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Terms modified by Non-diabetic Selected AbstractsDiabetes, pre-diabetes and associated risks on Minnesota code-indicated major electrocardiogram abnormality among Chinese: a cross-sectional diabetic study in Fujian province, southeast ChinaOBESITY REVIEWS, Issue 4 2009L. Lin Summary The goal of this study was to determine the prevalence of diabetes mellitus (DM), impaired glucose regulation (IGR) and related metabolic disorders (overweight, obesity and hypertension) in a Chinese population (20,74 years old). An additional goal was to investigate the relationship between glucose metabolism and the Minnesota code-indicated major abnormal electrocardiogram (MA-ECG). There were 3960 individuals selected from urban and rural areas of Fujian, China from July 2007 to May 2008 by multistage-stratified sampling. Ultimately, data from 3208 subjects (20,74 years old) were analysed (including physical measurements, blood biochemical analysis, oral glucose tolerance test and 12-lead resting ECG). According to World Health Organization diagnostic criteria, the prevalence rates of DM and IGR were 9.51% (male, 10.08%; female, 9.14%) and 14.40% (male, 14.48%; female, 14.35%) respectively. Newly diagnosed DM was found in 53.44% of the diabetic subjects. Based on the 2000 China census, the age-standardized prevalence rates of DM and IGR were 7.19% (male, 7.74%; female, 6.61%) and 11.96 % (male, 12.35%; female, 11.56%) respectively. The age-standardized prevalence rates of DM and IGR in urban areas (7.74% and 12.97% respectively) were slightly but no significantly higher than in rural areas (6.67%, 10.86%). The prevalence rates of overweight, obesity and hypertension were 25.50%, 3.52% and 28.52% respectively (age- and sex- standardized rates: 23.69%, 3.02 % and 22.45 %). After adjusting for other confounding risk factors, multiple logistic regression analysis showed that DM and impaired glucose tolerance were independent risk factors for MA-ECG. Non-diabetic subjects with increased 30-min plasma glucose (PG) after an oral glucose load had a higher risk of MA-ECG after adjusting for other risk factors, especially in those with normal glucose tolerance but with 30-min PG , 7.8 mmol L,1 (odds ratio = 1.371 [1.055,1.780]). The prevalence rates of DM and IGR as well as other metabolic disorders have increased dramatically in the last decade in China, especially in rural areas, with many undiagnosed cases of DM. Even slightly elevated PG levels may predict early cardiovascular events. [source] Rosiglitazone is more effective than metformin in improving fasting indexes of glucose metabolism in severely obese, non-diabetic patientsDIABETES OBESITY & METABOLISM, Issue 6 2008A. Brunani Aim:, In obese patients, the diet-induced weight loss markedly improves glucose tolerance with an increase in insulin sensitivity and a partial reduction of insulin secretion. The association with metformin treatment might potentiate the effect of diet alone. Methods:, From patients admitted to our Nutritional Division for diet programme, we selected obese, non-diabetic, uncomplicated patients with age 18,65 years and body mass index 35,50 kg/m2 and studied the effects of a 6-month pharmacological treatment with either metformin (850 mg twice daily) or rosiglitazone (4 mg twice daily) on possible changes in body weight, fat mass, glucose and lipids metabolism. Results:, A significant weight loss and reduction of fat mass was demonstrated with metformin (,9.7 ± 1.8 kg and ,6.6 ± 1.1 kg) and also with rosiglitazone (,11.0 ± 1.9 kg and ,7.2 ± 1.8 kg), without fluid retention in either treatment group. Rosiglitazone administration induced a significant decrease in glucose concentration (4.7 ± 0.1 vs. 4.4 ± 0.1 mmol/l, p < 0.005) and insulin-circulating level (13.6 ± 1.5 vs. 8.0 ± 0.,7 ,U/ml, p < 0.005), an increase in insulin sensitivity as measured by homeostatic model assessment (HOMA) of insulin sensitivity (68.9 ± 8.8 vs. 109.9 ± 10.3, p < 0.005) with a concomitant decrease in ,-cell function as measured by HOMA of ,-cell function (163.2 ± 16.1 vs. 127.4 ± 8.4, p < 0.005). In contrast, metformin did not produce any significant effect on blood glucose concentration, insulin level and HOMA2 indexes. No adverse events were registered with pharmacological treatments. Conclusion:, Our study shows that in severely obese, non-diabetic, hyperinsulinaemic patients undergoing a nutritional programme, rosiglitazone is more effective than metformin in producing favourable changes in fasting-based indexes of glucose metabolism, with a reduction of both insulin resistance and hyperinsulinaemia. In spite of previous studies reporting rosiglitazone-induced body weight gain, in our study the joint treatment with diet and rosiglitazone was accompanied by weight loss and fat mass reduction. [source] Effects of exendin-4 on islets from type 2 diabetes patientsDIABETES OBESITY & METABOLISM, Issue 6 2008R. Lupi Exendin-4 is a dipeptidyl peptidase IV (DPP-IV)-resistant glucagon-like peptide1 (GLP-1) mimetic and its synthetic counterpart, exenatide, is being used in the therapy of type 2 diabetes (T2DM). No information, however, is currently available as for the direct action of exendin-4 on human T2DM islets. In the present study, we exposed pancreatic islets prepared from non-diabetic and T2DM subjects to exendin-4 for 48 h and found that the compound had several, direct beneficial actions on insulin secretion and the expression of genes involved in beta-cell function and differentiation. [source] Brachial-ankle pulse wave velocity and cardiovascular risk factors in the non-diabetic and newly diagnosed diabetic Chinese: Guangzhou Biobank Cohort Study-CVDDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 2 2010Lin Xu Abstract Background Increased arterial stiffness is an important cause of cardiovascular disease (CVD). We examined determinants of arterial stiffness in subjects across strata of glycaemic status. Methods A total of 1249 subjects from a sub-study of the Guangzhou Biobank Cohort Study (GBCS-CVD) had brachial-ankle pulse wave velocity (baPWV) measured by automatic oscillometric method. Major cardiovascular risk factors including glycosylated haemoglobin A1c (HbA1c), high sensitivity C-reactive protein (hsCRP), fasting triglyceride, low- and high-density lipoprotein