Journal of Diabetes Investigation最新文献

{"title":"Validity of the short-form five-item Problem Area in Diabetes questionnaire as a depression screening tool in type 2 diabetes mellitus patients","authors":"Donovan Tay,&nbsp;Marvin Chua,&nbsp;Joan Khoo","doi":"10.1111/jdi.14051","DOIUrl":"https://doi.org/10.1111/jdi.14051","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>Depression is prevalent in diabetes patients and associated with poor outcomes, but is currently underdiagnosed, with no firm consensus on screening methods. We evaluated the validity of the short-form five-item Problem Areas in Diabetes (PAID-5) questionnaire as a screening tool for depression, comparing it with the Beck Depression Inventory-II (BDI-II) and nine-item Patient Health Questionnaire (PHQ-9).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 208 English-speaking adults with type 2 diabetes, recruited from outpatient clinics, completed the BDI-II, PHQ-9 and PAID-5 questionnaires in English. Cronbach's α was used for internal reliability. Convergent validity was examined with BDI-II and PHQ-9. Receiver operating characteristics analyses were used to identify optimal PAID-5 cut-offs for the diagnosis of depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All three screening tools were highly reliable, with BDI-II, PHQ-9 and PAID-5 having a Cronbach's α of 0.910, 0.870 and 0.940, respectively. There was a good correlation between BDI-II and PHQ-9, with a correlation co-efficient (<i>r</i>) of 0.73; and a moderate correlation between PAID-5 and PHQ-9, and PAID-5 and BDI-II, with <i>r</i> of 0.55 and 0.55 respectively (<i>P</i> values &lt;0.01). An optimal PAID-5 cut-off ≥9 corresponded to both a BDI-II cut-off &gt;14 (sensitivity 72%, specificity 784%, area under the curve 0.809) and a PHQ-9 cut-off &gt;10 (sensitivity 84%, specificity 74%, area under the curve 0.806). Using a PAID-5 cut-off ≥9, the prevalence of depressive symptoms was 36.1%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Depressive symptoms are prevalent in people with type 2 diabetes, with the degree of distress significantly related to the severity of depressive symptoms. PAID-5 is a valid and reliable screening tool, and a score ≥9 could prompt further confirmation for depression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 9","pages":"1128-1135"},"PeriodicalIF":3.2,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5728989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contribution of animal models to diabetes research: Its history, significance, and translation to humans","authors":"Soroku Yagihashi","doi":"10.1111/jdi.14034","DOIUrl":"https://doi.org/10.1111/jdi.14034","url":null,"abstract":"<p>Diabetes mellitus is still expanding globally and is epidemic in developing countries. The combat of this plague has caused enormous economic and social burdens related to a lowered quality of life in people with diabetes. Despite recent significant improvements of life expectancy in patients with diabetes, there is still a need for efforts to elucidate the complexities and mechanisms of the disease processes to overcome this difficult disorder. To this end, the use of appropriate animal models in diabetes studies is invaluable for translation to humans and for the development of effective treatment. In this review, a variety of animal models of diabetes with spontaneous onset in particular will be introduced and discussed for their implication in diabetes research.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 9","pages":"1015-1037"},"PeriodicalIF":3.2,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6102867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"miR-31 ameliorates type 2 diabetic vascular damage through up-regulation of hypoxia-inducible factor-1α/vascular endothelial growth factor-A","authors":"Yuan Fu,&nbsp;Ruochen Du,&nbsp;Yufei Wang,&nbsp;Yitong Yuan,&nbsp;Yujuan Zhang,&nbsp;Chunfang Wang,&nbsp;Xuanping Zhang","doi":"10.1111/jdi.14039","DOIUrl":"https://doi.org/10.1111/jdi.14039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>microRNA may be a new therapeutic direction for diabetes. As a typical tumor marker, miR-31 is involved in a variety of metabolic diseases, but the specific role is still unclear. This study aimed to investigate the effect of miR-31 on type 2 diabetes mellitus and its accompanying vascular injury, as well as on the effects of hypoxia-inducible factor-1α inhibitor (HIF1AN), hypoxia-inducible factor (HIF)-1α, and vascular endothelial growth factor (VEGF)-A expression <i>in vitro</i> and <i>in vivo</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p><i>In vitro</i>, a model of high-fat and high-glucose-induced human aortic endothelial cell (HAEC) injury was established to simulate diabetes mellitus (DM). Cell functions were compared between the control group, the DM damage group, and