-
1.
Macular thinning in prediabetes or type 2 diabetes without diabetic retinopathy: the Maastricht Study.
De Clerck, EEB, Schouten, JSAG, Berendschot, TTJM, Goezinne, F, Dagnelie, PC, Schaper, NC, Schram, MT, Stehouwer, CDA, Webers, CAB
Acta ophthalmologica. 2018;(2):174-182
-
-
Free full text
-
Abstract
PURPOSE To assess macular thinning in individuals with prediabetes or type 2 diabetes without diabetic retinopathy (DM2 w/o DR) compared with individuals with normal glucose metabolism (NGM). METHODS Using spectral domain optical coherence tomography (SD-OCT), we measured macular thickness in six subfields as defined by the Early Treatment Diabetic Retinopathy Study (ETDRS) in 1838 participants from The Maastricht Study, a population-based cohort study (mean age 59 ± 8 years, 49% men, 1087 NGM, 279 prediabetes, 472 DM2 w/o DR). Multivariable linear regression was used to assess the association between macular thickness and glucose metabolism status. RESULTS After adjustment for age, sex and spherical equivalent, individuals with prediabetes showed a significant decrease in pericentral superior macular thickness [β = -2.14 μm (95% confidence interval (CI): -4.24 to -0.03), p < 0.05] compared with individuals with NGM. In individuals with DM2 w/o DR, the fovea [β = -4.05 μm (95% CI: -6.30 to -1.79), p < 0.001] and the four pericentral quadrants (range: β = -4.64 to -5.29 μm, p < 0.001) were significantly thinner compared with individuals with NGM. There was a significant linear trend of macular thinning with severity of glucose metabolism status in five subfields (p < 0.001). CONCLUSION Macular thickness is reduced in prediabetes and a greater reduction occurs in DM2, even before DR is clinically present. About half of the thinning observed in DM2 w/o DR was already found in prediabetes. Generalized thinning of the macula could be related to thinning of the temporal side of the optic nerve head through the connecting papillo-macular bundle.
-
2.
Use of an online personal health record's Track Health function to promote positive lifestyle behaviors in Veterans with prediabetes.
Sharit, J, Idrees, T, Andrade, AD, Anam, R, Karanam, C, Valencia, W, Florez, H, Ruiz, JG
Journal of health psychology. 2018;(5):681-690
Abstract
This pilot 3-month clinical trial investigated the feasibility, effectiveness, and acceptability of using the Track Health function of the Veterans Health Administration's personal health record for eliciting a more positive physical activity and dietary intake lifestyle in a sample of 38 overweight and obese Veterans with prediabetes. Comparisons between baseline and 3 months post-intervention indicated significant improvements in weight, physical activity, abdominal circumference, and blood pressure. Use of a personal health record that users can identify with and find usable and useful coupled with instruction targeting critical functionalities could potentially promote healthy behavioral lifestyle changes.
-
3.
Osteogenic impact of football training in 55- to 70-year-old women and men with prediabetes.
Skoradal, MB, Helge, EW, Jørgensen, NR, Mortensen, J, Weihe, P, Krustrup, P, Mohr, M
Scandinavian journal of medicine & science in sports. 2018;:52-60
Abstract
The effects of football training on bone health were examined in 55- to 70-year-old sedentary women and men with prediabetes. Patients (n = 50) with prediabetes (age; 61 ± 9 years, BMI 29.7 ± 0.6 kg/m2 , body fat content; 37 ± 1%, VO2max ; 22.7 ± 0.8 mL/min/kg and mean arterial pressure; 104 ± 3 mm Hg) were randomized into a football training group (FTG; n = 27, 14 women) and a control group (CON; n = 23, 11 women). At baseline, 73% and 24% were diagnosed with femur osteopenia and osteoporosis, respectively. FTG performed football training twice weekly 30-60-minute sessions in 16 weeks, and both FTG and CON received professional dietary advice. Pre- and post-intervention whole-body and regional bone mineral content (BMC) and density (BMD) were determined with DXA-scans, and venous blood samples were drawn and analyzed for plasma bone turnover markers. Change scores were greater (P < 0.05) in FTG compared to CON in leg BMD (0.023 ± 0.005 vs -0.004 ± 0.001 g/cm2 ) and in leg BMC (32 ± 8 vs -4 ± 6 g). Between-group changes in favor of FTG (P < 0.05) also occurred in the femur neck BMD (3.2%) and femur shaft BMD (2.5%). Whole-body BMC and BMD were unchanged in both groups during the intervention. In FTG, resting plasma osteocalcin, P1NP, and CTX-1 rose (P < 0.05) by 23 ± 8, 52 ± 9 and 38 ± 7%, with greater change scores (P < 0.05) than in CON. Finally, P1NP (formation)/CTX-1 (resorption) ratio increased (P < 0.05) in FTG (127 ± 15 vs 150 ± 11) from pre- to post-intervention, with no change in CON (124 ± 12 and 123 ± 12). In conclusion, football training provides a powerful osteogenic stimulus and improves bone health in 55- to 70-year-old women and men diagnosed with prediabetes.