cholesterol and both fasting and post 2-h oral glucose-load glucose, systolic and diastolic blood pressure were assessed. Results In all, 649, 479 and 121 subjects were classified into normoglycaemia, impaired glucose metabolism (IGM) and newly diagnosed diabetes groups, respectively. Both age and systolic blood pressure were significantly associated with increased baPWV in all three groups (all p < 0.001). In both normoglycaemic and IGM groups, hsCRP and HbA1c were positively associated with baPWV (p from 0.04 to < 0.001), whereas current smoking and triglyceride were associated with baPWV in the normoglycaemic and IGM group, respectively (p = 0.04 and 0.001). No gender difference in baPWV was observed in the normoglycaemic or IGM groups. However, in the newly diagnosed diabetes group, men had higher baPWV than women (p = 0.01). Conclusions In the normoglycaemic and IGM subjects, after adjusting for age, blood pressure and other confounders, increasing HbA1c was associated with increased baPWV, suggesting a pathophysiological role of chronic glycaemia that can contribute to vascular disease risk in persons without diabetes. Copyright © 2010 John Wiley & Sons, Ltd. [source] The mechanisms that underlie glucose sensing during hypoglycaemia in diabetesDIABETIC MEDICINE, Issue 5 2008R. McCrimmon Abstract Hypoglycaemia is a frequent and greatly feared side-effect of insulin therapy, and a major obstacle to achieving near-normal glucose control. This review will focus on the more recent developments in our understanding of the mechanisms that underlie the sensing of hypoglycaemia in both non-diabetic and diabetic individuals, and how this mechanism becomes impaired over time. The research focus of my own laboratory and many others is directed by three principal questions. Where does the body sense a falling glucose? How does the body detect a falling glucose? And why does this mechanism fail in Type 1 diabetes? Hypoglycaemia is sensed by specialized neurons found in the brain and periphery, and of these the ventromedial hypothalamus appears to play a major role. Neurons that react to fluctuations in glucose use mechanisms very similar to those that operate in pancreatic B- and A-cells, in particular in their use of glucokinase and the KATP channel as key steps through which the metabolic signal is translated into altered neuronal firing rates. During hypoglycaemia, glucose-inhibited (GI) neurons may be regulated by the activity of AMP-activated protein kinase. This sensing mechanism is disturbed by recurrent hypoglycaemia, such that counter-regulatory defence responses are triggered at a lower glucose level. Why this should occur is not yet known, but it may involve increased metabolism or fuel delivery to glucose-sensing neurons or alterations in the mechanisms that regulate the stress response. [source] Post-challenge glucose predicts coronary atherosclerotic progression in non-diabetic, post-menopausal women,DIABETIC MEDICINE, Issue 10 2007P. B. Mellen Abstract Aims, We sought to determine whether fasting or post-challenge glucose were associated with progression of coronary atherosclerosis in non-diabetic women. Methods, We performed a post-hoc analysis of 132 non-diabetic women who underwent 75-g oral glucose tolerance testing. The primary outcome of interest was progression of atherosclerosis determined by baseline and follow-up coronary angiography, a mean of 3.1 ± 0.9 years apart. We analysed the association of change in minimal vessel diameter (,MD) by quartile of fasting and post-challenge glucose using mixed models that included adjustment for age, systolic blood pressure, total : high-density lipoprotein cholesterol ratio, current smoking, lipid-lowering and anti-hypertensive medication use and other covariates. Results, At baseline, participants had a mean age of 65.7 ± 6.7 years and a mean body mass index of 27.9 ± 8.5 kg/m2. Although there were no significant differences in atherosclerotic progression by fasting glucose category (P for trend across quartiles = 0.99), there was a significant inverse association between post-challenge glucose and ,MD (in mm) (Q1 : 0.01 ± 0.03; Q2 : 0.08 ± 0.03; Q3 : 0.13 ± 0.03; Q4 : 0.11 ± 0.03; P for trend = 0.02). Conclusions, In post-menopausal women without diabetes, post-challenge glucose predicts angiographic disease progression. These findings suggest that even modest post-challenge hyperglycaemia influences the pathogenesis of atherosclerotic progression. [source] The benefits of oestrogens on postprandial lipid metabolism are lost in post-menopausal women with Type 2 diabetesDIABETIC MEDICINE, Issue 7 2006M. G. Masding Abstract Aims, Women with Type 2 diabetes appear to lose the protection against cardiovascular disease (CVD) afforded by oestrogens. We examined the effects of oestrogen hormone replacement therapy (HRT) on postprandial clearance of dietary fat in non-diabetic and diabetic post-menopausal women. Methods, In a cross-sectional study, fasting subjects [HRT+ and HRT, control and diabetic women; Type 2 diabetes (DM) HRT+n = 8, DM HRT,n = 14, control HRT+n = 7, control HRT,n = 11] consumed a meal containing the stable isotope 1,1,1,[13]C-tripalmitin, with blood and breath sampled for 6 and 24 h, respectively, in the postprandial period. Results, In diabetic women, there were no differences between the HRT+ and HRT, groups for any of these parameters. In contrast, in HRT+ compared with HRT, control women, the triglyceride (TG) area under the curve was lower [AUC; HRT+ median (range) 7.7 (4.1, 12.8) mmol/l per 6 h, HRT, 9.7 (3.9, 18.5) mmol/l per 6 h, P < 0.05] and [13]C-palmitic acid in the TG fraction was also lower [HRT+ 23.2 (10.3, 41.3) ng/ml per 6 h, HRT, 47.7 (12.6, 77.2) ng/ml per 6 h, P < 0.05], suggesting the lower postprandial triglyceridaemia associated with HRT in non-diabetic women is because of better chylomicron clearance. Conclusions, The oestrogen-associated advantage in clearance of dietary lipid we observed in non-diabetic post-menopausal women is not seen in post-menopausal diabetic women. This is likely to promote an atherogenic lipoprotein profile and may contribute to the loss of CVD protection seen in diabetic women. [source] Circulating adipocytokines in non-diabetic and Type 1 diabetic children: relationship to insulin therapy, glycaemic control and pubertal