Current Diabetes Reports最新文献

{"title":"Cellular Senescence in Obesity and Associated Complications: a New Therapeutic Target.","authors":"Akilavalli Narasimhan, Rafael R Flores, Christina D Camell, David A Bernlohr, Paul D Robbins, Laura J Niedernhofer","doi":"10.1007/s11892-022-01493-w","DOIUrl":"10.1007/s11892-022-01493-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Obesity has increased worldwide recently and represents a major global health challenge. This review focuses on the obesity-associated cellular senescence in various organs and the role of these senescent cells (SnCs) in driving complications associated with obesity. Also, the ability to target SnCs pharmacologically with drugs termed senotherapeutics as a therapy for these complications is discussed.</p><p><strong>Recent findings: </strong>Several studies have shown a positive correlation between obesity and SnC burden in organs such as adipose tissue, liver, and pancreatic-β-cells. These SnCs produce several secretory factors which affect other cells and tissues in a paracrine manner resulting in organ dysfunction. The accumulation of SnCs in adipocytes affects their lipid storage and impairs adipogenesis. The inflammatory senescence-associated secretory phenotype (SASP) of SnCs downregulates the antioxidant capacity and mitochondrial function in tissues. Senescent hepatocytes cannot oxidize fatty acids, which leads to lipid deposition and senescence in β-cells decrease function. These and other adverse effects of SnCs contribute to insulin resistance and type-2 diabetes. The reduction in the SnC burden genetically or pharmacologically improves the complications associated with obesity. The accumulation of SnCs with age and disease accelerates aging. Obesity is a key driver of SnC accumulation, and the complications associated with obesity can be controlled by reducing the SnC burden. Thus, senotherapeutic drugs have the potential to be an effective therapeutic option.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"22 11","pages":"537-548"},"PeriodicalIF":4.2,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10123542/pdf/nihms-1890752.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9431956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Care Recommendations in National Diabetes Treatment Guidelines.","authors":"Benjamin Aceves, Rose Gunn, Maura Pisciotta, Na'amah Razon, Erika Cottrell, Danielle Hessler, Rachel Gold, Laura M Gottlieb","doi":"10.1007/s11892-022-01490-z","DOIUrl":"10.1007/s11892-022-01490-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>An expanding body of research documents associations between socioeconomic circumstances and health outcomes, which has led health care institutions to invest in new activities to identify and address patients' social circumstances in the context of care delivery. Despite growing national investment in these \"social care\" initiatives, the extent to which social care activities are routinely incorporated into care for patients with type II diabetes mellitus (T2D), specifically, is unknown. We conducted a scoping review of existing T2D treatment and management guidelines to explore whether and how these guidelines incorporate recommendations that reflect social care practice categories.</p><p><strong>Recent findings: </strong>We applied search terms to locate all T2D treatment and management guidelines for adults published in the US from 1977 to 2021. The search captured 158 national guidelines. We subsequently applied the National Academies of Science, Engineering, and Medicine framework to search each guideline for recommendations related to five social care activities: Awareness, Adjustment, Assistance, Advocacy, and Alignment. The majority of guidelines (122; 77%) did not recommend any social care activities. The remainder (36; 23%) referred to one or more social care activities. In the guidelines that referred to at least one type of social care activity, adjustments to medical treatment based on social risk were most common [34/36 (94%)]. Recommended adjustments included decreasing medication costs to accommodate financial strain, changing literacy level or language of handouts, and providing virtual visits to accommodate transportation insecurity. Ensuring that practice guidelines more consistently reflect social care best practices may improve outcomes for patients living with T2D.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"22 10","pages":"481-491"},"PeriodicalIF":4.