-
4.
Effect of Coenzyme Q10 on Insulin Resistance in Korean Patients with Prediabetes: A Pilot Single-Center, Randomized, Double-Blind, Placebo-Controlled Study.
Yoo, JY, Yum, KS
BioMed research international. 2018;:1613247
Abstract
INTRODUCTION This study aimed to examine whether administration of coenzyme Q10, an antioxidant, improves insulin resistance in patients with prediabetes. The study design was a pilot single-center, randomized, double-blind, placebo-controlled trial. METHODS This pilot single-center, randomized, double-blind, placebo-controlled trial included a total of 80 adults (aged ≥20 years) with impaired glucose tolerance. After the initial screening visit, subjects were assigned to either the experimental (n = 40) or placebo (n = 40) group via simple randomization. Insulin resistance was represented as the insulin resistance index estimated by homeostasis model assessment (HOMA-IR). RESULTS After the 8-week treatment period, the coenzyme group exhibited a significant decrease in the HOMA-IR (P < .001). The free oxygen radical and coenzyme Q10 concentrations were found to correlate significantly (P < .001). However, no significant changes in fasting blood glucose, insulin, and glycated hemoglobin levels were observed in either group. Additionally, no adverse events occurred in either group. CONCLUSION Patients with prediabetes who were administered coenzyme Q10 showed a significant reduction in HOMA-IR values. Therefore, administration of coenzyme Q10 in patients with impaired glucose tolerance may slow the progression from prediabetes to overt diabetes.
-
5.
Cultural adaptation of an evidence-based lifestyle intervention for diabetes prevention in Chinese women at risk for diabetes: results of a randomized trial.
Yin, Z, Perry, J, Duan, X, He, M, Johnson, R, Feng, Y, Strand, M
International health. 2018;(5):391-400
Abstract
BACKGROUND The prevalence of both obesity and type 2 diabetes has been on the rise in China. This randomized controlled trial was conducted to test the feasibility and effectiveness of an evidence-based diabetes prevention program in Yuci, Shanxi Province, China from 2012 to 2014. METHODS Women with pre-diabetes, ages 25-65 y, were assigned randomly to a comparison (n=75) or 6-mo lifestyle intervention condition (n=109). Weight, fasting glucose, hemoglobin A1c and self-reported diet and physical activity were measured at baseline, 6 mo and 12 mo. RESULTS All measures except fasting glucose improved favorably in both comparison and intervention participants at the 6- and 12-mo follow-ups. Participants in the intervention group lost more weight (-0.91 kg, p<0.05) and had a lower body mass index (-0.39 kg/m2, p<0.05) than the comparison group at follow-up. A total of 31.6% (31/98) and 16.2% (11/68) of the participants in the intervention and comparison groups, respectively, achieved the weight loss goal of 5% at follow-up. There was no significant group difference in outcome measures at the 12-mo follow-up. Participants in the intervention group also showed favorable changes in self-reported diet and physical activity measures. CONCLUSIONS A lifestyle intervention to prevent diabetes in at-risk women in community health centers in China is feasible and acceptable but effect sizes were small.
-
6.
Antidiabetic Effect of Rosella-Stevia Tea on Prediabetic Women in Yogyakarta, Indonesia.
