Bakgrund: Diabetes typ 2 har utvecklats till en global folksjukdom och utgör cirka 90 % av all diabetes. Kända orsaker till att insjukna i T2D är ärftlighet, ålder och dåliga levnadsvanor. En stor del av behandlingen består av egenvård och patienten har eget ansvar över sin sjukdom. För att kunna utföra egenvård på rätt sätt krävs det att patienter har kunskap om hur kost, motion och andra faktorer påverkar deras blodsockernivåer. Utmaningar och svårigheter som patienter upplever vid utförande av egenvård kommer att styra deras behov av kunskap samt stöd och därför är det viktigt att som sjuksköterska ha en förståelse om detta.   Syfte: Denna studies syfte var att beskriva patienter med diabetes typ 2 upplevelser av sin egenvård.  Metod: Systematisk litteraturöversikt som utgick från 14 vetenskapliga studier med kvalitativ ansats. Den analysmetod som användes var innehållsanalys. Resultat: Tre kategorier och 7 subkategorier kunde synliggöras. De tre kategorierna var Upplevelser av inre faktorer som hindrar genomförandet av egenvård, Upplevelser av inre faktorer som främjar genomförandet av egenvård samt Upplevelser av yttre faktorer som påverkar genomförandet av egenvård.  Konklusion: För att kunna erbjuda personcentrerad vård måste sjuksköterskan ha en förståelse för de hinder som patienter upplever vid utförandet av egenvård. Resultatet i denna studie visade att många patienter saknade kunskap om kosthållning och motion vilket inverkade negativt på deras sjukdomshantering. Patienter upplevde även utmaningar i att hantera de känslor som var vanligt förekommande samt de utökade krav som sjukdomen bidrog till. Faktorer som främjade genomförandet av egenvård var motivation, självinsikt samt acceptans och patienter upplevde att omgivningen hade en stor påverkan på deras förmåga att göra livsstilsförändringar. I och med komplexiteten på sjukdomen är det viktigt att behandlingen utformas och anpassas efter varje patients individuella behov och önskemål. / Background: Type 2 diabetes has developed into a global public disease and may account for about 90 percent for all diagnosed cases of diabetes. Known causes of T2D disease are heredity, older age and unhealthy lifestyle behaviors. Self-management is an important part of diabetes treatment and the patients have a responsibility over their illness. To be able to manage self-care in the right way requires that patients have knowledge about how diet, exercise and other factors affect their blood sugar levels. The challenges and difficulties that patients experience while managing self-care will control their need for knowledge and support and that is why it is important for nurses to have an understanding of these issues. Aim: The aim of this study was to describe how patients with type 2 diabetes experience their self-management.  Method: Systematic literature review based on 14 scientific studies with a qualitative approach. The analysis method used was content analysis. Result: Three categories and seven subcategories were identified and presented in this study. The three categories were Experiences of internal factors that hinder the implementation of self-care, Experiences of internal factors that promote the implementation of self-care and Experiences of external factors that affect the implementation of self-care.   Conclusion: To be able to offer patient centered care nurses need an understanding of the obstacles that patients experience when practicing self-care. The result of this study showed that a lot of patients lacked knowledge about nutrition and physical exercise which had a negative effect on their self-management behaviors. Patients also experienced challenges in dealing with common emotions and the increase of requirements that came along with the disease. Supporting factors that promoted self-care were motivation, self-perception and acceptance and patients experienced that the social environment had a major impact on their ability to make lifestyle changes. As a result of the complexity of the disease it is important that treatment is designed and adapted to every patient’s individual needs and wishes.

