scholarly journals Dietary Management of Type 2 Diabetes in the MENA Region: A Review of the Evidence

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1060
Author(s):  
Nahla Hwalla ◽  
Zeinab Jaafar ◽  
Sally Sawaya
Keyword(s):  
Type 2 Diabetes ◽  
Eating Habits ◽  
Middle Eastern ◽  
Global Public Health ◽  
Food Groups ◽  
Dietary Interventions ◽  
Mena Region ◽  
Underlying Mechanisms ◽  
Traditional Mediterranean Diet

The alarmingly rising trend of type 2 diabetes constitutes a major global public health challenge particularly in the Middle Eastern and North African (MENA) region where the prevalence is among the highest in the world with a projection to increase by 96% by 2045. The economic boom in the MENA region over the past decades has brought exceptionally rapid shifts in eating habits characterized by divergence from the traditional Mediterranean diet towards a more westernized unhealthy dietary pattern, thought to be leading to the dramatic rises in obesity and non-communicable diseases. Research efforts have brought a greater understanding of the different pathways through which diet and obesity may affect diabetes clinical outcomes, emphasizing the crucial role of dietary interventions and weight loss in the prevention and management of diabetes. The purpose of this review is to explore the mechanistic pathways linking obesity with diabetes and to summarize the most recent evidence on the association of the intake of different macronutrients and food groups with the risk of type 2 diabetes. We also summarize the most recent evidence on the effectiveness of different macronutrient manipulations in the prevention and management of diabetes while highlighting the possible underlying mechanisms of action and latest evidence-based recommendations. We finally discuss the need to adequately integrate dietetic services in diabetes care specific to the MENA region and conclude with recommendations to improve dietetic care for diabetes in the region.

scholarly journals Mechanisms of Venoarteriolar Reflex in Type 2 Diabetes with or without Peripheral Neuropathy

Biology ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 333
Author(s):  
Cécile Reynès ◽  
Antonia Perez-Martin ◽  
Houda Ennaifer ◽  
Henrique Silva ◽  
Yannick Knapp ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Peripheral Neuropathy ◽  
Spectral Power ◽  
Blood Perfusion ◽  
Doppler Flowmetry ◽  
Relative Contribution ◽  
Total Spectral Power ◽  
Underlying Mechanisms ◽  
Endothelial Nitric Oxide

The aim of this study is to investigate the underlying mechanisms of the venoarteriolar reflex (VAR) in type 2 diabetes mellitus (T2DM), with and without peripheral neuropathy. Laser Doppler flowmetry (LDF) recordings were performed on the medial malleus and dorsal foot skin, before and during leg dependency in healthy controls, in persons with obesity, in those with T2DM, in those with T2DM and subclinical neuropathy, and in those with T2DM and confirmed neuropathy. LDF recordings were analyzed with the wavelet transform to evaluate the mechanisms controlling the flowmotion (i.e., endothelial nitric oxide-independent and -dependent, neurogenic, myogenic, respiratory and cardiac mechanisms). Skin blood perfusion decreased throughout leg dependency at both sites. The decrease was blunted in persons with confirmed neuropathy compared to those with T2DM alone and the controls. During leg dependency, total spectral power increased in all groups compared to rest. The relative contribution of the endothelial bands increased and of the myogenic band decreased, without differences between groups. Neurogenic contribution decreased in controls, in persons with obesity and in those with T2DM, whereas it increased in subclinical- and confirmed neuropathy. In conclusion, this study provides evidence that confirmed diabetic neuropathy alters the VAR through the neurogenic response to leg dependency.

scholarly journals The Role of Lifestyle, Eating Habits and Social Environment in the Prevention and Treatment of Type 2 Diabetes and Hypertension

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1460
Author(s):  
Kalliopi Karatzi ◽  
Yannis Manios
Keyword(s):  
Type 2 Diabetes ◽  
Social Environment ◽  
Eating Habits ◽  
Health Problems ◽  
Major Health ◽  
The Past ◽  
Prevention And Treatment

Type 2 diabetes (T2DM) and hypertension are major health problems, with an undisputed growth burden in the past decades [...]

scholarly journals Low-Carb and Ketogenic Diets in Type 1 and Type 2 Diabetes

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 962 ◽  
Author(s):  
Bolla ◽  
Caretto ◽  
Laurenzi ◽  
Scavini ◽  
Piemonti
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Dietary Interventions ◽  
Ketogenic Diets ◽  
Patients With Diabetes ◽  
Intrinsic Complexity ◽  
Few Data ◽  
Reducing Carbohydrates