the group transfected with miR-31 after DM damage. <i>In vivo</i>, overexpressing miR-31 FVB mice and FVB mice were divided into the control and induced type 2 diabetes mellitus groups. Type 2 diabetes mellitus models were induced by a high-fat diet combined with streptozotocin. The lipid metabolism levels, viscera, and vascular damage were compared between the control and type 2 diabetes mellitus groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p><i>In vitro</i>, miR-31 improved the proliferation ability of damaged cells by targeting HIF1AN and up-regulating the expression of HIF-1α and VEGF-A. <i>In vivo</i>, miR-31 ameliorated the development of type 2 diabetes mellitus, disturbance of glucose and lipid metabolism, and damage to some organs. Meanwhile, miR-31 had a protective effect on vascular damage complicated by type 2 diabetes mellitus by increasing the levels of HIF-1α and VEGF-A.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our experiments show that miR-31 can delay the progression of type 2 diabetes mellitus and ameliorate diabetic vascular injury.</p>\u0000 </section>\u0000 </div>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 9","pages":"1070-1080"},"PeriodicalIF":3.2,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6089076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-classical monocytes frequency and serum vitamin D3 levels are linked to diabetic foot ulcer associated with peripheral artery disease","authors":"Reham Hammad,&nbsp;Maisa A Abdel Wahab,&nbsp;Nehal Farouk,&nbsp;Mohamed Yahia Zakaria,&nbsp;Mona A Eldosoky,&nbsp;Asmaa A Elmadbouly,&nbsp;Sara A Tahoun,&nbsp;Eman Mahmoud,&nbsp;Seham K Khirala,&nbsp;Amena Rezk Mohammed,&nbsp;Wafaa Abdelaziz Emam,&nbsp;Asmaa A Abo Elqasem,&nbsp;Fatma M Kotb,&nbsp;Rasha Abd Elaziz Abd Elghany","doi":"10.1111/jdi.14048","DOIUrl":"https://doi.org/10.1111/jdi.14048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>Peripheral artery disease (PAD) serves as a risk factor for diabetic foot ulcers (DFUs). PAD pathology involves atherosclerosis and impaired immunity. Non-classical monocytes are believed to have an anti-inflammatory role. 1,25-Dihydroxy vitamin D (vitamin D₃) is claimed to have immune-modulating and lipid-regulating roles. Vitamin D receptor is expressed on monocytes. We aimed to investigate if circulating non-classical monocytes and vitamin D₃ were implicated in DFUs associated with PAD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>There were two groups of DFU patients: group 1 (<i>n</i> = 40) included patients with first-degree DFUs not associated with PAD, and group 2 (<i>n</i> = 50) included patients with DFU with PAD. The monocyte phenotypes were detected using flow cytometry. Vitamin D₃ was assessed by enzyme-linked immunosorbent assay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>DFU patients with PAD showed a significant reduction in the frequency of non-classical monocytes and vitamin D₃ levels, when compared with DFU patients without PAD. The percentage of non-classical monocytes positively correlated with vitamin D₃ level (<i>r</i> = 0.4, <i>P</i> &lt; 0.01) and high-density lipoprotein (<i>r</i> = 0.5, <i>P</i> &lt; 0.001), whereas it was negatively correlated with cholesterol (<i>r</i> = −0.5, <i>P</i> &lt; 0.001). Vitamin D₃ was negatively correlated with triglyceride/high-density lipoprotein (<i>r</i> = −0.4, <i>P</i> &lt; 0.01). Regression analysis showed that a high vitamin D₃ serum level was a protective factor against PAD occurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Non-classical monocytes frequency and vitamin D₃ levels were significantly reduced in DFU patients with PAD. Non-classical monocytes frequency was associated with vitamin D₃ in DFUs patients, and both parameters were linked to lipid profile. Vitamin D₃ upregulation was a risk-reducing factor for PAD occurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 10","pages":"1192-1201"},"PeriodicalIF":3.2,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41081848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noninvasive evaluation of donor and native pancreases following simultaneous pancreas–kidney transplantation using positron emission tomography/computed tomography","authors":"Takaaki Murakami,&nbsp;Toshihiro Nakamura,&nbsp;Hiroyuki Fujimoto,&nbsp;Junji Fujikura,&nbsp;Yoichi Shimizu,&nbsp;Kanae K. Miyake,&nbsp;Daisuke Otani,&nbsp;Kentaro Sakaki,&nbsp;Sakura Kiyobayashi,&nbsp;Takayuki Anazawa,&nbsp;Yuji Nakamoto,&nbsp;Nobuya Inagaki","doi":"10.1111/jdi.14045","DOIUrl":"https://doi.org/10.1111/jdi.14045","url":null,"abstract":"<p>It is crucial to develop practical and noninvasive methods to assess the functional beta-cell mass in a donor pancreas, in which monitoring and precise evaluation is challenging. A patient with type 1 diabetes underwent noninvasive imaging following simultaneous