Mayasari, NR, Susetyowati, , Wahyuningsih, MSH, Probosuseno,
Journal of the American College of Nutrition. 2018;(5):373-379
Abstract
BACKGROUND Rosella tea (Hibiscuss sabdariffa. Linn) with stevia sweetener (Stevia rebaudiana Bertoni) is a combined herbal drink that is expected to have antidiabetic effect by lowering glucose levels in people with diabetes and prediabetes. This research investigates the effect of rosella-stevia tea to decrease fasting blood glucose (FBG) and 2 hours postprandial blood glucose (2-hour postprandial BG) level in prediabetic women. METHOD This is quasi-experimental research with control and treatment (rosella-stevia tea) group. Each group consists of 12 prediabetic women aged 30-60 years. Rosella-stevia tea (5 g rosella powder, 125 mg stevia sweetener) was administered to the treatment group twice a day for 14 days. RESULT Rosella-stevia tea consumption affects blood glucose levels. Rosella-stevia tea consumption significantly lowered the FBG level (from 111.25 ± 7.20 mg/dL to 88.58 ± 13.19 mg/dL; p < 0.01) but not the 2-hour postprandial BG level (from 123.25 ± 37.61 mg/dL to 106.92 ± 18.82 mg/dL). There are no significant differences in the control group (FBG level from 106.00 ± 5.27 mg/dL to 102.08 ± 8.36, and 2-hour postprandial BG level from 119.83 ± 16.43 mg/dL to 128.00 ± 23.54 mg/dL). CONCLUSION Rosella-stevia tea consumption can lower the FBG level but not the 2-hour postprandial BG level in prediabetic women.
-
7.
Effect of intensive lifestyle modification & metformin on cardiovascular risk in prediabetes: A pilot randomized control trial.
Kulkarni, S, Xavier, D, George, B, Umesh, S, Fathima, S, Bantwal, G
The Indian journal of medical research. 2018;(6):705-712
-
-
Free full text
-
Abstract
BACKGROUND & OBJECTIVES Prediabetes is associated with increased prevalence of cardiovascular disease (CVD). In participants with prediabetes, the effects of exercise and metformin were evaluated on high-sensitivity C-reactive protein (hsCRP) and carotid intima-media thickness (CIMT), surrogate markers of atherosclerosis and CVD compared with standard care. METHODS In a pilot randomized control trial, the participants were randomized in to three arms: standard care (STD), intensive lifestyle modification (ILSM) or ILSM and metformin (ILSM+Met) and followed up for six months. Monitoring of ILSM was done by a trained healthcare facilitator. hsCRP, CIMT and other relevant parameters were measured before and after intervention. RESULTS A total of 103 participants were randomized into three arms and followed up for six months. At six months, there was a reduction from baseline in weight and fasting blood sugar (FBS) (P <0.01) in all three arms and a reduction in haemoglobin A1c (P =0.03) only in the ILSM+Met arm. The differences in hsCRP over six months within the STD, ILSM and ILSM+Met arms were -0.12 (95% confidence interval, -1.81, 2.08), -0.58 (-2.64, 0.43) and -0.11 (-1.84, 1.56), respectively. There was no difference in hsCRP, CIMT (right) or CIMT (left) between the three arms at six months. INTERPRETATION & CONCLUSIONS There was a reduction in weight and FBS from baseline in all three arms. There was, however, no difference seen in hsCRP and CIMT in the two intervention arms compared to standard care. Larger studies with long-term follow up need to be done to detect differences in risk markers for CVD in prediabetes.
-
8.
Glucose Tolerance is Linked to Postprandial Fuel Use Independent of Exercise Dose.
Gilbertson, NM, Eichner, NZM, Francois, M, Gaitán, JM, Heiston, EM, Weltman, A, Malin, SK
Medicine and science in sports and exercise. 2018;(10):2058-2066
Abstract
PURPOSE The optimal short-term exercise dose to improve glucose tolerance in relation to metabolic flexibility and/or insulin resistance is unknown. Therefore, we tested if short-term, work-matched continuous (CONT) versus interval (INT) exercise training improves glucose tolerance in part by reducing insulin resistance and increasing metabolic flexibility independent of clinically meaningful fat loss in adults with prediabetes. METHODS Subjects (age = 60.9 ± 1.4 yr, body mass index = 33.5 ± 1.1 kg·m) were screened for prediabetes using the American Diabetes Association criteria (75 g oral glucose tolerance test [OGTT] and/or HbA1c) and were randomized to 60 min·d of supervised CONT (n = 17, 70% HRpeak) or work-matched INT (n = 14; 90% HRpeak for 3 min and 50% HRpeak for 3 min) exercise for 12 bouts. Fitness (V˙O2peak) and body composition were assessed pre- and postintervention. A 180-min 75-g OGTT was performed, and glucose, insulin, and free fatty acids were collected to calculate glucose tolerance (tAUC180min) and whole-body as well as adipose tissue insulin resistance pre- and postintervention. RER (indirect calorimetry) was also measured at 0, 60, 120, and 180 min of the OGTT to assess fasting and postprandial metabolic flexibility. RESULTS CONT and INT training improved V˙O2peak (L·min; P = 0.001) and glucose tolerance (P = 0.01) and reduced fasting RER (P = 0.006), as well as whole-body and adipose insulin resistance (both P = 0.02) with no effect on body fat (P = 0.18). Increased postprandial RER was correlated with reduced glucose tAUC180min (r = -0.38, P = 0.05) and increased 180-min RER related to decreased whole-body insulin resistance (r = -0.42, P = 0.03). CONCLUSION Independent of exercise dose and fat loss, short-term training improves glucose tolerance in relation to enhanced postprandial fuel use.
