/, CF /p: 0.018/). Strong negative (inhibitor) association was observed with broad-spectrum, beta-lactamase resistant penicillin (J01CR /p: 0.003/), macrolide (J01F /p: 0.008/) and quinolone (J01M /p: 0.001/). T2D showed significant positive associations with cephalosporin (J01D /p: 0.048/) and quinolone (J01M /p: 0.025/), and a non-significant negative association was detected with broad-spectrum, beta-lactamase-sensitive penicillin (J01CA /p: 0.67/). Countries with the highest prevalence of diabetes (first 10 positions) showed concordance with the higher consumption of &ldquo;enhancer&rdquo; and the lower consumption of &ldquo;inhibitor&rdquo; antibiotics (first 10 positions) as indicated by variance analysis. Countries with high prevalence of T1D showed high consumption of tetracycline (p: 0.015), and narrow spectrum, beta-lactamase sensitive penicillin (p: 0.008), and low consumption of &ldquo;inhibitor&rdquo; antibiotics (broad-spectrum, beta-lactamase resistant, combination penicillin (p: 0.005), cephalosporin (p: 0.036), and quinolone (p: 0.003). Countries with a high prevalence of T2D consumed more cephalosporin (p: 0.084), quinolone (p: 0.54), and less broad-spectrum, beta-lactamase sensitive penicillin (p: 0.012) than other countries. Conclusion/Interpretation: The development of diabetes-related dysbiosis might be attached to higher consumption of specific classes of antibiotics, showing positive (enhancer) associations with the prevalence of diabetes, and the low consumption of other classes of antibiotics shoving negative (inhibitory) associations. Those groups of antibiotics are different in T1D and T2D