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9109305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mindfulness-Based Interventions: Focus on Pediatric Type 1 and Type 2 Diabetes.","authors":"Hailey Inverso, Hailey R Moore, Francesca Lupini, Christine H Wang, Randi Streisand, Lauren B Shomaker, Eleanor R Mackey","doi":"10.1007/s11892-022-01492-x","DOIUrl":"10.1007/s11892-022-01492-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>Mindfulness-based interventions (MBIs) focus on promoting nonjudgmental, purposeful awareness of the present experience, and they include specific components such as body scan, meditation, and breathing techniques for healthier coping with stress and reduced negative affect. In adult populations with chronic illness (e.g., type 1 diabetes [T1D], type 2 diabetes [T2D], overweight), MBIs have been shown to improve psychosocial outcomes with some improvements in health outcomes as well. Youth with T1D/T2D frequently experience heightened depression as well as diabetes distress, which are associated with less frequent blood glucose monitoring, insulin administration, and nutrition oversight. Thus, MBIs have potential to alleviate psychosocial distress in youth with T1D/T2D and also improve health outcomes. This paper is a review of the literature on potential psychosocial and health benefits of MBIs for youth with T1D/T2D.</p><p><strong>Recent findings: </strong>Among youth with T1D/T2D, MBIs have been shown to reduce symptoms of depression and diabetes distress. Improvements in health outcomes, such as A1c, have been inconsistent across studies. Although research on the efficacy of MBIs to improve psychosocial and health outcomes in youth with T1D/T2D is promising, this area of study is in its early stages. Future investigation of MBIs in youth with T1D and T2D is warranted, recognizing that these are heterogeneous groups with potential benefit of specifically tailored interventions.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"22 10","pages":"493-500"},"PeriodicalIF":4.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10976454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9319971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Type 2 Diabetes Among Individuals with Excess Weight: Weight Trajectory Effects.","authors":"Arthur H Owora,&nbsp;David B Allison,&nbsp;Xuan Zhang,&nbsp;Nana Gletsu-Miller,&nbsp;Kishore M Gadde","doi":"10.1007/s11892-022-01486-9","DOIUrl":"https://doi.org/10.1007/s11892-022-01486-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>Increased risk of type 2 diabetes mellitus (T2D) among individuals with overweight or obesity is well-established; however, questions remain about the temporal dynamics of weight change (gain or loss) on the natural course of T2D in this at-risk population. Existing epidemiologic evidence is limited to studies that discretely sample and assess excess weight and T2D risk at different ages with limited follow-up, yet changes in weight may have time-varying and possibly non-linear effects on T2D risk. Predicting the impact of weight change on the risk of T2D is key to informing primary prevention. We critically review the relationship between weight change, trajectory groups (i.e., distinct weight change patterns), and T2D risk among individuals with excess weight in recently published T2D prevention randomized controlled trials (RCTs) and longitudinal cohort studies.</p><p><strong>Recent findings: </strong>Overall, weight trajectory groups have been shown to differ by age of onset, sex, and patterns of insulin resistance or beta-cell function biomarkers. Lifestyle (diet and physical activity), pharmacological, and surgical interventions can modify an individual's weight trajectory. Adolescence is a critical etiologically relevant window during which onset of excess weight may be associated with higher risk of T2D. Changes in insulin resistance and beta-cell function biomarkers are distinct but related correlates of weight trajectory groups that evolve contemporaneously over time. These multi-trajectory markers are differentially associated with T2D risk. T2D risk may differ by the age of onset and duration of excess body weight, and the type of weight loss intervention. A better understanding of the changes in weight, insulin sensitivity, and beta-cell function as distinct but related correlates of T2D risk that evolve contemporaneously over time has important implications for designing and targeting primary prevention efforts.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"22 9","pages":"471-479"},"PeriodicalIF":4.2,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10094425/pdf/nihms-1885056.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10131875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Natural Experiments that Impact the Diabetes Epidemic: an Introduction to the NEXT-D3 Network.","authors":"Karen R Siegel, Mohammed K Ali, Ronald T Ackermann, Bernard Black, Nathalie Huguet, Abel Kho, Carol M Mangione, Elizabeth Nauman, Dennis Ross-Degnan, Dean Schillinger, Lizheng Shi, J Frank Wharam, O Kenrik Duru","doi":"10.1007/s11892-022-01480-1","DOIUrl":"10.1007/s11892-022-01480-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>Diabetes is an ongoing public health issue in the USA, and, despite progress, recent reports suggest acute and chronic diabetes complications are increasing.