Low-carb and ketogenic diets are popular among clinicians and patients, but the appropriateness of reducing carbohydrates intake in obese patients and in patients with diabetes is still debated. Studies in the literature are indeed controversial, possibly because these diets are generally poorly defined; this, together with the intrinsic complexity of dietary interventions, makes it difficult to compare results from different studies. Despite the evidence that reducing carbohydrates intake lowers body weight and, in patients with type 2 diabetes, improves glucose control, few data are available about sustainability, safety and efficacy in the long-term. In this review we explored the possible role of low-carb and ketogenic diets in the pathogenesis and management of type 2 diabetes and obesity. Furthermore, we also reviewed evidence of carbohydrates restriction in both pathogenesis of type 1 diabetes, through gut microbiota modification, and treatment of type 1 diabetes, addressing the legitimate concerns about the use of such diets in patients who are ketosis-prone and often have not completed their growth.

scholarly journals Sodium Intake and Incidence of Diabetes Complications in Elderly Patients with Type 2 Diabetes—Analysis of Data from the Japanese Elderly Diabetes Intervention Study (J-EDIT)

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 689
Author(s):  
Chika Horikawa ◽  
Rei Aida ◽  
Shiro Tanaka ◽  
Chiemi Kamada ◽  
Sachiko Tanaka ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Elderly Patients ◽  
Diabetes Complications ◽  
Vegetable Intake ◽  
Sodium Intake ◽  
Food Groups ◽  
High Sodium ◽  
Increased Risk

This study investigates the associations between sodium intake and diabetes complications in a nationwide cohort of elderly Japanese patients with type 2 diabetes aged 65–85. Data from 912 individuals regarding their dietary intake at baseline is analyzed and assessed by the Food Frequency Questionnaire based on food groups. Primary outcomes are times to diabetic retinopathy, overt nephropathy, cardiovascular disease (CVD), and all-cause mortality during six years. We find that mean sodium intake in quartiles ranges from 2.5 g to 5.9 g/day. After adjustment for confounders, no significant associations are observed between sodium intake quartiles and incidence of diabetes complications and mortality, except for a significant trend for an increased risk of diabetic retinopathy (p = 0.039). Among patients whose vegetable intake was less than the average of 268.7 g, hazard ratios (HRs) for diabetic retinopathy in patients in the second, third, and fourth quartiles of sodium intake compared with the first quartile were 0.87 (95% CI, 0.31–2.41), 2.61 (1.00–6.83), and 3.70 (1.37–10.02), respectively. Findings indicate that high sodium intake under conditions of low vegetable intake is associated with an elevated incidence of diabetic retinopathy in elderly patients with type 2 diabetes.

scholarly journals Pathology, Risk Factors, and Oxidative Damage Related to Type 2 Diabetes-Mediated Alzheimer’s Disease and the Rescuing Effects of the Potent Antioxidant Anthocyanin

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Muhammad Sohail Khan ◽  
Muhammad Ikram ◽  
Tae Ju Park ◽  
Myeong Ok Kim
Keyword(s):  
Alzheimer’S Disease ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Alzheimer's Disease ◽  
Inflammatory Cytokines ◽  
Amyloid Beta ◽  
Acid Oxidation ◽  
Chronic Hyperglycemia ◽  
Underlying Mechanisms

The pathology and neurodegeneration in type 2 diabetes- (T2D-) mediated Alzheimer’s disease (AD) have been reported in several studies. Despite the lack of information regarding the basic underlying mechanisms involved in the development of T2D-mediated AD, some common features of the two conditions have been reported, such as brain atrophy, reduced cerebral glucose metabolism, and insulin resistance. T2D phenotypes such as glucose dyshomeostasis, insulin resistance, impaired insulin signaling, and systemic inflammatory cytokines have been shown to be involved in the progression of AD pathology by increasing amyloid-beta accumulation, tau hyperphosphorylation, and overall neuroinflammation. Similarly, oxidative stress, mitochondrial dysfunction, and the generation of advanced glycation end products (AGEs) and their receptor (RAGE) as a result of chronic hyperglycemia may serve as critical links between diabetes and AD. The natural dietary polyflavonoid anthocyanin enhances insulin sensitivity, attenuates insulin resistance at the level of the target tissues, inhibits free fatty acid oxidation, and abrogates the release of peripheral inflammatory cytokines in obese (prediabetic) individuals, which are responsible for insulin resistance, systemic hyperglycemia, systemic inflammation, brain metabolism dyshomeostasis, amyloid-beta accumulation, and neuroinflammatory responses. In this review, we have shown that obesity may induce T2D-mediated AD and assessed the recent therapeutic advances, especially the use of anthocyanin, against T2D-mediated AD pathology. Taken together, the findings of current studies may help elucidate a new approach for the prevention and treatment of T2D-mediated AD by using the polyflavonoid anthocyanin.

