Khaoula Bouazizi, Mohamed Zarai, Abdallah Noufaily, Mikaël Prigent, Thomas Dietenbeck, Emilie Bollache, Toan Nguyen, Valéria Della Valle, Eléonore Blondiaux, Karine Clément, Judith Aron-Wisnewsky, Fabrizio Andreelli, Alban Redheuil, Nadjia Kachenoura
{"title":"Associations of aortic stiffness and intra-aortic flow parameters with epicardial adipose tissue in patients with type-2 diabetes.","authors":"Khaoula Bouazizi, Mohamed Zarai, Abdallah Noufaily, Mikaël Prigent, Thomas Dietenbeck, Emilie Bollache, Toan Nguyen, Valéria Della Valle, Eléonore Blondiaux, Karine Clément, Judith Aron-Wisnewsky, Fabrizio Andreelli, Alban Redheuil, Nadjia Kachenoura","doi":"10.3389/fcdhc.2023.1106342","DOIUrl":"https://doi.org/10.3389/fcdhc.2023.1106342","url":null,"abstract":"<p><strong>Background: </strong>It has been shown that increased aortic stiffness is related to type-2 diabetes (T2D) which is considered as a risk factor for cardiovascular disease. Among other risk factors is epicardial adipose tissue (EAT) which is increased in T2D and is a relevant biomarker of metabolic severity and adverse outcome.</p><p><strong>Purpose: </strong>To assess aortic flow parameters in T2D patients as compared to healthy individuals and to evaluate their associations with EAT accumulation as an index of cardiometabolic severity in T2D patients.</p><p><strong>Materials and methods: </strong>Thirty-six T2D patients as well as 29 healthy controls matched by age and sex were included in this study. Participants had cardiac and aortic MRI exams at 1.5 T. Imaging sequences included cine SSFP for left ventricle (LV) function and EAT assessment and aortic cine and phase-contrast imaging for strain and flow parameters quantification.</p><p><strong>Results: </strong>In this study, we found LV phenotype to be characterized by concentric remodeling with decreased stroke volume index despite global LV mass within a normal range. EAT was increased in T2D patients compared to controls (p<0.0001). Moreover, EAT, a biomarker of metabolic severity, was negatively correlated to ascending aortic (AA) distensibility (p=0.048) and positively to the normalized backward flow volume (p=0.001). These relationships remained significant after further adjustment for age, sex and central mean blood pressure. In a multivariate model, presence/absence of T2D and AA normalized backward flow (BF) to forward flow (FF) volumes ratio are both significant and independent correlates of EAT.</p><p><strong>Conclusion: </strong>In our study, aortic stiffness as depicted by an increased backward flow volume and decreased distensibility seems to be related to EAT volume in T2D patients. This observation should be confirmed in the future on a larger population while considering additional biomarkers specific to inflammation and using a longitudinal prospective study design.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10250660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9619022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eleonora Panfili, Giulio Frontino, Maria Teresa Pallotta
{"title":"GLP-1 receptor agonists as promising disease-modifying agents in WFS1 spectrum disorder.","authors":"Eleonora Panfili, Giulio Frontino, Maria Teresa Pallotta","doi":"10.3389/fcdhc.2023.1171091","DOIUrl":"https://doi.org/10.3389/fcdhc.2023.1171091","url":null,"abstract":"<p><p>WFS1 spectrum disorder (WFS1-SD) is a rare monogenic neurodegenerative disorder whose cardinal symptoms are childhood-onset diabetes mellitus, optic atrophy, deafness, diabetes insipidus, and neurological signs ranging from mild to severe. The prognosis is poor as most patients die prematurely with severe neurological disabilities such as bulbar dysfunction and organic brain syndrome. Mutation of the <i>WFS1</i> gene is recognized as the prime mover of the disease and responsible for a dysregulated ER stress signaling, which leads to neuron and pancreatic β-cell death. There is no currently cure and no treatment that definitively arrests the progression of the disease. GLP-1 receptor agonists appear to be an efficient way to reduce elevated ER stress <i>in vitro</i> and <i>in vivo</i>, and increasing findings suggest they could be effective in delaying the progression of WFS1-SD. Here, we summarize the characteristics of GLP-1 receptor agonists and preclinical and clinical data obtained by testing them in WFS1-SD as a feasible strategy for managing this disease.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10275359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9663706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kelly N B Palmer, Rebecca M Crocker, David G Marrero, Tze-Woei Tan
{"title":"A vicious cycle: employment challenges associated with diabetes foot ulcers in an economically marginalized Southwest US sample.","authors":"Kelly N B Palmer, Rebecca M Crocker, David G Marrero, Tze-Woei Tan","doi":"10.3389/fcdhc.2023.1027578","DOIUrl":"https://doi.org/10.3389/fcdhc.2023.1027578","url":null,"abstract":"<p><strong>Aim: </strong>To describe patients' reported employment challenges associated with diabetic foot ulcers (DFUs).</p><p><strong>Methods: </strong>Fifteen patients from under-resourced communities in Southern Arizona, with a history of DFUs and/or amputations, were recruited from a tertiary referral center from June 2020 to February 2021. Participants consented to an audio-recorded semi-structured phone interview. Interviews were transcribed and thematically analyzed using the Dedoose data analysis platform.