developmentDIABETIC MEDICINE, Issue 6 2006F. Celi Abstract Aim To determine the influence of Type 1 diabetes mellitus on circulating adipocytokines in children. Methods The circulating concentrations of leptin, adiponectin, resistin and tumour necrosis factor (TNF)-, were measured in 91 children, aged 11.1 ± 2.7 years, with Type 1 diabetes mellitus (T1DM). Ninety-one healthy children were selected as control subjects. Results Body mass index-adjusted leptin concentrations were higher in the pubertal diabetic children compared with the control children. There was a significant positive correlation between leptin and daily insulin dose in the diabetic group. Circulating adiponectin concentrations were higher in the prepubertal diabetic children and were positively associated with HbA1c. Resistin concentrations were lower in the prepubertal non-diabetic subjects compared with the pubertal non-diabetic children, whose values were higher than those of the diabetic children. TNF-, concentrations were similar in non-diabetic and diabetic children. Conclusions Circulating concentrations of adipocytokines are abnormal in Type 1 diabetic children, although the direction of change differs by cytokine. Pubertal development, in addition to insulin treatment and glycaemic control, also influences the concentrations. [source] Interaction of the G182C polymorphism in the APOA5 gene and fasting plasma glucose on plasma triglycerides in Type 2 diabetic subjectsDIABETIC MEDICINE, Issue 12 2005Y.-D. Jiang Abstract Aim Apolipoprotein AV (APOA5) is an important determinant of plasma triglyceride concentration. This study aimed to investigate the relationship of an amino acid substitution at position 182 (G182C) of the apolipoprotein AV (APOA5) gene with triglyceride concentration in a Taiwanese population. Methods This study enrolled two cohorts: non-diabetic subjects (112 males and 89 females) aged 50.3 ± 11.0 years (mean ± sd) and diabetic subjects (106 males and 96 females) aged 62.1 ± 10.3 years. The relationship between the G182C polymorphism (rs 2075291) and plasma triglycerides was examined. Demographic and metabolic parameters including age, sex, body mass index, fasting plasma glucose and total cholesterol were also obtained. Results The G182C polymorphism was a determinant of plasma triglycerides in both non-diabetic (P = 0.022) and diabetic (P = 0.003) groups, independent of age, gender, fasting plasma glucose, body mass index and total cholesterol. In the diabetic group, this genetic polymorphism interacts significantly (P = 0.032) with fasting plasma glucose concentration on plasma triglycerides after adjustment for age, sex, body mass index and total cholesterol. Conclusions In conclusion, the G182C polymorphism of the APOA5 gene affects plasma triglycerides in both non-diabetic and diabetic populations. The observed interaction of gene and glycaemic control further indicates a multifactorial nature of clinical phenotypes in subjects with Type 2 diabetes. Diabet. Med. (2005) [source] Improvements in insulin sensitivity and ,-cell function (HOMA) with weight loss in the severely obeseDIABETIC MEDICINE, Issue 2 2003J. B. Dixon Abstract Aims To examine the effect of weight loss on insulin sensitivity and ,-cell function in severely obese subjects of varying glycaemic control. Patients and methods Subjects were 254 (F:M 209:45) patients having adjustable gastric banding for severe obesity, with paired biochemical data from before operation and at 1-year follow up. The homeostatic model assessment method was used to calculate insulin sensitivity (HOMA%S) and ,-cell function (HOMA%B). Subjects were grouped by diabetic status and by pre-weight loss HbA1c. Results Initial mean (sd) weight and body mass index were 128 (26) kg and 46.2 (7.7) kg/m2, respectively, and at 1-year were 101 (22) kg and 36.4 (6.7) kg/m2. The percentage of excess weight lost (%EWL) was 44.3 (14)%. HOMA%S improved from 37.5 (16)% presurgery to 62 (25)% (P < 0.001). %EWL was the only predictor of HOMA%S improvement (r = 0.28, P < 0.001). Subjects with normal fasting glucose, impaired fasting glucose and Type 2 diabetes had a fall, no change and increase in HOMA%B, respectively. The improvement in HOMA%B in subjects with diabetes (n = 39) was inversely related to the time with diabetes (r = ,0.36, P = 0.02). In non-diabetic subjects the HOMA%S,HOMA%B relationship was favourably altered with weight loss, so that for any given HOMA%S there was an increase in HOMA%B (f = 11.8, P = 0.001). This improvement in HOMA%B was positively related to %EWL (r = 0.25, P = 0.019). Discussion There are beneficial changes in both insulin sensitivity and ,-cell function with weight loss. Modern laparoscopic obesity surgery may have an important early role in the management of Type 2 diabetes in obese subjects. [source] Transforming growth factor-beta 1, 2, 3 and receptor type I and II in diabetic foot ulcersDIABETIC MEDICINE, Issue 6 2002E. B. Jude Abstract Aims To study the distribution of transforming growth factor-beta (TGF-,) 1, 2 and 3, and TGF-, receptor types I and II in diabetic foot ulcers, diabetic skin and normal skin by immunohistochemistry, immunofluorescence and Western blotting. We also compared the TGF-,s with those of chronic venous ulcers. Methods Skin biopsies were obtained from the leg or the foot of non-diabetic and diabetic subjects, and from the edge of diabetic foot ulcers and chronic venous ulcers. Distribution (by immunofluorescence and immunocytochemistry) of TGF-, 1, 2 and 3 and TGF-, receptors (RI and RII) was done by staining 8-µm skin sections using appropriate antibodies. Protein levels of TGF-, were measured by Western blot analysis. Results TGF-,3 expression was increased in the epithelium at the edge of diabetic foot ulcers, being more intense than diabetic and normal skin (P = 0.03, 0.02, respectively), as was its expression in venous ulcers compared with normal skin. However, TGF-,1 expression was not increased in diabetic foot ulcers and chronic venous ulcers, and was comparable to diabetic and normal skin. There was also no increase for the receptors in diabetic foot ulcers. Conclusion The lack of TGF-,1 up-regulation in both diabetic foot ulcers and venous ulcers may explain the impaired healing in these chronic wounds, and could represent a general pattern for chronicity. [source] Spatial