kidney–pancreas transplantation with positron emission tomography/computed tomography (PET/CT) using an exendin-based probe, [¹⁸F]FB(ePEG12)12-exendin-4. Following transplantation, PET imaging with [¹⁸F]FB(ePEG12)12-exendin-4 revealed simultaneous and distinct accumulations in the donor and native pancreases. The pancreases were outlined at a reasonable distance from the surrounding organs using [¹⁸F]FB(ePEG12)12-exendin-4 whole-body maximum intensity projection and axial PET images. At 1 and 2 h after [¹⁸F]FB(ePEG12)12-exendin-4 administration, the mean standardized uptake values were 2.96 and 3.08, respectively, in the donor pancreas and 1.97 and 2.25, respectively, in the native pancreas. [¹⁸F]FB(ePEG12)12-exendin-4 positron emission tomography imaging allowed repeatable and quantitative assessment of beta-cell mass following simultaneous kidney–pancreas transplantation.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 10","pages":"1187-1191"},"PeriodicalIF":3.2,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41082024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of countermeasure for polypharmacy by multidisciplinary team review in patients with diabetes mellitus","authors":"Shohei Nishida,&nbsp;Takehiro Kato,&nbsp;Yuichi Hayashi,&nbsp;Shoya Yamada,&nbsp;Hironori Fujii,&nbsp;Michi Yamada,&nbsp;Nao Asai,&nbsp;Shinya Shimizu,&nbsp;Takashi Niwa,&nbsp;Hirotoshi Iihara,&nbsp;Sodai Kubota,&nbsp;Mayu Sakai,&nbsp;Yoshihiro Takahashi,&nbsp;Ken Takao,&nbsp;Masami Mizuno,&nbsp;Takuo Hirota,&nbsp;Ryo Kobayashi,&nbsp;Yukio Horikawa,&nbsp;Daisuke Yabe,&nbsp;Akio Suzuki","doi":"10.1111/jdi.14046","DOIUrl":"https://doi.org/10.1111/jdi.14046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>Polypharmacy in diabetes patients is related to worse clinical outcomes. The aim of this study was to evaluate the usefulness of our countermeasure for polypharmacy, which combines a pharmacist check followed by a multidisciplinary team review in diabetic patients with polypharmacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-center, retrospective observational study was conducted at Gifu University Hospital. Study participants included diabetic patients taking six or more drugs on admission to the diabetes ward between July 2021 and June 2022. Drugs which were discontinued by the present countermeasure were examined, and the number of drugs being taken by each patient was compared between admission and discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>102 of 308 patients were taking six or more drugs on admission. The drugs being taken by these patients were evaluated by pharmacists using a checklist for polypharmacy. Eighty-four drugs which were evaluated as inappropriate or potentially inappropriate medications by pharmacists were discontinued following the multidisciplinary team review. The median and mean number of drugs taken by the 102 patients significantly decreased from 9.0 (IQR: 8–12) and 9.26 ± 2.64 on admission to 9.0 (IQR: 6–10) and 8.42 ± 2.95 on discharge (<i>P</i> = 0.0002). We followed up with these patients after discontinuation of the drugs and confirmed that their clinical status had not deteriorated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The present countermeasure for polypharmacy, which combines a pharmacist check based on a checklist for evaluating polypharmacy followed by a multidisciplinary team review, was useful for reducing the number of inappropriate or potentially inappropriate medications taken by diabetes patients with polypharmacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 10","pages":"1202-1208"},"PeriodicalIF":3.2,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41082161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the angiotensin receptor-neprilysin inhibitor in clinical diabetes management: Potential benefits and pitfalls","authors":"Tomoko Kato,&nbsp;Takaaki Murakami,&nbsp;Daisuke Yabe,&nbsp;Norio Harada","doi":"10.1111/jdi.14044","DOIUrl":"https://doi.org/10.1111/jdi.14044","url":null,"abstract":"<p>The possible mechanism of increased urinary C-peptide due to neprilysin inhibitors is investigated. Neprilysin inhibition blocks degradation of natriuretic peptides, and elicits a natriuretic and antihypertensive effect. Neprilysin inhibition might similarly block degradation of C-peptides in the kidney and thus increase the urinary C-peptide level.