Eleven participants living with non-insulin-requiring Type 2 Diabetes (T2DM) discussed their self-monitoring blood glucose (SMBG) experience. All had been recently diagnosed (< 2 years) and treated for diabetes with a self-regulating SMBG guideline for primary care practice. Their digitally-recorded interviews and photographed logbooks were analyzed thematically and interpreted through the lens of numeracy literature to answer 2 questions: 1. What is the meaning of SMBG among people with non-insulinrequiring T2DM? 2. How do people with non-insulin-requiring T2DM perceive the function of SMBG in diabetes self-management? The meanings of SMBG were patient competence, "It is easy, just a little pin prick"; patient control, "I can control it. It doesn't control me"; and patient security, "It is not that way anymore." Three periods of lived time were observed: Diagnosis "The numbers say I have diabetes"; "I just can't figure out why it does that"; and Routine "I make my numbers." Prominent numeracy functions emerged by time period. During Diagnosis primary numeracy functions included comparing SMBG results to target values. Participants expressed this experience as, "I am some kind of O.K." During applied numeracy functions included taking medication correctly. SMBG readings were experienced as a clue to the diabetes mystery, sometimes confusing the participants, "I just don't know why it does what it does," or answering questions, "Now there is no question marks." Numbers motivated some people for action "The numbers get me out a walking" or restraint "If I didn't have the numbers, I would be tempted to cheat." During Routine interpretive numeracy functioned to aid the evaluation of the efficacy of participant's health behavior change. Numbers had taken on meaning helping a person to "know where I am at." Clinical implications are suggested including adjustments to the selfregulating SMBG guideline for primary care practice. Findings are discussed in relation to personal knowledge processes (Sweeny, 1994) and related SMBG research. Participants concluded that routine SMBG is essential to maintaining and restraining health behavior. This study provides a model for use of SMBG in diabetes selfmanagement and patient perspectives on SMBG during the 2 years following T2DM diagnosis.

<p>Diet is the number one leading modifiable cause of poor health globally, with poor diets accounting for 10.9 million (22%) of all deaths among adults in 2017. In addition, one of our generation’s forthcoming challenges is the rapid expansion of the population aged 60 years and older. Although people are living longer, there is an associated increase in the prevalence of aged-related chronic diseases and functional impairment, such as cardiometabolic diseases and sarcopenia. As such, dietary components can play a role in positively or negatively influencing the prevention and treatment of chronic cardiometabolic diseases and sarcopenia. One such dietary component is dietary protein, which is essential throughout the life course, from gestation through old age. Evidence supports dietary protein playing an important role in reducing the risk of developing age-related chronic diseases such as sarcopenia and cardiometabolic diseases. </p> <p><em><strong>     Study 1, Chapter 2:</strong></em> The Dietary Guidelines for Americans (DGA) recommends consuming a variety of “Protein Foods” based on “ounce equivalent” (oz-eq) portions. In addition, the 2020-2030 Strategic Plan for NIH Nutrition Research includes to “define the role of nutrition across the lifespan” with an objective to “assess the role of nutrition in older adults to promote healthy aging.” However, there is a paucity of primary research that directly compares EAAs bioavailability between young and older adults consuming the same oz-eq portions of varied Protein Foods. No study has assessed the same oz-eq portions of animal- versus plant-based Protein Foods on essential amino acids (EAAs) bioavailability for protein anabolism in young and older adults. Therefore, we conducted two sequential randomized, investigator-blinded, crossover, acute feeding trials with the same study design; first in a cohort of young adults and second in a cohort of older adults. The primary objective of this project was to assess the effect of consuming two oz-eq portions of animal-based (unprocessed lean pork or whole eggs) vs. plant-based (black beans or sliced almonds) Protein Foods as part of a mixed whole foods meal on plasma EAAs bioavailability for protein anabolism. Consistent with our hypotheses, participant age did not affect postprandial EAAs bioavailability, and consuming a meal with two oz-eq of unprocessed lean pork or whole eggs resulted in greater postprandial EAAs bioavailability compared to a meal with two oz-eq of black beans or raw sliced almonds in 1) young adults; 2) older adults; and 3) young and older adults combined. These findings show on the same oz-eq basis, consuming these animal- vs. plant-based Protein Foods more effectively provide bioavailable EAAs for protein anabolism. </p> <p><em><strong>     Study 2, Chapter 3:</strong></em> Poultry meat is the most consumed type of meat worldwide and in the US. Poultry is generally considered to be a “healthy” meat as it is a high-quality protein source and provides other essential nutrients. However, research assessing poultry and its effects on and relations with chronic diseases in humans is sparse, and the forms of poultry typically consumed in the US, are not necessarily in line with recommendations provided by the DGA. Therefore, we conducted a scoping review to systematically search and chronicle scientific literature pertinent to poultry intake and human health. Main findings from this project were 1) historically, little research, especially randomized diet-controlled