-
9.
Diabetes prevalence in rural Indigenous Guatemala: A geographic-randomized cross-sectional analysis of risk.
Bream, KDW, Breyre, A, Garcia, K, Calgua, E, Chuc, JM, Taylor, L
PloS one. 2018;(8):e0200434
Abstract
BACKGROUND Developing countries and Indigenous populations are disproportionately affected by global trends in diabetes (T2DM), but inconsistent data are available to corroborate this pattern in Guatemala and indigenous communities in Central America. Historic estimates of T2DM, using a variety of sampling techniques and diagnostic methods, in Guatemala include a T2DM prevalence of: 4·2% (1970) and 8·4% (2003). Objectives of this geographically randomized, cross-sectional analysis of risk include: (1) use HbA1c to determine prevalence of T2DM and prediabetes in rural Indigenous community of Atitlán (2) identify risk factors for T2DM including age, BMI and gender. METHODS A spatially random sampling method was used to identify 400 subjects. Prevalence was compared using the confidence interval method, and logistic regression and linear regression were used to assess association between diabetes and risk factors. FINDINGS The overall prevalence of T2DM using HbA1c was 13·81% and prediabetes was also 13·81% in Atitlán, representing a tripling in diabetes from historic estimates and a large population with pre-diabetes. The probability of diabetes increased dramatically with increasing age, however no significant overall relationship existed with gender or BMI. CONCLUSIONS Diabetes is a larger epidemic than previously expected and appears to be related to ageing rather than BMI. Our proposed explanations for these findings include: possible Indigenous unique genetic susceptibility to T2DM, shortcomings in BMI as a metric for adiposity in assessing risk, changes in lifestyle and diet, and an overall aging population. The conclusion of this study suggest that (1) T2DM in rural regions of Guatemala may be of epidemic proportion. With pre-diabetes, more than 25% of the population will be diabetic in the very near future; (2) Age is a significant risk factor in the Indigenous population but BMI is not. This suggests that in some populations diabetes may be a disease of ageing.
-
10.
A Preliminary Study of the Effects of a Multitheory-Driven Intervention in Adults With Prediabetes Mellitus.
Tsai, FM, Lin, CC, Lin, HS, Liu, Y
The journal of nursing research : JNR. 2018;(3):216-225
Abstract
BACKGROUND Prediabetes mellitus (pre-DM) is an important predictive indicator of Type 2 diabetes. A person with pre-DM is eight times more likely to develop diabetes than a person without pre-DM. Prior research suggests that proactive interventions may delay the progression of this disease and reduce the rate of disease development. PURPOSE The purposes of this preliminary study were to develop a multitheory-driven lifestyle intervention protocol for adults with pre-DM and to evaluate its feasibility and impacts on knowledge regarding pre-DM, dietary behaviors, and physical activity (primary outcomes) as well as to describe the disease progression indicators (secondary outcomes). METHODS A single-group, longitudinal study design was used. Thirty-nine participants were included in the analysis. A generalized estimating equation model was used to determine the trends in changes in the outcomes. All of the participants underwent testing at baseline (T0) and at 3 (T1), 6 (T2), and 12 (T3) months after the 4-week lifestyle intervention. RESULTS There were significantly increasing trends for each study parameter (Pre-DM Knowledge Assessment Form-12, p < .01; Dietary Behavior Scale, p < .01) and significantly positive changes in body weight (p < .01), body mass index (p < .01), fasting glucose level (p < .01), and glycated hemoglobin level (p < .01) over the 12-month study period. CONCLUSIONS/IMPLICATIONS FOR PRACTICE This study supports the feasibility of the developed multitheory-driven lifestyle intervention protocol and suggests that its application may improve the effectiveness of diabetes prevention programs in clinical settings. Further randomized controlled trials are needed.