The Impact of Diet and Fibre Fractions on Plasma Adipocytokine Levels in Prediabetic Adults

The impact of diet and fibre fractions on adipocytokines in obese subjects with a risk of diabetes has not been investigated in detail yet. The purpose of the study is to evaluate the effects of a 12-month lifestyle intervention with different fibre profiles (resistant starch (RS)—rich fibre, or ordinary food fibre profiles) on adipocytokine levels. Fifty participants are divided into two groups (RS group and Fibre group). The groups differ only in the percentage of the recommended level of the RS consumed as a fraction of the same total fibre amount. The applied dietary intervention includes intake of 7531 KJ/daywith a total fibre portion of 25–35 g/dayfor both groups that includes 15 g/day of RS for the RS group only. The levels of leptin, adiponectin, apelin, resistin, tumor necrosis factor (TNF)-alpha and C-reactive protein (CRP) are measured, and their relationship to anthropometric and biochemical parameters is estimated. Along with significant body weight loss, only leptin is significantly reduced by 13% in the RS group while in the Fibre group, apelin levels are significant (−21%). Polynomial regression shows a negative correlation between RS intake and adiponectin (R2 = 0.145) and resistin level (R2 = 0.461) in the RS group. This study indicates the possibility that fibre fractions differently influence the outcome of lifestyle interventions, as well as their adipocytokine levels, in obese prediabetic adults.     

Diabetes and Prediabetes Inhibit Reversion from Mild Cognitive Impairment to Normal Cognition

ObjectivesDiabetes and prediabetes contribute to an increased risk of cognitive decline and dementia. Currently, it remains unclear whether elevated blood HbA1c levels, including prediabetes levels, affect reversion from mild cognitive impairment (MCI) to normal cognition. This study, therefore, aimed to examine the prospective associations of diabetes and prediabetes with reversion from MCI to normal cognition among community-dwelling older adults.DesignLongitudinal cohort study with a 4-year follow-up.Setting and ParticipantsCommunity-dwelling older adults with MCI, aged ≥65 years at baseline (n = 787).MethodsParticipants’ medical history of diabetes and blood HbA1c levels at baseline were assessed, and they were classified as control, prediabetes, and diabetes. Objective cognitive screening was performed using a multicomponent neurocognitive test at baseline and follow-up. Reversion from MCI to normal cognition over 4 years was determined. In the longitudinal analysis, we performed multiple imputations to adjust for a selection bias and loss of information.ResultsThe reversion rates of MCI in the control, prediabetes, and diabetes groups were 63.4%, 55.6%, and 42.9%, respectively, in the completed follow-up dataset, and 54.6%, 47.2%, and 34.1%, respectively, in the imputed dataset. Multivariate logistic regression showed that diabetes decreases the probability of MCI reversion both before and after multiple imputations [odds ratio (OR) 0.37; 95% confidence interval (CI) 0.18–0.74 for before imputation, OR 0.37; 95% CI 0.19–0.72 for after imputation]. Furthermore, prediabetes also showed significantly decreased probabilities of MCI reversion both before and after multiple imputations (OR 0.57; 95% CI 0.34–0.94 for before imputation, OR 0.60; 95% CI 0.37–0.97 for after imputation).Conclusions and ImplicationsDiabetes and prediabetes could inhibit MCI reversion. Adequate glycemic control may be effective in enhancing the reversion from MCI to normal cognition in a community setting.     

Comparison of lifestyle behaviors and related factors between Asian American and white adults with prediabetes

This study compares lifestyle behaviors and related factors between Asian American and white adults with self‐reported prediabetes and identifies covariates/predictors for regular physical activity and adequate intake of fruits/vegetables. Using data from the United States of America Behavioral Risk Factor Surveillance System, 302 Asian Americans and 9558 white adults were analyzed. There were no significant differences for participating in regular physical activity or consumption of adequate fruits/vegetables between the two groups. Overall, 40% of the respondents engaged in regular physical activity, whereas less than 25% reported an adequate intake of fruits/vegetables. In the adjusted models, compared to white, Asian Americans were less likely to have impaired physical (OR = 0.54, 95% CI: 0.36 0.80) or mental health (OR = 0.36, 95% CI: 0.21, 0.61), or cardiovascular diseases (OR = 0.59, 95% CI: 0.41, 0.87). The covariates/predictors that relate to the behaviors differed between the groups. We conclude that interventions to increase physical activity and healthy eating for Asian American and white adults with prediabetes should address the different covariates/predictors for each group.     

Racquetball Injuries

It doesn't take a lot of skill to play racquetball and benefit from the excellent exercise it provides. Most of the injuries can be prevented if safety precautions are observed.     

The response to intravenous glucose infusion in normal and diabetic subjects

Summary Data from single injection studies on 23 normal subjects led to development of an intravenous primed — constant infusion test. The plasma glucose response to this test was determined in 48 normal and 24 diabetic subjects. Variation in plasma glucose concentration at equilibrium was minimal in normal and marked in diabetic subjects — assessed by the difference between maximum and minimum glucose concentration over the final 25 min of a 50 min infusion. This parameter was used successfully in predicting the course of 16 pregnant women with clinical suspicion of prediabetes unresolved by oral glucose tolerance tests.Submitted as part fulfillment of the requirements for Doctor of Medicine, Monash University, Melbourne, 1967.     