</p><p><strong>Recent findings: </strong>The Natural Experiments for Translation in Diabetes 3.0 (NEXT-D3) Network is a 5-year research collaboration involving six academic centers (Harvard University, Northwestern University, Oregon Health & Science University, Tulane University, University of California Los Angeles, and University of California San Francisco) and two funding agencies (Centers for Disease Control and Prevention and National Institutes of Health) to address the gaps leading to persisting diabetes burdens. The network builds on previously funded networks, expanding to include type 2 diabetes (T2D) prevention and an emphasis on health equity. NEXT-D3 researchers use rigorous natural experiment study designs to evaluate impacts of naturally occurring programs and policies, with a focus on diabetes-related outcomes. NEXT-D3 projects address whether and to what extent federal or state legislative policies and health plan innovations affect T2D risk and diabetes treatment and outcomes in the USA; real-world effects of increased access to health insurance under the Affordable Care Act; and the effectiveness of interventions that reduce barriers to medication access (e.g., decreased or eliminated cost sharing for cardiometabolic medications and new medications such as SGLT-2 inhibitors for Medicaid patients). Overarching goals include (1) expanding generalizable knowledge about policies and programs to manage or prevent T2D and educate decision-makers and organizations and (2) generating evidence to guide the development of health equity goals to reduce disparities in T2D-related risk factors, treatment, and complications.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"22 8","pages":"393-403"},"PeriodicalIF":4.2,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9303841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9913782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and Facilitators to Diabetes Device Adoption for People with Type 1 Diabetes.","authors":"Molly L Tanenbaum,&nbsp;Persis V Commissariat","doi":"10.1007/s11892-022-01469-w","DOIUrl":"https://doi.org/10.1007/s11892-022-01469-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Diabetes technology (insulin pumps, continuous glucose monitoring, automated insulin delivery systems) has advanced significantly and provides benefits to the user. This article reviews the current barriers to diabetes device adoption and sustained use, and outlines the known and potential facilitators for increasing and sustaining device adoption.</p><p><strong>Recent findings: </strong>Barriers to diabetes device adoption continue to exist at the system-, provider-, and individual-level. Known facilitators to promote sustained adoption include consistent insurance coverage, support for providers and clinics, structured education and support for technology users, and device user access to support as needed (e.g., through online resources). Systemic barriers to diabetes device adoption persist while growing evidence demonstrates the increasing benefits of newest devices and systems. There are ongoing efforts to develop evidence-based structured education programs to support device adoption and sustained use.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"22 7","pages":"291-299"},"PeriodicalIF":4.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9189072/pdf/nihms-1807311.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9721757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thinking Ahead to the Next Generation of Cardiometabolic Investigators: What It Takes to Successfully Engage Underrepresented Minorities in Biomedical and Public Health Careers.","authors":"Wendy B White,&nbsp;Kisa K Harris,&nbsp;Amel Mohamed,&nbsp;Frances C Henderson","doi":"10.1007/s11892-022-01472-1","DOIUrl":"https://doi.org/10.1007/s11892-022-01472-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to examine the existing information regarding cardiometabolic syndrome (CMS) manifestations among underrepresented minority populations, underrepresented minorities' representation in the cardiometabolic workforce, and the models that successfully recruit and retain underrepresented minorities in the field.</p><p><strong>Recent findings: </strong>The scientific literature is replete with information on methods to recruit and train URM in research careers. However, there are few programs that are specifically designed to train URM to become diabetes researchers, or more specifically cardiometabolic researchers. The CMS scientific community leaders do not have to design a new learning program to engage URM in research. They only have to follow the prototypes by other organizations and make applicable to cardiometabolic research.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"22 7","pages":"311-316"},"PeriodicalIF":4.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9110944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9510758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Friend or Foe: a Narrative Review of the Impact of Diabetes Technology on Sleep.","authors":"Erin C Cobry,&nbsp;Angela J Karami,&nbsp;Lisa J Meltzer","doi":"10.1007/s11892-022-01468-x","DOIUrl":"https://doi.org/10.1007/s11892-022-01468-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to present a review of sleep science, the relationship between sleep and type 1 diabetes, and highlight the current literature on sleep outcomes in adult and pediatric diabetes technology research.