Differences in early‐phase insulin secretion and glucose disposition index between aged and middle‐aged patients with newly diagnosed type 2 diabetes

2020 ◽  
Vol 20 (3) ◽  
pp. 206-211
Author(s):  
Yun Yu ◽  
Fenghui Pan ◽  
Wenxia Cui ◽  
Wei Tang ◽  
Yun Hu
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Secretion ◽  
Early Phase ◽  
Disposition Index ◽  
Newly Diagnosed ◽  
Middle Aged ◽  
Aged Patients

scholarly journals P979 Subclinical left ventricular dysfunction and silent myocardial ischemia in asymptomatic middle-aged patients with type 2 diabetes mellitus

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Kisko ◽  
J Lesko ◽  
L Dernarova ◽  
N Kishko
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Male Gender ◽  
Silent Myocardial Ischemia ◽  
Middle Aged ◽  
Aged Patients

Abstract Early detection of silent myocardial ischemia (SMI) in asymptomatic middle-aged patients (pts) with type 2 diabetes mellitus (T2DM) may be important due to the generally poor prognosis and early myocardial involvement in this specific subgroup of diabetic population. Our goal was to evaluate whether subclinical left ventricular (LV) systolic dysfunction assessed by two-dimensional speckle-tracking echocardiography (2D-STE) is independently related to SMI detected by MPI (gated SPECT myocardial scintigraphy) and if it could provide incremental information over baseline characteristics to identify it. We have tested the hypothesis that the myocardial mechanics significantly differ in asymptomatic middle-aged diabetics, depending on the presence or absence of SMI. In total, 60 consecutive middle-aged (<60 years; 42 males, 70.0%) asymptomatic T2DM pts were enrolled into the study. MPI was performed in one-day protocol according to the EANM procedural guidelines, and SMI was diagnosed consensually by two experts as myocardial perfusion abnormalities without associated symptoms. The T2DM pts were subdivided into two groups according to the results of MPI, namely SMI group (n = 11) and non-SMI group (n= 49) Global longitudinal peak systolic strain (GLPSS) was measured from two- and four-chamber views cines using Automated Function Imaging (Vivid S6, GE). Subclinical LV dysfunction was defined as GLPSS of > -20%. Prevalence of SMI in T2DM pts was 18,3%. All pts in SMI group (n = 11) were of male gender, and disease duration ≥ 5 years. Pooled data from 2D-STE showed significant reduction in mean absolute GLPSS values (p<.001). Further more, pts in SMI group had more impaired GLPSS when compared with patients in non-SMI group (-16.1 ± 1.5% vs. -20.4 ± 1.8%, P < .01). At multivariate analysis, male gender, an amount of epicardial adipose tissue and erectile dysfunction in men were independently associated with SMI. The addition of the LV GLPSS values to other selected independent clinical variables significantly improved the ability to predict SMI in these patients (χ(2) = 48.62; P = .001). Asymptomatic middle-aged T2DM pts with SMI showed a more impaired LV GLPSS compared with patients without silent ischemia. The presence of subclinical LV systolic dysfunction provides significant incremental value for the identification of SMI in asymptomatic middle-aged diabetics.

scholarly journals Risk of hypertension in middle-aged and elderly participants with newly diagnosed type 2 diabetes and prediabetes

2020 ◽  
Vol 8 (1) ◽  
pp. e001500
Author(s):  
Nobuo Sasaki ◽  
Ryoji Ozono ◽  
Ryo Maeda ◽  
Yukihito Higashi
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Tolerance ◽  
Fasting Glucose ◽  
Early Stage ◽  
Normal Glucose Tolerance ◽  
Oral Glucose ◽  
Newly Diagnosed ◽  
Middle Aged ◽  
Early Stages

IntroductionLittle is known about the risk of hypertension in patients with the early stage of type 2 diabetes. We investigated the risk of hypertension in participants with newly diagnosed type 2 diabetes and prediabetes.Research design and methodsThis is a retrospective cohort study consisting of 2136 middle-aged participants (1022 with normal fasting glucose/normal glucose tolerance (NFG/NGT), 418 with impaired fasting glucose (IFG), 466 with impaired glucose tolerance (IGT) and 230 with diabetes) and 3426 elderly participants (1762 with NFG/NGT, 599 with IFG, 781 with IGT, and 284 with diabetes). All participants underwent 75 g oral glucose tolerance tests at baseline.ResultsOver a median 59-month follow-up period, 459 middle-aged and 1170 elderly participants developed hypertension. In middle-aged participants, the odds of incident hypertension were significantly higher in those with IFG (OR 1.40; p=0.019), IGT (OR 1.49; p=0.004), and diabetes (OR 1.55; p=0.013) than those with NFG/NGT, which was no longer significant after adjustment for body mass index. Subgroup analysis showed that the risk of hypertension was significantly higher in diabetes than NFG/NGT only in participants without obesity. Conversely, obesity was a risk factor of hypertension only in those with IFG and NFG/NGT. In elderly participants, there was no difference in the risk of hypertension among the NFG/NGT, IFG, IGT and diabetes groups.ConclusionsThe risk of hypertension is modest in participants with newly diagnosed type 2 diabetes and prediabetes. Our findings suggest that the early stages of type 2 diabetes and prediabetes may be a key period for reducing hypertension, given the pronounced risk of hypertension in patients with diabetes reported in previous studies. In terms of reducing the risk for hypertension, obesity treatment might be advantageous in the early stages rather than the advanced stages of impaired glucose metabolism.

