British Journal of Diabetes最新文献

{"title":"Vitamin D in the prevention of type 1 diabetes: would increasing food fortification reduce the incidence?","authors":"J. Harvey","doi":"10.15277/bjd.2023.405","DOIUrl":"https://doi.org/10.15277/bjd.2023.405","url":null,"abstract":"This paper reviews data regarding the role of vitamin D in the genesis of type 1 diabetes (T1DM) and considers the hypothesis that vitamin D deficiency increases the incidence rate of T1DM. Vitamin D has actions on immune cells that would suppress autoimmunity with preservation of anti- infective actions. Geographical latitude and both season of diagnosis and of birth affect case numbers, most likely via the effect of UVB sunlight on vitamin D synthesis. Other factors, such as seasonal viral infections, may be important. Serum concentrations of 25(OH) vitamin D have mostly been found to be lower with diagnosis of T1DM.\u0000Vitamin D deficiency is common, particularly in the UK. From data on vitamin D concentrations in non-diabetic controls in mostly southerly nations this review estimates the population mean serum 25(OH)D concentration associated with low T1DM incidence to be >80 nmol/l. Achieving this in Britain would require supplementing current intake with 1500-2000 IU vitamin D daily. Increased food fortification would be the most effective method. An estimate based on the limited data available suggests this might generate a 25-30% reduction in the incidence of T1DM.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43653106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food fortification to tackle vitamin D deficiency: to address classic or non-classic effects?","authors":"S. Uday","doi":"10.15277/bjd.2023.408","DOIUrl":"https://doi.org/10.15277/bjd.2023.408","url":null,"abstract":"Vitamin D is a hormone synthesised in the skin from 7-dehydrocholesterol following ultraviolet B (UVB) radiation exposure from sunlight. Limited dietary sources of vitamin D make it difficult for certain groups to maintain optimum serum 25hydroxyvitamin D (25OHD) levels. These high-risk groups include individuals residing at high latitude, dark-skinned populations and those who avoid the sun for medical or cosmetic reasons or who wear full body clothing for religious reasons.1 The classic role of vitamin D in optimising bone health through mineral homeostasis is undisputable. Deficiency causes rickets (impaired mineralisation of the growth plates) in children and osteomalacia (impaired mineralisation of pre-formed bone) in children and adults, which can manifest as muscle pain, weakness, delayed development and bony deformities.2 However, over the last three decades or so understanding of the nonclassic role of vitamin D against inflammation and infection has evolved. A growing body of evidence suggests a role for vitamin D in immune modulation through 1,25 dihydroxyvitamin D [1,25(OH)2D], the active form of 25OHD, regulating the expression of vitamin D-responsive genes which influence immune cell signalling pathways.3 Vitamin D deficiency has been linked to autoimmune conditions such as type 1 diabetes mellitus (T1DM), multiple sclerosis, Crohn’s disease and infections such as tuberculosis. The article by Harvey JN4 proposes food fortification with vitamin D to reduce the incidence of T1DM. In autoimmune conditions, it is challenging to conclude causality given the observational nature of the majority of studies and also the widespread prevalence of vitamin D deficiency globally. Due to the practical difficulties in excluding the influence of confounding environmental factors on disease incidence, the results of most studies can only be speculative at best. Through monozygotic twin studies we understand that environmental factors play a key role in the pathogenesis of T1DM. Childhood obesity, seasonal infections, enterovirus exposure, gut microbiome and vaccination programmes are some of the factors that have been considered to influence the incidence of T1DM. Studies evaluating vitamin D receptor polymorphisms in T1DM have been small and heterogenous, thereby providing conflicting results.5 Moreover, ethnic minority groups, who are disproportionately affected by vitamin D deficiency, are often under-represented in these studies. Whether optimising 25OHD levels beyond those essential for bone health through vitamin D supplementation and fortification protects against autoimmune disease onset or supports its treatment is yet to be elucidated. Clarifying the specific role of vitamin D in prevention or treatment of autoimmune diseases would require prospective randomised clinical trials which poses several logistic challenges. Despite increased numbers of cases of nutritional rickets and growing evidence that vitamin D deficiency is a major public ","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46103429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between preoperative glucose- lowering medication agents and the status of type 2 diabetes mellitus after bariatric surgery","authors":"H. Raja, Saarah Ebrahim, R. Mamidanna, K. Patel, A. Askari, C. Arhi, A. Munasinghe, F. Rashid, O. Al-Taan, P. Jambulingam, D. Whitelaw, V. Jain, A. Zalin, T. Rehman, MD Tanveer Asil","doi":"10.15277/bjd.2023.409","DOIUrl":"https://doi.org/10.15277/bjd.2023.409","url":null,"abstract":"Introduction: Bariatric surgery is an effective treatment for type 2 diabetes mellitus (T2DM) in patients with morbid obesity. This study investigates whether duration of diabetes and anti-diabetes therapy are associated with glycaemic control after surgery in a routine clinical setting.