Jennifer M Kolb, Nicole R Kitos, Ambili Ramachandran, Jenny J Lin, Devin M Mann
{"title":"What do primary care prediabetes patients need? A baseline assessment of patients engaging in a technology-enhanced lifestyle intervention.","authors":"Jennifer M Kolb, Nicole R Kitos, Ambili Ramachandran, Jenny J Lin, Devin M Mann","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed the baseline knowledge, perceptions, attitudes and behaviors of prediabetes patients in order to tailor a new technology-enhanced primary care-based lifestyle modification intervention.</p><p><strong>Methods: </strong>Patients with a diagnosis of prediabetes were enrolled in a randomized, controlled pilot study, Avoiding Diabetes Thru Action Plan Targeting (ADAPT), a technology-based intervention to promote action plan discussions around patient-selected behavior change goals.</p><p><strong>Results: </strong>A total of 54 adults (82% female) were enrolled in the pilot study. Most (89%) had comorbid conditions and mean BMI was 36. Participants exhibited high risk of diabetes knowledge (knowledge score 20 on a 32 point scale) and high levels of willingness to make changes to decrease diabetes risk. Number of daily steps was inversely correlated with perceived physical activity (r=-0.35082, p<0.001). Poorer scores on diet quality were inversely correlated with BMI.</p><p><strong>Conclusion: </strong>Participants in this sample demonstrated requisite levels of knowledge, self-efficacy, motivation and risk perception for effective behavior change. These data suggest that primary care-based prediabetes interventions can move beyond educational goals and focus on enhancing patients' ability to select, plan and enact action plans.</p>","PeriodicalId":90577,"journal":{"name":"Journal of bioinformatics and diabetes","volume":"1 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2014-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291122/pdf/nihms648960.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32978921","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":"Kynurenines and vitamin B6: link between diabetes and depression.","authors":"Gregory Oxenkrug, Rebecca Ratner, Paul Summergrad","doi":"10.14302/issn.2374-9431.jbd-13-218","DOIUrl":"10.14302/issn.2374-9431.jbd-13-218","url":null,"abstract":"<p><p>The increased association between depression and diabetes mellitus is generally acknowledged. Recent studies suggest that depression leads to diabetes. However, the underlying molecular mechanisms for this association remain unclear. Literature and our data indicate that inflammatory and/or stress factors in depression up-regulate tryptophan (TRP) conversion into kynurenine (KYN), a substrate for nicotinamide adenine dinucleotide (NAD) biosynthesis. Deficiency of vitamin B6, a cofactor of the key enzymes of KYN - NAD pathway, shunts KYN metabolism from formation of NAD towards production of xanthurenic (XA) and kynurenic (KYNA) acids. Human and experimental studies reveal that XA, KYNA and their metabolites interfere with production, release and biological activity of insulin. We propose that inflammation- and/or stress-induced up-regulation of TRP - KYN metabolism in combination with vitamin B6 deficiency is one of the mechanisms mediating increased risk of diabetes in depression. Consequently, monitoring formation of diabetogenic KYN derivatives might help to identify subjects-at-risk for the development of diabetes. Pharmacological down-regulation of the TRP - KYN - NAD pathway and maintenance of adequate vitamin B6 status might help to prevent the development of diabetes in depression and other conditions associated with inflammation/stress- induced excessive production of KYN and vitamin B6 deficiency, e.g., obesity, cardiovascular diseases, aging, menopause, pregnancy, and hepatitis C virus infection.</p>","PeriodicalId":90577,"journal":{"name":"Journal of bioinformatics and diabetes","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4229017/pdf/nihms-510773.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32818117","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}