Elevated serum levels of macrophage-derived cytokines precede and accompany the onset of IDDM

Summary To determine whether cytokines could have a role in the development of insulin-dependent diabetes mellitus (IDDM), we measured serum levels of cytokines derived from T helper 1 (interleukin-2 and interferon-), T helper 2 (interleukin-4 and inter-leukin-10) lymphocytes and macrophages (tumour necrosis factor-, interleukin-1 and interleukin-1 ) in patients before and after the onset of IDDM. Recently diagnosed IDDM patients had significantly higher levels of interleukin-2, interferon-, tumour necrosis factor- and interleukin-1 than patients with either long-standing IDDM, non-insulin-dependent diabetes (NIDDM), Graves' disease, or control subjects (p<0.05 for all). Compared with control subjects, patients with long-standing IDDM and those with NIDDM had higher interleukin-2 and tumour necrosis factor- levels (p<0.01 for all). Interleukin-4 and interleukin-10 were detectable in sera of patients with Graves' disease only, while interleukin-1 was not detectable in the serum of any control or test subject. To investigate whether high cytokine levels precede the onset of IDDM, we studied 28 non-diabetic identical co-twins of patients with IDDM, followed-up prospectively for up to 6 years after the diagnosis of the index. Levels of tumour necrosis factor- and interleukin-1 were elevated above the normal range more frequently in the eight twins who developed diabetes than in those 20 who did not (p<0.005). Analysis of T helper 1 and T helper 2 profiles of the twin groups did not reveal a clear difference between prediabetic twins and twins remaining non-diabetic. These results support the notion that T helper 1 lymphocytes may play a role in the development of IDDM. This is associated with release of macrophage-derived cytokines, which is also a feature of the prediabetic period. The lack of evidence of a dominant T helper 1 profile of cytokine release before diabetes onset suggests that additional events, activating this arm of the cellular immune response, are required in the immediate prediabetic period.Abbreviations IL Interleukin - IFN- interferon-gamma - T_H T helper - ICA islet-cell antibody - GAD glutamic acid decar-boxylase - IDDM insulin-dependent diabetes mellitus - NIDDM non-insulin-dependent diabetes mellitus - TNF- tumour necrosis factor-alpha - CTLL-16 murine cytotoxic cell line     

Impaired compensatory beta‐cell function and growth in response to high‐fat diet in LDL receptor knockout mice

In this study, we investigated the effect of low density lipoprotein receptor (LDLr) deficiency on gap junctional connexin 36 (Cx36) islet content and on the functional and growth response of pancreatic beta-cells in C57BL/6 mice fed a high-fat (HF) diet. After 60 days on regular or HF diet, the metabolic state and morphometric islet parameters of wild-type (WT) and LDLr−/− mice were assessed. HF diet-fed WT animals became obese and hypercholesterolaemic as well as hyperglycaemic, hyperinsulinaemic, glucose intolerant and insulin resistant, characterizing them as prediabetic. Also they showed a significant decrease in beta-cell secretory response to glucose. Overall, LDLr−/− mice displayed greater susceptibility to HF diet as judged by their marked cholesterolaemia, intolerance to glucose and pronounced decrease in glucose-stimulated insulin secretion. HF diet induced similarly in WT and LDLr−/− mice, a significant decrease in Cx36 beta-cell content as revealed by immunoblotting. Prediabetic WT mice displayed marked increase in beta-cell mass mainly due to beta-cell hypertrophy/replication. Nevertheless, HF diet-fed LDLr−/− mice showed no significant changes in beta-cell mass, but lower islet–duct association (neogenesis) and higher beta-cell apoptosis index were seen as compared to controls. The higher metabolic susceptibility to HF diet of LDLr−/− mice may be explained by a deficiency in insulin secretory response to glucose associated with lack of compensatory beta-cell expansion.     

Differences in Glycemic Variability Between Normoglycemic and Prediabetic Subjects

So far the criteria for NGT and abnormal glucose tolerance (AGT) are based on HbA1c and 75 g oGTT. We present data on GV and diurnal profiles in stratified cohorts with AGT versus controls. 28 NGT, 42 AGT (15 IGT, 11 IFG, 16 CGI) matched for age and BMI classified by 75 g oGTT underwent a CGM with test meal (TM). Diurnal profiles, glucose excursion after TM, and GV (SD, MAGE) were calculated for day 2 and 3. HbA1c, with its values of 5.5 ± 0.37% versus 5.65 ± 0.36%, was within normal range. Average interstitial glucose (AiG) was 5.84 ± 0.52 mmol/l) in NGT and 6.35 ± 0.65 mmol/l in AGT (P = .002). The 2 h incremental area under curve (iAUC) from TM until 2 h after TM was 1.94 ± 1.31 mmol/l*h versus 2.89 ( ± 1.75) mmol/l*h (P = .012), AiG 2 hours after TM was 5.99 ± 1.14 mmol/l*d versus 6.64 ± 1.30 mmol/l (P = .035). Peaks of AiG after TM were 7.69 ± 1.48 mmol/l*d versus 9.18 ± 1.67 mmol/l*d (P = .001). SD was significantly higher for AGT (1.12 ± 0.37 vs. 0.85 ± 0.32 mmol/l, P = .01) and MAGE 2.26 ± 0.84 vs. 1.60 ± 0.69 mmol/l, P = .005). In this comparative analysis NGT and AGT well matched for age, BMI, and comorbidities, CGM revealed significant differences in daytime AiG, pp glucose excursion and postprandial peaks. SD and MAGE was significantly higher for subjects with AGT. I Impaired glucose homeostasis a better characterizes degree of AGTe than HbA1c and 75 g OGTT.