</p><p><strong>Results: </strong>Participants shared a common theme around the cyclic challenges of DFU prevention/management and employment. Those employed in manual labor-intensive jobs or jobs requiring them to be on their feet for long durations of time believed working conditions contributed to the development of their DFUs. Patients reported work incapacity due to declines in mobility and the need to offload for DFU management. Many expressed frustration and emotional distress related to these challenges noting that DFUs resulted in lower remuneration as medical expenses increased. Consequently, loss of income and/or medical insurance often hindered participants' ability to manage DFUs and subsequent complications.</p><p><strong>Conclusion: </strong>These data illuminate the vicious cycle of DFU and employment challenges that must be addressed through patient-centered prevention strategies. Healthcare providers should consider a person's contextual factors such as employment type to tailor treatment approaches. Employers should establish inclusive policies that support patients with DFUs returning to work through flexible working hours and adapted work tasks as needed. Policymakers can also mitigate employment challenges by implementing social programs that provide resources for employees who are unable to return to work in their former capacity.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10140327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9393389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Metabolic syndrome in patients with type 2 diabetes mellitus at Adama Hospital Medical College, Ethiopia: a hospital-based cross-sectional study.","authors":"Tesfaye Getachew Charkos, Menberu Getnet","doi":"10.3389/fcdhc.2023.1165015","DOIUrl":"https://doi.org/10.3389/fcdhc.2023.1165015","url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome is one of the most serious global public health problems. It is associated with a higher risk of heart attack and other cardiovascular diseases. However, the magnitude of metabolic syndrome among patients with type 2 diabetes mellitus is not well understood, especially in developing countries such as Ethiopia.</p><p><strong>Objective: </strong>To determine the magnitude of metabolic syndrome and associated factors among type 2 diabetes mellitus patients at Adama Hospital Medical College, Ethiopia, in 2022.</p><p><strong>Method: </strong>A facility-based cross-sectional study was conducted from September 1 to October 30, 2022. The data was collected through a self-administered questionnaire. A systematic random sampling method was used to select the participants. Data were entered using Epi Info version 7.2 and analyzed by SPSS version 23. Multivariable logistic regression was used to model this study. Statistical significance was set at p-values of < 0.05.</p><p><strong>Result: </strong>A total of 237 participants were included in this study, with a response rate of 95.1%. Overall, the magnitude of metabolic syndrome was 53.2% (95% CI: 46.8 - 59.6), 41.3% (95% CI: 35.0 - 47.5), and 41.8% (95% CI: 35.5 - 48.1) based on 2009 harmonized criteria of MetS, Revised National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), and International Diabetes Federation (IDF) criteria, respectively. In multivariable logistic analysis, urban residence (AOR=3.07, 95% CI: 1.46-6.42), earning a high income (AOR=5.87 95% CI: 1.8-19.1), history of cardiac illness (AOR=3.33, 95% CI: 1.41-7.84), history of hypertension (AOR=2.65, 95% CI: 1.22-5.78), dyslipidemia (AOR=4.47, 95% CI: 1.96-10.19), current cigarette smoker (AOR=6.2, 95% CI: 1.7-22.93), sedentary activity (AOR=3.62, 95% CI: 1.68-7.82), use of palm oil (AOR=4.87, 95% CI: 2.06-11.51), and BMI ≥25 kg/m<sup>2</sup> (AOR=3.36, 95% CI: 1.57-7.16) were significantly associated with metabolic syndrome.</p><p><strong>Conclusion: </strong>The findings of this study suggested that the magnitude of metabolic syndrome among T2DM patients was high. We found consistent results using the NCEP-ATP III and IDF criteria. Similarly, urban residence, high income, history of cardiac, history of hypertension, dyslipidemia, current cigarette smoker, sedentary activity, palm oil, and BMI ≥25 kg/m<sup>2</sup> were significantly associated with metabolic syndrome.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10311433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9742906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Periodic health checkups reduce the risk of hospitalization in patients with type 2 diabetes.","authors":"Hidetaka Hamasaki, Hidekatsu Yanai","doi":"10.3389/fcdhc.2023.1087303","DOIUrl":"https://doi.org/10.3389/fcdhc.2023.1087303","url":null,"abstract":"<p><strong>Introduction: </strong>Periodic health checkups (PHCs) represent a unique system in Japan that is useful for the early detection of lifestyle-related diseases and cardiovascular diseases (CVDs). This study aims to investigate the association of PHCs with the hospitalization risk of patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>A retrospective cohort study was conducted from April 2013 to December 2015 and included participant information such as CVD history, lifestyle, and whether PHC was conducted in addition to regular medical examinations. Difference in clinical data between patients with and without PHC was examined. Furthermore, Cox regression analysis was performed to investigate the independent association of PHCs with hospitalization.</p><p><strong>Results: </strong>Herein, 1,256 patients were selected and followed up for 2.35 ± 0.73 years. In the PHC group, body mass index, waist circumference, proportion of patients with a history of CVD, and number of hospitalizations were lower than those in the non-PHC group. Furthermore, the PHC group exhibited a significant association with lower hospitalization risk (hazard ratio = 0.825; 95% confidence interval, 0.684 to 0.997; p = 0.046) in the Cox model.