QRS-T angle: association with diabetes and left ventricular performanceEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 9 2006Ch. Voulgari Abstract Background, The spatial QRS-T angle obtained by vectorcardiography is a combined measurement of the electrical activity of the heart and predicts cardiovascular morbidity and mortality. Disturbances in repolarization and depolarization are common in diabetes. No data, however, exist on the effect of diabetes on QRS-T angle. In this study we examined differences in QRS-T angle between type 2 diabetic and non-diabetic subjects; in addition, the potential relationship between QRS-T angle and left ventricular performance as well as glycaemic control were also examined. Patients and methods, A total of 74 subjects with type 2 diabetes and 74 non-diabetic individuals, matched for age and sex with the diabetic subjects were examined. All subjects were free of clinically apparent macrovascular complications. Spatial vectorcardiogaphic descriptors of ventricular depolarization and repolarization were reconstructed from the 12-electrocardiographic leads using a computer-based electrocardiogram. Left ventricular mass and performance were measured using M-mode and Doppler echocardiography. Results, QRS-T angle values were higher (by almost 2-fold) in the diabetic in comparison with the non-diabetic subjects (P < 0·001). After multivariate adjustment, QRS-T angle was independently associated with age (P = 0·01), HbA1c (P = 0·003), and low-density lipoprotein cholesterol levels (P = 0·04) in the non-diabetic, and with HbA1c (P = 0·03) as well as Tei index (P = 0·003) in the diabetic subjects. Conclusions, The spatial QRS-T angle is high in subjects with type 2 diabetes and is associated with glycaemic control and left ventricular performance. The prognostic importance of the higher spQRS-T angle values in subjects with diabetes remains to be evaluated in prospective studies. [source] Insulin resistance and liver injury in hepatitis C is not associated with virus-specific changes in adipocytokines,HEPATOLOGY, Issue 1 2007Ian Homer Y. Cua The role of tumor necrosis factor ,, interleukin 6, leptin, and adiponectin in the pathogenesis of hepatitis C virus (HCV)-associated insulin resistance (IR) remains controversial. We tested the hypothesis that these adipocytokines contribute to chronic HCV-associated IR and liver injury by first comparing their serum levels and homeostasis model assessment of insulin resistance (HOMA-IR) in 154 untreated, non-diabetic, HCV-infected male subjects with fibrosis stage 0-2, to that in 75 healthy volunteers matched for age, body mass index (BMI), and waist-hip ratio (WHR). We next examined whether the adipocytokine levels were associated with the extent of hepatic steatosis, portal/periportal inflammation and fibrosis in our total cohort of 240 HCV-infected male subjects. Significantly higher levels of HOMA-IR (2.12 versus 1.63, P = 0.01), TNF, (1.28 versus 0.60 pg/ml, P < 0.001) and IL6 (2.42 versus 1.15 pg/ml, P = 0.001) were noted in the HCV cohort compared with healthy controls respectively, but there were no significant differences in leptin and adiponectin concentrations. By multiple linear regression, independent predictors of HOMA-IR included the body mass index, and the serum levels of leptin (positive correlation) and adiponectin (negative correlation), but not that of TNF, and IL6. Only TNF, levels were correlated with the extent of histological injury (portal/periportal inflammation, P = 0.02). Conclusion: Whereas leptin and adiponectin contribute to IR, none of the adipocytokines accounted for the elevated IR in HCV-infected subjects. The adipocytokines were not associated with histological features of chronic HCV infection except for TNF, which correlated with portal/periportal inflammation. HCV-associated IR is most likely an adipocytokine-independent effect of the virus to modulate insulin sensitivity. (HEPATOLOGY 2007;46:66,73.) [source] Seroprevalence of hepatitis C in patients with type 2 diabetes mellitus and non-diabetic on haemodialysisINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 6 2006S. Ocak Summary Type 2 diabetes mellitus (DM) has emerged as the commonest cause of end-stage renal disease. Haemodialysis (HD) treatment constitutes a high-risk environment for the transmission of hepatitis C virus (HCV). The aim of this study was to establish a potential relationship between type 2 DM and HCV infection in HD patients. Of the 267 HD patients, 67 (25.1%) had type 2 DM and 200 (74.9%) were with diverse aetiology for end-stage renal disease. The serum markers of HCV infection were tested by a second-generation enzyme-linked immunosorbent assay test for antibodies and by qualitative reverse-transcription polymerase chain reaction technique for viral RNA. The overall prevalence of anti-HCV antibodies and HCV RNA was found to be 12.7% (34/267) and 10.1% (27/267), respectively. Patients with type 2 DM were found to have a higher HCV prevalence compared with non-diabetic patients [20.8% (14/67) vs. 10% (20/200)] (p < 0.05). The mean period on dialysis of anti-HCV-positive patients with type 2 DM was shorter than that observed for anti-HCV-positive non-diabetic patients (43.9 ± 9.8 months vs. 59.7 ± 28.4 months) (p < 0.05). This study has shown that although the period on dialysis of diabetic patients are shorter than non-diabetic patients, the prevalence of HCV in HD patients with type 2 DM is higher than that detected in non-diabetic HD patients. [source] Markers of bone destruction and formation and periodontitis in type 1 diabetes mellitusJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2009David F. Lappin Abstract Aim: To determine plasma concentrations of bone metabolism markers in type 1 diabetes mellitus patients and non-diabetic and to evaluate the influence of periodontitis on biomarkers of bone formation in these patient groups. Methods: Plasma concentrations of receptor activator of nuclear factor- ,B ligand (RANKL), osteoprotegerin (OPG), C-terminal telopeptide of type 1 collagen and osteocalcin were measured in type 1 diabetes mellitus patients (n=63) and non-diabetics (n=38) who were also subdivided on the basis of their periodontal status. Results: Diabetics had significantly lower osteocalcin concentrations, lower RANKL to OPG ratios and higher OPG