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 9","pages":"1038-1040"},"PeriodicalIF":3.2,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6038421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serine supplementation: Is it a new option for the treatment of diabetic polyneuropathy?","authors":"Hiroki Mizukami","doi":"10.1111/jdi.14047","DOIUrl":"https://doi.org/10.1111/jdi.14047","url":null,"abstract":"<p>Subjects with diabetes develop marked disturbances in amino acid metabolism and the concentration in plasma and tissues. Most consistently, the levels of branched-chain amino acids (BCAAs) and aromatic amino acids are increased, and the levels of <span>l</span>-serine and glycine are decreased<span>¹</span>. Aberrant nonessential amino acid metabolism is involved in the pathogenesis of diabetes. Elevated levels of plasma BCAAs have been associated with insulin resistance and type 2 diabetes since the 1960s<span>²</span>. A cluster of obesity-associated changes in the specific amino acid, acylcarnitine, and organic acid metabolites in obese compared with lean subjects was also associated with insulin resistance. Although it is also speculated that disturbances in aminoacidemia play a role in the development of diabetic complications, their pathogenesis has not been sufficiently elucidated in detail.</p><p>Diabetic peripheral neuropathy (DPN) is the most frequent complication among diabetic patients. Its symptoms are pain, hyperalgesia, hypoalgesia, and paralysis, which can decrease the quality of life of patients. In diabetic peripheral neuropathy, peripheral nerve fibers are affected from the prediabetic stage. Because diabetic peripheral neuropathy is a retrograde-type neuropathy, small nerve fibers located in the epidermis or cornea are first degraded. Small nerve fibers consist of myelinated Aδ fibers and unmyelinated C fibers. Small fiber neuropathy is a disorder of these nerve fibers, manifesting as spontaneous pain or loss of pain sensation with reduction of their density. As diabetic peripheral neuropathy progresses, large myelinated fibers are also decreased with segmental demyelination and microvascular changes, such as thickening of the vascular wall and stenosis of intraneuronal vessels. Without proper treatment, these patients develop paralysis or ulcer formation on the foot. To date, diabetic peripheral neuropathy is thought to be caused by aberrant glucose metabolism in neuronal cells, Schwann cells and endothelial cells in the peripheral nervous system. Abnormal glycemic metabolism elicits nerve dysfunction with activation of the polyol pathway, protein kinase C, advanced glycation end products and its receptor, the receptor for advanced glycation end product (RAGE) pathway, oxidative stress, and inflammation. Clinically, in addition to hyperglycemia, metabolic syndrome, including dyslipidemia, obesity and hypertension, is well known to be a contributor to the pathogenesis of diabetic peripheral neuropathy. In addition to glucose and fatty acid metabolism, recent metabolomics studies have revealed the involvement of another metabolite, glucosamine, in the pathogenesis of diabetic peripheral neuropathy. Lower baseline amino acid levels such as asparagine and glutamine were correlated with cardiovascular autonomic neuropathy in a small sample of subjects with type 1 diabetes<span>³</span>. Thus, to","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 10","pages":"1157-1159"},"PeriodicalIF":3.2,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41081658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updates on dyslipidemia in patients with diabetes","authors":"Shintaro Ide,&nbsp;Yoshiro Maezawa,&nbsp;Koutaro Yokote","doi":"10.1111/jdi.14042","DOIUrl":"https://doi.org/10.1111/jdi.14042","url":null,"abstract":"<p>The main aim of diabetes management is to prevent atherosclerotic cardiovascular diseases (ASCVD) and microvascular complications. ASCVD, the major cause of diabetes-related mobility and mortality, greatly increases healthcare costs in patients with type 2 diabetes<span>¹</span>. Dyslipidemia often coexists with diabetes mellitus and is a significant risk factor for ASCVD, along with smoking, hypertension and chronic kidney disease. Dyslipidemia is involved in the progression of diabetic kidney disease<span>²</span> and diabetic retinopathy<span>³</span>. Patients with diabetes mellitus show atherogenic lipid profiles exhibiting elevated low-density lipoprotein cholesterol (LDL-C) levels with small dense LDL particles; decreased high-density lipoprotein cholesterol (HDL-C) levels; and hypertriglyceridemia (TG) due to insufficient insulin action. Furthermore, a retrospective cohort study identified an elevated LDL-C/HDL-C ratio as a potential independent risk factor for new-onset diabetes<span>⁴</span>. Therefore, abnormal lipid profiles must be managed to reduce the risk of cardiovascular (CV) events and microvascular complications.</p><p>A high LDL-C level is a strong risk factor for ASCVD in patients with and without diabetes mellitus. Numerous outcome trials have shown that cholesterol-lowering therapy using 3-hydroxy 3-methylglutaryl-coenzyme A reductase inhibitors (statins) reduces the relative risk of primary and secondary ASCVD events<span>⁵</span>. Furthermore, a recent randomized controlled trial showed that LDL-C control using statins reduced the risk of kidney events in patients with diabetic kidney disease<span>⁶</span>. In addition to statin therapy, proprotein convertase subtilisin/kexin type 9 inhibitors and ezetimibe therapies reduced CV event risk<span>^7-9</span>.