</p><p><strong>Conclusion: </strong>This study revealed that PHCs minimized the risk of hospitalization in patients with T2DM. Furthermore, we discussed the effectiveness of PHCs in enhancing health outcomes and reducing health care costs in such patients.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9589755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impact of diabetes mellitus on immunity to latent tuberculosis infection.","authors":"Nathella Pavan Kumar, Subash Babu","doi":"10.3389/fcdhc.2023.1095467","DOIUrl":"https://doi.org/10.3389/fcdhc.2023.1095467","url":null,"abstract":"<p><p>Tuberculosis (TB) is an infectious disease that poses a major health threat and is one of the leading causes of death worldwide. Following exposure to <i>Mycobacterium tuberculosis</i> (<i>M.tb</i>) bacilli, hosts who fail to clear <i>M.tb</i> end up in a state of latent tuberculosis infection (LTBI), in which the bacteria are contained but not eliminated. Type 2 diabetes mellitus (DM) is a noncommunicable disease that can weaken host immunity and lead to increased susceptibility to various infectious diseases. Despite numerous studies on the relationship between DM and active TB, data on the association between DM and LTBI remains limited. Immunological data suggest that LTBI in the presence of DM leads to an impaired production of protective cytokines and poly-functional T cell responses, accounting for a potential immunological mechanism that could leads to an increased risk of active TB. This review highlights the salient features of the immunological underpinnings influencing the interaction between TB and DM in humans.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9574145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Breanna McSweeney, Rachel B Campbell, Eshleen K Grewal, David J T Campbell
{"title":"Pharmacists' role in diabetes management for persons with lived experience of homelessness in Canada: A qualitative study.","authors":"Breanna McSweeney, Rachel B Campbell, Eshleen K Grewal, David J T Campbell","doi":"10.3389/fcdhc.2022.1087751","DOIUrl":"10.3389/fcdhc.2022.1087751","url":null,"abstract":"<p><strong>Introduction: </strong>Persons with lived experience of homelessness face many challenges in managing diabetes, including purchasing and storing medications, procuring healthy food and accessing healthcare services. Prior studies have found that pharmacy-led interventions for diabetes improved A1C, and lowered blood pressure and cholesterol in general populations. This study evaluated how select pharmacists in Canada have tailored their practices to serve persons with lived experiences of homelessness with diabetes.</p><p><strong>Methods: </strong>We conducted a qualitative descriptive study using open-ended interviews with inner-city pharmacists in select Canadian municipalities (Calgary, Edmonton, Vancouver, and Ottawa). We used NVivo qualitative data analysis software to facilitate thematic analysis of the data, focusing on how pharmacists contributed to diabetes care for persons with lived experience of homelessness.</p><p><strong>Results: </strong>These pharmacists developed diabetes programs after discovering an unmet need in the population. Pharmacists have the unique ability to see patients frequently, allowing tailored education and hands-on assistance with diabetes management. These pharmacists provided extra-ordinary care like financial and housing resources and many of them were uniquely embedded within other services for persons with lived experience of homelessness (i.e. housing and social work supports). Pharmacists reported struggling with balancing optimal medical care for individuals with the financial constraints of running a business.</p><p><strong>Conclusion: </strong>Pharmacists are vital members of the diabetes care team for persons with lived experience of homelessness. Government policies should support and encourage unique models of care provided by pharmacists to improve diabetes management for this population.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9219038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Making sense of glucose sensors in end-stage kidney disease: A review.","authors":"Mark E Williams, Devin Steenkamp, Howard Wolpert","doi":"10.3389/fcdhc.2022.1025328","DOIUrl":"10.3389/fcdhc.2022.1025328","url":null,"abstract":"<p><p>Diabetes mellitus remains the leading cause of end-stage kidney disease worldwide. Inadequate glucose monitoring has been identified as one of the gaps in care for hemodialysis patients with diabetes, and lack of reliable methods to assess glycemia has contributed to uncertainty regarding the benefit of glycemic control in these individuals. Hemoglobin A1c, the standard metric to evaluate glycemic control, is inaccurate in patients with kidney failure, and does not capture the full range of glucose values for patients with diabetes. Recent advances in continuous glucose monitoring have established this technology as the new gold standard for glucose management in diabetes. Glucose fluctuations are uniquely challenging in patients dependent on intermittent hemodialysis, and lead to clinically significant glycemic variability. This review evaluates continuous glucose monitoring technology, its validity in the setting of kidney failure, and interpretation of glucose monitoring results for the nephrologist. Continuous glucose monitoring targets for patients on dialysis have yet to be established. While continuous glucose monitoring provides a more complete picture of the glycemic profile than hemoglobin A1c and can mitigate high-risk hypoglycemia and hyperglycemia in the context of the hemodialysis procedure itself, whether the technology can improve clinical outcomes merits further investigation.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9226459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}