concentrations (as shown by other researchers) than non-diabetics. The ratio of RANKL to OPG was altered by the periodontal status. Osteocalcin had a negative correlation and OPG a positive correlation with the percentage of glycated haemoglobin in the blood. Conclusion: Because, osteocalcin, a biomarker of bone formation, is lower in patients with periodontitis and in patients with type 1 diabetes mellitus with and without periodontitis than in non-diabetics without periodontitis, this might indicate that diabetics are less able to replace bone lost during active bursts of periodontitis and explain the greater severity of disease seen in studies of patients with diabetes. [source] Role of serum cytokines tumour necrosis factor- , and interleukin-6 in the association between body weight and periodontal infectionJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2009Tuomas Saxlin Abstract Aim: To study the role of serum cytokines tumour necrosis factor , (TNF- ,) and interleukin 6 (IL-6) as potential mediators in the association between body weight and periodontal infection among an adult population. Material and Methods: This study was based on a subpopulation of the Health 2000 Health Examination Survey, which included dentate non-diabetic, non-rheumatic subjects, aged between 45 and 64 years, who had never smoked and whose serum levels of TNF- , and IL-6 were analysed and whose periodontal status was clinically determined (effective n=425). The number of teeth with periodontal pockets of 4 mm or more and the number of teeth with periodontal pockets of 6 mm or more were used as outcome variables. Relative risks and 95% confidence intervals were estimated using Poisson regression models. Results: Serum IL-6, but not TNF- , associated with teeth with deepened periodontal pockets. Multivariate models showed that IL-6, but not TNF- ,, could mediate the effect of body weight on periodontium. Conclusion: In this population of non-diabetic and non-rheumatic subjects, who had never smoked, serum IL-6 was associated with periodontal infection. The results suggest that serum IL-6 could be one mediating factor that connects body weight and periodontal infection. [source] Association between body weight and periodontal infectionJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2008Pekka Ylöstalo Abstract Background: Besides being a risk factor for cardiovascular diseases, certain cancers and type II diabetes, obesity has been suggested to be a risk factor for periodontitis. A number of epidemiological studies have studied the association between obesity and periodontitis, but the results have been partly inconclusive. The aim of this study was to examine the association of body weight with periodontal infection. Material and Methods: The association between body weight and periodontal infection was examined using a nationally representative Health 2000 Health Examination Survey. The study was based on a subpopulation of dentate non-diabetic subjects aged 30,49 (n=2841). Periodontal infection was measured by the number of teeth with periodontal pockets of 4 mm or deeper and 6 mm or deeper. Body weight was measured using body mass index (BMI). Results: We detected a weak exposure,response association of BMI with teeth with deepened periodontal pockets after controlling for smoking habits by restricting the sample to subjects who have never smoked and for other potential confounders by including them in the multivariate models. Conclusions: The results showed an association between body weight and periodontal infection among the non-diabetic, non-smoking population aged 30,49. Additional research is needed to determine the nature of this association. [source] Effect of non-surgical periodontal therapy on clinical and immunological response and glycaemic control in type 2 diabetic patients with moderate periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2007Ana Belén Navarro-Sanchez Abstract Objetives: The purpose of this study was to compare the local efficacy of nonsurgical periodontal therapy between type 2 diabetic and non-diabetic patients and the effect of periodontal therapy on glycaemic control. Background: A complex two-way relationship exists between diabetes mellitus and periodontitis. Material and Methods: After selection, 20 subjects (10 diabetic and 10 non-diabetic) underwent baseline examination, periodontal clinical study and biochemical analysis of gingival crevicular fluid (GCF). After the pre-treatment phase, subgingival scaling and root planing were performed. Subsequently, all subjects continued the maintenance programme and were re-examined at 3 and 6 months. Results: Diabetic and non-diabetic subjects responded well after therapy, showing a very similar progression during the follow-up period. Both groups showed clinically and immunologically significant improvements. Significant reductions were also found in the total volume of GCF and levels of interleukin-1, and tumour necrosis factor- ,. Diabetic subjects showed an improvement in their metabolic control. The change in glycosylated haemoglobin (HbA1C) was statistically significant at 3 and 6 months. Conclusions: The clinical and immunological improvements obtained were accompanied by a significant reduction in HbA1C values in type 2 diabetic subjects. Larger studies are needed to confirm this finding and establish whether periodontal therapy has a significant effect on glycaemic control. [source] Weight loss and incretin responsiveness improve glucose control independently after gastric bypass surgeryJOURNAL OF DIABETES, Issue 1 2010Mousumi BOSE Abstract Background:, The aim of the present study was to determine the mechanisms underlying Type 2 diabetes remission after gastric bypass (GBP) surgery by characterizing the short- and long-term changes in hormonal determinants of blood glucose. Methods:, Eleven morbidly obese women with diabetes were studied before and 1, 6, and 12 months after GBP; eight non-diabetic morbidly obese women were used as controls. The incretin effect was measured as the difference in insulin levels in response to oral glucose and to an isoglycemic intravenous challenge. Outcome measures were glucose, insulin, C-peptide, proinsulin, amylin, glucagon, glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-1 (GLP-1) levels and the incretin effect on insulin