scholarly journals Association of dietary fiber intake with newly-diagnosed type 2 diabetes mellitus in middle-aged Chinese population

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Fubi Jin ◽  
Jinghong Zhang ◽  
Long Shu ◽  
Wei Han
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Dietary Fiber ◽  
Chinese Population ◽  
Newly Diagnosed ◽  
Fiber Intake ◽  
Middle Aged ◽  
Dietary Fiber Intake

Abstract Background Epidemiological evidence concerning dietary fiber on newly-diagnosed type 2 diabetes mellitus (T2DM) is sparse. Therefore, the purpose of this study was to investigate the relationship between dietary fiber intake and newly-diagnosed T2DM in a middle-aged Chinese population. Methods Using data from the Hangzhou Nutrition and Health Survey collected between June 2015 and December 2016, we investigated the associations between dietary patterns and the risk of chronic non- communicable diseases. Anthropometric measurements and samples collection for biochemical assays are conducted by the well-trained staff and nurse, respectively. Multivariable logistic regression analysis was used to analyze the effect of dietary fiber intake on the risk of newly-diagnosed T2DM in crude and adjusted models. Results Among 3250 participants, 182 (5.6%) people were identified as newly-diagnosed T2DM. Pearson correlation coefficients revealed a significant inverse association of total dietary fiber with BMI, SBP, DBP, HbA1c and LDL-C in all participants, participants with and without T2DM (P < 0.05). Compared with the study participants in the first quartile (Q1, the lowest consumption)of dietary fiber intake, participants in the fourth quartile (Q4) had a lower prevalence of newly-diagnosed T2DM(OR = 0.70; 95%CI:0.49-1.00; P < 0.05), after adjustment for potential confounders. Conclusions In this middle-aged Chinese population, higher intake of dietary fiber was significantly associated with lower risk of newly-diagnosed T2DM. However, our findings need to be confirmed in future large-scale prospective studies.

scholarly journals Relationship Between Insulin Secretion and Insulin Sensitivity and its Role in Development of Type 2 Diabetes Mellitus: Beyond the Disposition Index

2021 ◽  
Author(s):  
Elsa Vazquez Arreola ◽  
Robert L. Hanson ◽  
Clifton Bogardus ◽  
William C. Knowler
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Secretion ◽  
Insulin Sensitivity ◽  
Allostatic Load ◽  
Regression Line ◽  
Epidemiologic Study ◽  
Disposition Index ◽  
Lower Sensitivity ◽  
The Relationship

We assessed whether the relationship between insulin secretion and sensitivity predicted development of type 2 diabetes in American Indians participating in a longitudinal epidemiologic study. At baseline, when all subjects did not have diabetes, 1566 participants underwent oral tests and 420 had intravenous measures of glucose regulation with estimates of insulin secretion and sensitivity. Standardized major axis regression was used to study the relationship of secretion and sensitivity. Distances away from and along the regression line estimated compensatory insulin secretion and secretory demand, respectively. This relationship differed according to glucose tolerance and BMI categories. The distance away from the line is similar to the disposition index (DI) defined as the product of estimated secretion and sensitivity, but the regression line may differ from a line with constant DI (i.e., it is not necessarily hyperbolic). Subjects with the same DI but different levels of insulin secretion and sensitivity had different incidence rates of diabetes; lower sensitivity with higher secretory demand was associated with greater diabetes risk. Insulin secretion and insulin sensitivity, analyzed together, predict diabetes better than DI alone. Physiologically, this may reflect long-term risk associated with increased allostatic load resulting from the stimulation of insulin hypersecretion by increased glycemia.

scholarly journals Relationship Between Insulin Secretion and Insulin Sensitivity and its Role in Development of Type 2 Diabetes Mellitus: Beyond the Disposition Index

2021 ◽  
Author(s):  
Elsa Vazquez Arreola ◽  
Robert L. Hanson ◽  
Clifton Bogardus ◽  
William C. Knowler
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Secretion ◽  
Insulin Sensitivity ◽  
Allostatic Load ◽  
Regression Line ◽  
Epidemiologic Study ◽  
Disposition Index ◽  
Lower Sensitivity ◽  
The Relationship

We assessed whether the relationship between insulin secretion and sensitivity predicted development of type 2 diabetes in American Indians participating in a longitudinal epidemiologic study. At baseline, when all subjects did not have diabetes, 1566 participants underwent oral tests and 420 had intravenous measures of glucose regulation with estimates of insulin secretion and sensitivity. Standardized major axis regression was used to study the relationship of secretion and sensitivity. Distances away from and along the regression line estimated compensatory insulin secretion and secretory demand, respectively. This relationship differed according to glucose tolerance and BMI categories. The distance away from the line is similar to the disposition index (DI) defined as the product of estimated secretion and sensitivity, but the regression line may differ from a line with constant DI (i.e., it is not necessarily hyperbolic). Subjects with the same DI but different levels of insulin secretion and sensitivity had different incidence rates of diabetes; lower sensitivity with higher secretory demand was associated with greater diabetes risk. Insulin secretion and insulin sensitivity, analyzed together, predict diabetes better than DI alone. Physiologically, this may reflect long-term risk associated with increased allostatic load resulting from the stimulation of insulin hypersecretion by increased glycemia.

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