</p><p>Although these LDL-C-lowering therapies can decrease the risk of ASCVD, the risk rate reduction is only 30–40%, suggesting the presence of residual risk factors, such as hypertriglyceridemia, low HDL-C levels and highly oxidized or small dense LDL particles. Interestingly, a recent prospective study showed the TG/HDL-C ratio to be correlated with an increased risk of major ASCVD events, suggesting that the TG/HDL-C ratio can be a parameter for assessing atherogenic dyslipidemia<span>¹⁰</span>. Furthermore, in addition to fasting hypertriglyceridemia, postprandial hypertriglyceridemia is a risk factor for CV events<span>¹¹</span>.</p><p>Several epidemiological, genetic and clinical studies have shown that a high TG level is a residual risk factor; however, neither the Action to Control Cardiovascular Risk in Diabetes (ACCORD) lipid trial nor the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study reported reduced CV events in patients with type 2 diabetes<span>¹²</span>. A meta-analysis of fibrate users in 11,590 patients with type 2 di","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 9","pages":"1041-1044"},"PeriodicalIF":3.2,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5750737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diet and exercise are a fundamental part of comprehensive care for type 2 diabetes","authors":"Yun Kai Yeh,&nbsp;Fu-Shun Yen,&nbsp;Chii-Min Hwu","doi":"10.1111/jdi.14043","DOIUrl":"https://doi.org/10.1111/jdi.14043","url":null,"abstract":"<p>In this modern era, numerous innovative glucose-lowering medications have emerged, leading to a wide range of treatment options for type 2 diabetes mellitus. While pharmacologic interventions are crucial for achieving glycemic control in type 2 diabetes mellitus, it is essential to recognize the fundamental role of lifestyle modifications in attaining glycemic targets. Among various lifestyle modifications, dietary adjustments and exercise hold significant importance in the management of type 2 diabetes mellitus, offering numerous benefits such as improved glycated hemoglobin (HbA1c) levels and a reduced risk of cardiovascular events.</p><p>Appropriate medical nutrition therapy has been shown to reduce HbA1c levels by 0.3–2.0% in patients with type 2 diabetes mellitus<span>¹</span>. Even after initiating medication, nutrition therapy continues to play a crucial role in the overall management of diabetes. In an animal study involving mice, it was observed that the use of sodium–glucose cotransporter 2 inhibitors (SGLT-2i) in conjunction with controlled feeding led to weight loss and a decrease in hepatic gluconeogenic response. However, these effects were diminished in a group of mice with unrestricted access to food<span>²</span>. This suggests that dietary control remains essential when combined with glucose-lowering medications such as SGLT-2i for optimal glycemic control.</p><p>Currently, there is no specific recommendation for the ideal percentage of calories from carbohydrates, proteins, and fats for individuals with diabetes based on existing evidence. Instead, the emphasis is on developing individualized nutrition plans. While there is no specific ideal percentage for the nutritional components in the diet of individuals with type 2 diabetes mellitus, there are general recommendations that can be followed. These recommendations emphasize the importance of consuming non-starchy vegetables, minimizing the intake of added sugars and refined grain, and opting for whole foods instead of highly processed foods<span>^{3, 4}</span>. Some studies have revealed that exogenous ketone ingestion would decrease the blood sugar level which may be related to an increase of early phase insulin<span>^{5, 6}</span>. Still, evidence for prolonged ketone ingestion for blood glucose is limited<span>⁶</span>. There are also several eating patterns that have been proposed for individuals with type 2 diabetes mellitus. These include the Mediterranean diet, low-carbohydrate diet, fiber-rich diet, intermittent very-low-calorie diet, and vegetarian or plant-based diet (Table 1)<span>^7-16</span>. Some of these eating patterns have also been associated with a lower risk of developing type 2 diabetes mellitus in healthy individuals<span>^{8, 10}</span>.</p><p>Excessive alcohol intake should be avoided in individuals with type 2 diabetes mellitus due to several reasons. First, it increases the risk of","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 8","pages":"936-939"},"PeriodicalIF":3.2,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5953932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}