secretion. Results:, The decrease in fasting glucose (r = 0.724) and insulin (r = 0.576) was associated with weight loss up to 12 months after GBP. In contrast, the blunted incretin effect (calculated at 22%) that improved at 1 month remained unchanged with further weight loss at 6 (52%) and 12 (52%) months. The blunted incretin (GLP-1 and GIP) levels, early phase insulin secretion, and other parameters of ,-cell function (amylin, proinsulin/insulin) followed the same pattern, with rapid improvement at 1 month that remained unchanged at 1 year. Conclusions:, The data suggest that weight loss and incretins may contribute independently to improved glucose levels in the first year after GBP surgery. [source] CB1 Receptor Blockade and its Impact on Cardiometabolic Risk Factors: Overview of the RIO Programme with RimonabantJOURNAL OF NEUROENDOCRINOLOGY, Issue 2008A. J. Scheen Rimonabant, the first selective CB1 receptor antagonist in clinical use, has been extensively investigated in the Rimonabant in Obesity (RIO) programme, comprising four 1,2 year placebo-controlled randomised clinical trials recruiting more than 6600 overweight/obese patients with or without co-morbidities. Rimonabant 20 mg daily consistently reduced body weight, waist circumference, triglycerides, blood pressure, insulin resistance and C-reactive protein levels, and increased HDL cholesterol concentrations in both non-diabetic and type-2 diabetic overweight/obese patients. Adiponectin levels were increased, an effect that correlated with HDL cholesterol augmentation, while small dense LDL cholesterol levels were decreased in patients receiving rimonabant 20 mg compared with those receiving placebo in RIO Lipids. Furthermore, in RIO Diabetes, a 0.7% reduction in glycated haemoglobin (HbA1c) levels was observed in metformin- or sulphonylurea-treated patients with type-2 diabetes, an effect recently confirmed in the 6-month SERENADE (Study Evaluating Rimonabant Efficacy in drug-NAïve DiabEtic patients) trial in drug-naïve diabetic patients. Almost half of metabolic changes occurred beyond weight loss, in agreement with direct peripheral effects. The positive effects observed after 1 year were maintained after 2 years. Rimonabant was generally well-tolerated, but with a slightly higher incidence of depressed mood disorders, anxiety, nausea and dizziness compared with placebo. In clinical practice, rimonabant has to be prescribed to the right patient, i.e. overweight/obese subjects with cardiometabolic risk factors and with no major depressive illness and/or ongoing antidepressive treatment, in order to both maximise efficacy and minimise safety issues. New trials are supposed to confirm the potential role of rimonabant in patients with abdominal adiposity, atherogenic dyslipidaemia and/or type-2 diabetes, i.e. at high cardiometabolic risk. [source] Amylase and cyclic amp receptor protein expression in human diabetic parotid glandsJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 9 2010Monica Piras J Oral Pathol Med (2010) 39: 715,721 Background:, Salivary dysfunction and oral disorders have been described in both type 1 and type 2 diabetes mellitus. However, the cellular and molecular consequences of diabetes on oral tissues remain to be ascertained. The purpose of this investigation was to study, by means of electron microscopy, the morphologic and molecular changes that occur in salivary glands during diabetes. Methods:, Biopsy samples of parotid glands were excised from non-diabetic and diabetic (type 1 and type 2) consenting patients and processed by standard methods for routine morphology and electron microscopic immunogold labeling. Specific antibodies were used to determine and quantify the expression of secretory proteins (alphaamylase and the regulatory subunit of type II protein kinase A). Results:, Morphologic changes in the diabetic samples included increased numbers of secretory granules, and alterations in internal granule structure. Quantitative analysis of immunogold labeling showed that labeling densities were variable among the parotid gland samples. In type 1 diabetes amylase expression was greater than in non-diabetic glands, whereas in type 2 diabetes it was not significantly changed. Expression of type II regulatory subunits was slightly, although not significantly, increased in acinar secretory granules of type 1 diabetic samples and was unchanged in type 2 diabetic samples. Conclusions:, Our data show that diabetes elicits specific changes in secretory protein expression in human salivary glands, thus contributing to the altered oral environment and oral disease associated with diabetes. [source] The anti-diabetic effects and pharmacokinetic profiles of bis(maltolato)oxovanadium in non-diabetic and diabetic ratsJOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 1 2008Shuang-Qing Zhang ABSTRACT The purpose of this study was to evaluate the anti-diabetic effects and pharmacokinetics of bis(maltolato)oxovanadium (BMOV) in rats. The anti-diabetic study was carried out in non-diabetic and diabetic rats by single-dose subcutaneous and intragastric administration. Pharmacokinetic investigation was performed using non-diabetic rats. Results showed that BMOV significantly decreased plasma glucose levels in diabetic rats at all given doses, and restored hyperglycaemic values to normal values after subcutaneous injections at doses of 4 and 8 mg vanadium (V)/kg or after intragastric administration at doses of 14 and 28 mgV/kg, respectively, but did not affect the plasma glucose level in non-diabetic rats. BMOV could be rapidly absorbed, slowly eliminated from plasma, widely distributed in various tissues and accumulated to a greater extent in the femur tissue. The average absolute bioavailability for intragastric administration at a single dose of 3, 6 and 12 mgV/kg was 28.1%, 33.7% and 21.4%, respectively. The presence of the peak vanadium level in the plasma was not coincident with that of the maximum effect of lowering plasma glucose levels. In conclusion, at the present dosing levels and administration routes, BMOV was effective in lowering plasma glucose levels in diabetic rats. BMOV has a promising outlook as an oral glucose-lowering drug. [source] Health benefits of dietary fiberNUTRITION REVIEWS, Issue 4 2009James W Anderson Dietary fiber intake provides many health