\u0000Method: A cohort analysis of a prospectively maintained database was carried out for consecutive bariatric operations performed between April 2017 and March 2018 for patients with T2DM.\u0000Results: A total 105 patients with T2DM underwent bariatric surgery (89 Roux-en-Y gastric bypass and 16 sleeve gastrectomy). Median follow-up was 19 months ([interquartile range] IQR 13-24 months). Median weight and body mass index (BMI) on the day of surgery were 125 kg (IQR 103.9- 138.7) and 42.4 kg/m2 (IQR 39-46.8), respectively. At follow- up, 68 patients (64.8%) had achieved remission of diabetes. Patients who were pre-operatively on more than one glucose-lowering medication were less likely to go into remission (odds ratio [OR] 0.13, 95% CI 0.04-0.44, p=0.001) compared to those that were on a single glucose-lowering medication agent. Pre-operative use of insulin therapy (OR 0.09, 95% CI 0.03-0.31, p=<0.001) and SGLT2 inhibitors (OR 0.23, 95% CI 0.05-0.92, p=0.038) were significant negative predictors of remission. Type of operation (p=0.34), pre-operative BMI (p=0.99), and % total weight loss (TWL) (p=0.83) did not predict remission from T2DM after surgery.\u0000Conclusions: Most patients who are medicated for T2DM can stop their glucose-lowering medication after bariatric surgery. Patients who are on multiple glucose-lowering medication agents or those dependent on insulin or SGLT2 inhibitors before bariatric surgery are less likely to undergo complete remission >12 months after bariatric surgery.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42675928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts from ABCD Diabetes Update","authors":"Diabetes Update 2023","doi":"10.15277/bjd.2023.406","DOIUrl":"https://doi.org/10.15277/bjd.2023.406","url":null,"abstract":"","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43730766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pembrolizumab and diabetes: a case of diabetic ketoacidosis in a patient with metastatic melanoma","authors":"Songo Lolomari, S. Thayyil, M. Kong","doi":"10.15277/bjd.2023.410","DOIUrl":"https://doi.org/10.15277/bjd.2023.410","url":null,"abstract":"Introduction The advent of immunotherapy has revolutionised the management of certain malignancies, and its use has increased over the past decade. Monoclonal antibody therapies known as checkpoint inhibitors work by enhancing the immune response against malignant cells by blocking the pathways that inhibit T-cell regulation. Checkpoint inhibitors can be administered alone or in combination as an intravenous infusion every 3-6 weeks for a maximum of two years. However, about 10% of patients may experience endocrine adverse effects. Thyroid disease and hypophysitis are those most commonly encountered; there are also reports of diabetes mellitus and primary adrenal insufficiency as well as rarer endocrinopathies. Pembrolizumab, an immune checkpoint inhibitor, received FDA approval in 2014 for advanced melanoma, and in 2015 for metastatic non-small cell lung cancer. It is also approved for recurrent/metastatic head and neck cancer, and for refractory classical Hodgkin’s lymphoma. We report the case of a 75-year-old man who developed new-onset diabetes mellitus and diabetic ketoacidosis while undergoing pembrolizumab chemotherapy for metastatic melanoma. He was not taking steroids.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43141030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effective analysis of using total contact casting for diabetic foot ulcer management","authors":"Abbas See, Manjula Mallikage, Jacqueline Mildred, Andrea Friel, Mary Gray, S. Kirmani, M. Pierides","doi":"10.15277/bjd.2023.404","DOIUrl":"https://doi.org/10.15277/bjd.2023.404","url":null,"abstract":"","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45087314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes mellitus and periodontal disease: education, collaboration and information sharing between doctors, dentists and patients","authors":"Chris Turner, P. Bouloux","doi":"10.15277/bjd.2023.403","DOIUrl":"https://doi.org/10.15277/bjd.2023.403","url":null,"abstract":"People living with diabetes (DM) are at higher risk of developing periodontal disease than those without diabetes. This observation was first recorded in 1928. It is now believed that the risk is 3-4 times greater than for people without DM, and more for smokers. However, many doctors are not aware of this.