</p><p><strong>Recent findings: </strong>Sleep quality is associated with glycemic outcomes, diabetes self-management, and mental health in people with type 1 diabetes. Diabetes technologies, including insulin pumps, continuous glucose monitors, and hybrid closed-loop systems improve glycemic outcomes. However, many people find this technology challenging for a variety of reasons, including increased burden and frequent alarms, especially during the night. The impact of different devices on sleep quality and quantity has been mixed. The newest technology, the hybrid closed-loop systems, offers the best opportunity for nocturnal glycemic regulation and has improved patient and family perspectives on sleep quality. However, objective sleep assessment has not shown significant improvement on sleep duration. Sleep quality and quantity in people with type 1 diabetes are widely recognized as an important component of health care, and the literature regarding the impact of diabetes devices on sleep is increasing. However, sleep disruptions are common and a barrier to device use. Despite finding minimal changes to sleep duration with device use, subjective accounts of sleep quality are overall positive, especially in those using hybrid closed-loop systems. Sleep quantity and quality are important outcomes to consider as diabetes technology continues to evolve.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"22 7","pages":"283-290"},"PeriodicalIF":4.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9996025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Diabetes Technology to Address Inequity in Health Outcomes: Limitations and Opportunities.","authors":"Shivani Agarwal, Iman Simmonds, Alyson K Myers","doi":"10.1007/s11892-022-01470-3","DOIUrl":"10.1007/s11892-022-01470-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>The management of diabetes has been revolutionized by the introduction of novel technological treatments and modalities of care, such as continuous glucose monitoring, insulin pump therapy, and telehealth. While these technologies have demonstrated improvement in health outcomes, it remains unclear whether they have reduced inequities from racial/ethnic minority or socioeconomic status. We review the current literature to discuss evidence of benefit, current limitations, and future opportunities of diabetes technologies.</p><p><strong>Findings: </strong>While there is ample evidence of the health and psychological benefit of diabetes technologies in large populations of people with type 1 and type 2 diabetes, there remain wide disparities in the use of diabetes technologies, which may be perpetuating or widening inequities. Multilevel barriers include inequitable prescribing practices, lack of support for social determinants of health, mismatch of patient preferences and care models, and cost. We provide a review of disparities in diabetes technology use, possible root causes of continued inequity in outcomes, and insight into ways to overcome remaining gaps.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"22 7","pages":"275-281"},"PeriodicalIF":5.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9157044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9552604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Inpatient Diabetes Management with Non-insulin Agents: an Overview of International Practices.","authors":"Rodolfo J Galindo,&nbsp;Ketan Dhatariya,&nbsp;Fernando Gomez-Peralta,&nbsp;Guillermo E Umpierrez","doi":"10.1007/s11892-022-01464-1","DOIUrl":"https://doi.org/10.1007/s11892-022-01464-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>The field of inpatient diabetes has advanced significantly over the last 20 years, leading to the development of personalized treatment approaches. However, outdated guidelines still recommend the use of basal-bolus insulin therapy as the preferred treatment approach, and against the use of non-insulin anti-hyperglycemic agents.</p><p><strong>Recent findings: </strong>Several observational and prospective randomized controlled studies have demonstrated that oral anti-hyperglycemic agents are widely used in the hospital, including studies of DPP-4 agents and GLP-1 agonists. With advances in the field of inpatient diabetes management, a paradigm shift has occurred, from an approach of recommending \"basal-bolus regimens\" for all patients to a more precision medicine option for hospitalized non-critically ill patients with type 2 diabetes.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"22 6","pages":"237-246"},"PeriodicalIF":4.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9065239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9913775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}