benefits. However, average fiber intakes for US children and adults are less than half of the recommended levels. Individuals with high intakes of dietary fiber appear to be at significantly lower risk for developing coronary heart disease, stroke, hypertension, diabetes, obesity, and certain gastrointestinal diseases. Increasing fiber intake lowers blood pressure and serum cholesterol levels. Increased intake of soluble fiber improves glycemia and insulin sensitivity in non-diabetic and diabetic individuals. Fiber supplementation in obese individuals significantly enhances weight loss. Increased fiber intake benefits a number of gastrointestinal disorders including the following: gastroesophageal reflux disease, duodenal ulcer, diverticulitis, constipation, and hemorrhoids. Prebiotic fibers appear to enhance immune function. Dietary fiber intake provides similar benefits for children as for adults. The recommended dietary fiber intakes for children and adults are 14 g/1000 kcal. More effective communication and consumer education is required to enhance fiber consumption from foods or supplements. [source] Hypoglycaemic effect of Opuntia lindheimeri Englem. in a diabetic pig modelPHYTOTHERAPY RESEARCH, Issue 1 2003Jamie C. Laurenz Abstract The hypoglycaemic activity of Opuntia lindheimeri Englem. was investigated in non-diabetic (control pigs) and streptozotocin-induced diabetic pigs using an enteral (oral) route of administration. Following the administration of O. lindheimeri extract (0, 250 or 500,mg/kg body weight), blood glucose concentrations in control pigs fluctuated around initial baseline concentrations, but were not consistently affected by either the dose of O. lindheimeri or by the time following administration. In contrast, administration of O. lindheimeri extract to STZ-treated pigs resulted in both a dose- (p,<,0.001) and time-dependent (p,<,0.001) decrease in blood glucose concentrations. The hypoglycaemic effect of the extract was apparent within 1,h of administration, with maximal effects occurring at 4,h after administration. These results confirm the hypoglycaemic effect of O. lindheimeri extract in a diabetic pig model. In addition, given the physiological similarities of the pig to humans, this model will be of tremendous use in assessing the long-term effects of Opuntia administration on the secondary problems associated with diabetes. Copyright © 2003 John Wiley & Sons, Ltd. [source] Alterations of oestradiol, testosterone, gonadotrophins and SHBG by type 2 diabetes in postmenopausal womenPRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 9 2007Clinical implications for the incidence of breast cancer, cardiovascular risk in diabetic women? Abstract Sex hormones influence cardiovascular risk and bone mineral density. Total oestradiol is increased in postmenopausal women with type 2 diabetes, whereas its impact on androgens, sex hormone binding globulin (SHBG) and gonadotrophins in postmenopausal women is not so clearly understood. This study aims to clarify the impact of type 2 diabetes on sex hormone levels in Caucasian postmenopausal women. Type 2 diabetic (n=42) and non-diabetic (n=45) postmenopausal women were recruited. Venous blood samples were drawn and assayed for total oestradiol, total testosterone, luteinising hormone (LH), follicle stimulating hormone (FSH) and SHBG. Ratio of total testosterone to SHBG was used as an index of free testosterone (FT). Total oestradiol and FT were significantly higher in diabetic subjects compared to controls, oestradiol median: 59.5(25th,75th centiles: 41.5,74.5) vs 42.5(37.0,59.8)pmol/L, p=0.009 Mann-Whitney test; and FT: 0.038(0.021,0.070) vs 0.022(0.012,0.036), p=0.003. SHBG, FSH and LH were lower in diabetic subjects compared to controls, SHBG: 32(23.3,47.3) vs 55(37,70)nmol/L, p<0.001; FSH: 54.8(42.2,68.7) vs 71.8(55.9,98.9)iu/L, p=0.001; and LH: 27.9(20.6,39.7) vs 39.2(30.9,48.1)iu/L, p=0.011, but total testosterone was not different. The differences in oestradiol, SHBG and FSH remained when subjects were matched for BMI and age (n=29). Preliminary sub-group analysis suggests that these differences may be influenced by form of diabetic therapy and glycaemic control. Type 2 diabetes is associated with altered levels of total oestradiol, FT, SHBG, FSH, LH, in postmenopausal women. However, further research is required to determine the impact of diabetic therapy and glycaemic control, and also the clinical relevance of these alterations. Copyright © 2007 John Wiley & Sons. [source] The Rydel Seiffer tuning fork: an inexpensive device for screening diabetic patients with high-risk footPRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 5 2001V. Vijay Abstract Considering the simple and inexpensive nature of the graduated tuning fork, we evaluated its usefulness in screening for vibratory sensation loss in non-diabetic and diabetic subjects, compared with the values obtained with biothesiometer. The vibration perception scores were tested in 195 non-diabetic healthy control subjects (n=195, M:F, 80:115, Mean±SD, age 50.3±10.4 (years), in 455 Type 2 diabetic subjects who had signs and symptoms of sensory neuropathy and abnormal biothesiometric readings (reading>25V), (n=455, M:F 326:129, Mean Age 58.1±7.7 years, HbA1c 10.1±2.4%) and in 471 diabetic patients with no evidence of neuropathy by biothesiometry. (M:F 299:172, Mean Age 48.0±7.5 years, HbA1c 9.5±2.2%). Patients with neuropathy had a lower mean score of 4.5±2.6 compared with the non-neuropathy cases (7.7±0.5, P<0.001). Among the 455 patients identified as having neuropathy by abnormal biothesiometric values, 235 had an abnormal tuning fork score of ,4.0. Tuning fork scores were normal in all the 471 non-neuropathy cases, thus giving a specificity of 100%. This study shows that the graduated tuning fork has a high specificity and a fairly good sensitivity in the diagnosis of diabetic foot problems. Copyright © 2001 John Wiley & Sons, Ltd. [source] Morphometric and Quantitative Evaluation of the NADH-Diaphorase Positive Myenteric Neurons of the Jejunum of Streptozotocin-Diabetic Rats Supplemented with Acetyl-L-CarnitineANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 3 2005M. H. de Miranda Neto Summary In this study we investigated the effect of the acetyl-L-carnitine (ALC) supplementation on the myenteric neurons of the