Dietary fibers in the prevention of type 2 diabetes mellitus

2021 ◽  
pp. 97-114
Author(s):  
Ellen E. Blaak ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Dietary Fiber ◽  
Positive Impact ◽  
Metabolic Health ◽  
Dietary Fibers ◽  
Fermentative Capacity ◽  
Underlying Mechanisms

This chapter reviews how dietary fibers can be used to prevent Type 2 diabetes mellitus. Dietary fibers are a heterogenous group of food compounds. The physicochemical properties of dietary fibers determine their effects on gastrointestinal and metabolic health, including effect on gastro-intestinal transit, glycemic response, microbial composition and fermentative capacity. Most fiber rich foods contain insoluble, prebiotic and viscous fibers in varying ratios. The chapter begins by discussing underlying mechanisms of action of insoluble fibers. It then goes on to discuss the various dietary fiber intervention studies, specifically focusing on prebiotic fibers and soluble viscous fibers. The chapter concludes by highlighting the importance of consuming high levels dietary fiber and whole grains and their positive impact on metabolic health.

scholarly journals Sex differences in metabolic regulation and diabetes susceptibility

Diabetologia ◽  
2019 ◽  
Vol 63 (3) ◽  
pp. 453-461 ◽  
Author(s):  
Blandine Tramunt ◽  
Sarra Smati ◽  
Naia Grandgeorge ◽  
Françoise Lenfant ◽  
Jean-François Arnal ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Energy Balance ◽  
Pancreatic Beta Cells ◽  
Metabolic Regulation ◽  
Biological Sex ◽  
Type 2 Diabetes Prevention ◽  
Reproductive Life ◽  
Underlying Mechanisms ◽  
Almost All

AbstractGender and biological sex impact the pathogenesis of numerous diseases, including metabolic disorders such as diabetes. In most parts of the world, diabetes is more prevalent in men than in women, especially in middle-aged populations. In line with this, considering almost all animal models, males are more likely to develop obesity, insulin resistance and hyperglycaemia than females in response to nutritional challenges. As summarised in this review, it is now obvious that many aspects of energy balance and glucose metabolism are regulated differently in males and females and influence their predisposition to type 2 diabetes. During their reproductive life, women exhibit specificities in energy partitioning as compared with men, with carbohydrate and lipid utilisation as fuel sources that favour energy storage in subcutaneous adipose tissues and preserve them from visceral and ectopic fat accumulation. Insulin sensitivity is higher in women, who are also characterised by higher capacities for insulin secretion and incretin responses than men; although, these sex advantages all disappear when glucose tolerance deteriorates towards diabetes. Clinical and experimental observations evidence the protective actions of endogenous oestrogens, mainly through oestrogen receptor α activation in various tissues, including the brain, the liver, skeletal muscle, adipose tissue and pancreatic beta cells. However, beside sex steroids, underlying mechanisms need to be further investigated, especially the role of sex chromosomes, fetal/neonatal programming and epigenetic modifications. On the path to precision medicine, further deciphering sex-specific traits in energy balance and glucose homeostasis is indeed a priority topic to optimise individual approaches in type 2 diabetes prevention and treatment.

scholarly journals Mediterranean Diet Effects on Type 2 Diabetes Prevention, Disease Progression, and Related Mechanisms. A Review

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2236 ◽  
Author(s):  
Sandra Martín-Peláez ◽  
Montse Fito ◽  
Olga Castaner
Keyword(s):  
Type 2 Diabetes ◽  
Mediterranean Diet ◽  
Healthy Lifestyle ◽  
Diabetes Type 2 ◽  
Antioxidant Compounds ◽  
Published Evidence ◽  
Quality Diet ◽  
The Mediterranean ◽  
Traditional Mediterranean Diet

The search for a quality diet has grown over the past decade. Diet is considered one of the pillars for the prevention and progression of several diseases, among them: diabetes. Type 2 diabetes (T2D) is an epidemic of western countries that increases the vulnerability of other diseases, such as cardiovascular and cancer. T2D is associated with lifestyle and diet. The traditional Mediterranean diet has proven its benefits over several cardiovascular risk factors, and specifically on diabetes. This review compiles recent published evidence on the effects of the Mediterranean diet on the incidence and progression of type 2 diabetes (T2D) and its relation with several other cardiovascular healthy diets. We will also focus on how the Mediterranean diet could play a role in T2D-related mechanisms, such as anti-inflammatory or antioxidant compounds, glucagon-like peptide agonist compounds, and changes in gut microbiota. Each component of the Mediterranean diet could be involved in processes related to diabetes homeostasis, many of them sharing common physio-pathological pathways. The importance of this diet within the set of habits of a healthy lifestyle must be emphasized.

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