\u0000DM and periodontal disease are bi-directionally linked, the one affecting the other and vice versa, although the mechanism is not fully understood. Periodontal disease has an adverse effect on glycaemic control. That improves when periodontitis is successfully treated.\u0000Doctors should consider periodontal disease when their patients have persistently high glycated haemoglobin (HbA1c) levels, and dentists should consider diabetes or pre-diabetes when they have patients with unstable periodontitis.\u0000Doctors and dentists, and their teams, need to share results. This paper considers what that shared information should be. A system of red, amber and green for both medical and dental risks is proposed. Until there are reliable methods of information exchanges and a paradigm shift in inter-professional working, patients should obtain their medical and dental results and share them with their respective advisors.\u0000Those patients who do not attend for dental care should be advised by their doctor about the potential benefits of dental screening for periodontitis.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44821513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CRY1 polymorphism may influence the association of low carbohydrate diet (LCD) score on glucose homeostasis in overweight and obese women","authors":"A. Mirzababaei, Farideh Shiraseb, Sara Hajishizari, Mena Farazi, Hadith Tangestani, Leila Khorraminezhad, C. Clark, K. Mirzaei","doi":"10.15277/bjd.2023.402","DOIUrl":"https://doi.org/10.15277/bjd.2023.402","url":null,"abstract":"Background and aims: We sought to examine the interaction between CRY1 genotypes and low carbohydrate diet (LCD) score and the effect on insulin resistance, insulin sensitivity, homeostasis model assessment of insulin resistance (HOMA- IR) and quantitative insulin sensitivity check index (ISQUKI).\u0000Methods: This cross-sectional study was conducted with a total of 228 overweight and obese women. The data related to anthropometric and biochemical measures were collected and a food frequency questionnaire (FFQ), with 147 items, was used to assess dietary intake. Based on the FFQ, we calculated an LCD score for each study participant, ranging from 0 to 70. Biochemical assessments, including TC, HDL, LDL, TG, FBS, insulin and HOMA-IR, were performed. Deoxyribonucleic acid (DNA) samples were assessed to be genotyped for the rs2287161, which was genotyped by the restriction fragment length polymorphism (PCR-RFLP) method. A generalised linear model was performed for interaction analysis.\u0000Results: The results of the study demonstrated that, after controlling for several confounders, increased adherence to an LCD (T3 vs. T1) in the interaction with one risk allele genotype (CG) increases ISQUKI level (β: 0.001, CI: 0.00, 0.002, p=0.041). Also, there was a marginally negative interaction between higher adherence to LCD and two risk alleles genotype (CC) on insulin level (β: -0.012, CI: 0-0.024, 0.001, p=0.054).\u0000Conclusions: This study revealed a negative interaction of CRY1 genotypes with two risk allele and higher LCD adherence on insulin level, and a positive interaction on ISQUKI. However, the mechanism of interaction between LCDs and CRY1 genotypes remains unclear.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":"1 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41731475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"British Journal of Diabetes (and Vascular Disease): a brief history","authors":"C. Day, Cliff Bailey","doi":"10.15277/bjd.2022.365","DOIUrl":"https://doi.org/10.15277/bjd.2022.365","url":null,"abstract":"","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47342191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#We don't have to wait any more Closed-loop systems: transforming the landscape","authors":"C. Boughton, R. Hovorka","doi":"10.15277/bjd.2022.374","DOIUrl":"https://doi.org/10.15277/bjd.2022.374","url":null,"abstract":"Hybrid closed-loop systems are transforming the clinical management of T1DM. Large randomised controlled trials of hybrid closed-loop systems have demonstrated safety and efficacy, with significant improvements in glycaemic control compared to control therapy, and there are now several commercially approved hybrid closed-loop systems available in the UK. There is also a growing body of evidence demonstrating the quality of life benefits associated with hybrid closed-loop systems, both for users and also for parents/caregivers and other family members.\u0000We review the clinical evidence supporting currently available hybrid closed-loop systems in the UK and also new systems on the horizon. We discuss the emerging evidence for associated psychosocial benefits of hybrid closed-loop therapy. We also address future challenges around healthcare professional readiness to deliver closed-loop technology and ensuring equitable access across the UK.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44418737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}