jejunum of rats made diabetic at the age of 105 days by streptozotocin (35 mg/kg body weight). Four groups were used: non-diabetic (C), non-diabetic supplemented with ALC (CC), diabetic (D), diabetic supplemented with ALC (DC). After 15 weeks of diabetes induction the blood was collected by cardiac puncture to evaluate glycaemia and glycated haemoglobin. Next the animals were killed and the jejunum was collected and subjected to whole-mount preparation to evidence the myenteric neurons through the histochemical technique of the NADH-diaphorase. The neuronal counts were made in 80 microscopic fields, in tissue samples of five animals of each group. The profiles of the cell bodies of 1000 neurons per group were analysed. Diabetes induced a significant increase in the area of the cell body and decrease in the number of NADH-diaphorase positive myoenteric neurons. ALC suplementation to the diabetic group promoted smaller hypertrophic effects and less neuronal loss than in the myoenteric neurons of the diabetic rats, and in addition diminished the body weight decrease and reduced the fasting glycaemia. [source] Variants in Intron 13 of the ELMO1 Gene are Associated with Diabetic Nephropathy in African AmericansANNALS OF HUMAN GENETICS, Issue 2 2009T. S. Leak Summary Variants in the engulfment and cell motility 1 (ELMO1) gene are associated with nephropathy due to type 2 diabetes mellitus (T2DM) in a Japanese cohort. We comprehensively evaluated this gene in African American (AA) T2DM patients with end-stage renal disease (ESRD). Three hundred and nine HapMap tagging SNPs and 9 reportedly associated SNPs were genotyped in 577 AA T2DM-ESRD patients and 596 AA non-diabetic controls, plus 43 non-diabetic European American controls and 45 Yoruba Nigerian samples for admixture adjustment. Replication analyses were conducted in 558 AA with T2DM-ESRD and 564 controls without diabetes. Extension analyses included 328 AA with T2DM lacking nephropathy and 326 with non-diabetic ESRD. The original and replication analyses confirmed association with four SNPs in intron 13 (permutation p-values for combined analyses = 0.001,0.003), one in intron 1 (P = 0.004) and one in intron 5 (P = 0.002) with T2DM-associated ESRD. In a subsequent combined analysis of all 1,135 T2DM-ESRD cases and 1,160 controls, an additional 7 intron 13 SNPs produced evidence of association (P = 3.5 × 10,5, P = 0.05). No associations were seen with these SNPs in those with T2DM lacking nephropathy or with ESRD due to non-diabetic causes. Variants in intron 13 of the ELMO1 gene appear to confer risk for diabetic nephropathy in AA. [source] Effects of antioxidant stobadine on protein carbonylation, advanced oxidation protein products and reductive capacity of liver in streptozotocin-diabetic rats: Role of oxidative/nitrosative stressBIOFACTORS, Issue 3 2007Ahmet Cumao Background: Increased oxidative/nitrosative stress is important in the pathogenesis of diabetic complications, and the protective effects of antioxidants are a topic of intense research. The purpose of this study was to investigate whether a pyridoindole antioxidant stobadine (STB) have a protective effect on tissue oxidative protein damage represented by the parameters such as protein carbonylation (PC), protein thiol (P-SH), total thiol (T-SH) and non-protein thiol (Np-SH), nitrotyrosine (3-NT), and advanced oxidation protein products (AOPP) in streptozotocin-diabetic rats. Methods: Diabetes was induced in male Wistar rats by intraperitonal injection of streptozotocin (55 mg/kg). Some of the non-diabetic (control) and diabetic rats treated with STB (24.7 mg/kg/day) during 16 weeks, and the effects on blood glucose, PC, AOPP, 3-NT, P-SH, T-SH and Np-SH were studied. Biomarkers were assayed by enzyme-linked immunosorbent assay (ELISA) or by colorimetric methods. Results: Administration of stobadine to diabetic animals lowered elevated blood glucose levels by ,16% relative to untreated diabetic rats. Although stobadine decreased blood glucose, poor glycemic control was maintained in stobadine treated diabetic rats during the treatment period. Biochemical analyses of liver proteins showed significant diminution of sulfhydryl groups, P-SH, T-SH, Np-SH, and elevation of carbonyl groups in diabetic animals in comparison to healthy controls. As a biomarker of nitrosative stress, 3-NT levels did not significantly change by diabetes induction or by stobadine treatment when compared to control animals. However, the treatment with stobadine resulted in a significant decrease in PC, AOPP levels and normalized P-SH, T-SH, Np-SH groups in liver of diabetic animals. [source] Effects of Hilsa ilisa fish oil on the atherogenic lipid profile and glycaemic status of streptozotocin-treated type 1 diabetic ratsCLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 1-2 2004Ishtiaq Mahmud Summary 1.,The effects of oral administration of Hilsa (Hilsa ilisa) fish oil (1 g oil/kg bodyweight per day) on the lipid profile, platelet aggregation, anti-oxidative status and glycaemic control of streptozotocin (STZ; 90 mg/kg bodyweight)-treated type 1 diabetic rats were compared with those in fish oil-treated or untreated non-diabetic rats. 2.,After 3 weeks of fish oil feeding, plasma total cholesterol decreased in both the non-diabetic and diabetic rats by 35 and approximately 10%, respectively, and triglyceride fell by 69 and 20%, respectively, compared with control rats. 3.,Fish oil feeding decreased non-esterified fatty acids (NEFA) by 29% in diabetic rats but the NEFA level in non-diabetic rats was unaffected. 4.,In non-diabetic and diabetic rats, platelet aggregation decreased by 49 and 37%, respectively, and total anti-oxidant status increased by 18 and 17%, respectively, after fish oil feeding. 5.,Insulin levels increased by 27% in the fish oil-fed non-diabetic rats, whereas insulin levels were markedly decreased in diabetic rats. Glucose levels were not altered at all and fructosamine levels decreased by 29% only in fish oil-fed diabetic rats. 6.,The results of the present study suggest that Hilsa ilisa fish oil may ameliorate the atherogenic lipid profile, platelet hyperaggregation and the anti-oxidative defence of STZ-diabetic rats and the amelioration is thought to be independent of the effects of Hilsa on glycaemic control. [source] | |||||||||||||||||||||||||||||||