feeding trials, has been conducted to understand associations between and effects of consuming poultry products on human health; 2) the majority of research is from observational studies assessing relationships between poultry intake and risks of morbidity and mortality from various types of cancer; 3) a paucity of research exists to support chicken as a health-promoting food in children; and 4) research taking into account poultry product processing and cooking methods is needed. Science and health professionals, the poultry industry, and the public will benefit from new observational and experimental research to address cutting-edge scientific, public policy, and consumer topics pertinent to poultry intake and human health. </p> <p><em><strong>     Study 3, Chapter 4:</strong></em> Emerging research on whey protein supplementation suggests it may be a potential modifier of type 2 diabetes mellitus (T2DM) risk factors, including glucose control. As systematic reviews and/or meta-analyses of randomized controlled trials are gaining importance in nutrition literature, we conducted an umbrella systematic review to search for and chronicle published systematic reviews and/or meta-analyses of randomized controlled trials pertinent to whey protein supplementation and T2DM modifiable risk factors (study 3, Chapter 4). Among the 13 systematic reviews, including 12 meta-analyses critically assessed for this umbrella review, no reviews reported any adverse effects of whey protein on any reported T2DM-related risk factor. Collectively, a preponderance of evidence indicates whey protein supplementation improves multiple clinical indicators of glucose control in apparently healthy adults and those at increased risk for type 2 diabetes mellitus. </p>

Bakgrund: Typ 2-diabetes är en allvarlig sjukdom som ökar kraftigt världen över. Övervikt och ohälsosamma levnadsvanor är de största riskfaktorerna för att utveckla sjukdomen och risken att drabbas av komplikationer är stor. Genom hälsosamma levnadsvanor kan dock risken för komplikationer minska påtagligt. Syfte: Syftet var att beskriva patienter med typ 2-diabetes upplevelser och erfarenheter av hinder och stöd vid livsstilsförändringar. Metod: En empirisk, kvalitativ intervjustudie med induktiv ansats genomfördes där åtta patienter med typ 2-diabetes intervjuades. Intervjumaterialet analyserades enligt Graneheim och Lundmans kvalitativa manifesta innehållsanalys. Resultat: Personliga, sociala samt vårdrelaterade hinder och stöd framkom som betydande faktorer vid arbetet med livsstilsförändringar. Symtom relaterade till sjukdomen ökade motivationen till att genomföra livsstilsförändringar, medan fysiska besvär relaterade till andra sjukdomar och smärttillstånd ansågs vara betydande hinder. Kunskap om sjukdomen och dess komplikationer, engagemang hos närstående samt kontinuerliga besök med personcentrerad information hos diabetessjuksköterskan ansågs stödjande, medan en stressig vardag upplevdes hindra genomförandet av livsstilsförändringar. Slutsats: Patienters genomförande av livsstilsförändringar påverkas av diverse upplevda hinder och stöd. Studiens resultat belyser bland annat betydelsen av den regelbundna, personcentrerade vården och kan användas som vägledning för vårdpersonal i deras hälsofrämjande arbete med patienter med typ 2-diabetes. / Background: Type 2 diabetes is a severe disease that is increasing worldwide. Obesity and unhealthy lifestyle is the main risk factor to developing the disease and the risk of developing further complications are high. Leading a healthy lifestyle, the complications can be significantly reduced. Purpose: The aim was to describe patients with type 2 diabetes experiences of obstacles and support while making lifestyle changes. Method: An empirical, qualitative interview study with an inductive approach was conducted, where eight persons with type 2 diabetes were interviewed. The study material was analyzed according to Graneheim and Lundman’s qualitative manifest content analysis. Results: Personal, social and health care-related obstacles and support emerged as important factors when working with lifestyle changes. Symptoms related to the disease increased the motivation to implement lifestyle changes, while physical complaints related to other diseases and pain conditions were considered to be hindering factors. Having knowledge about the disease and its complications, involvement of relatives and continuous visits with person-centered information from the diabetes nurse were considered to be supportive, while a stressful everyday life was perceived to hinder the implementation of lifestyle changes. Conclusion: Patients' implementation of lifestyle changes is affected by several perceived obstacles and support. The study's results highlight the importance of regular, person-centered care and can be used as guidance for health care professionals in their health promotion work with patients living with type 2 diabetes.

Our study provided an analysis and comparison of specific blood values, dietary intake, body composition, and inflammatory markers (high sensitivity-C-reactive protein (HS-CRP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6)) between adults with type 2 diabetes mellitus (T2DM) and prediabetes (PDM) to adults without diabetes. A total of 22 participants (PDM/T2DM n=12, controls n=10) in the San Luis Obispo, CA area completed the study prior to our ending recruitment due to Covid-19. Body composition data were collected through DXA scans. Dietary intake was assessed using a 3-day food record survey and nutritional analysis conducted using ESHA food processing software. In addition, participants completed an overnight fast and early morning blood draw for evaluation of blood glucose regulation, blood lipid profile and inflammatory biomarkers. Analysis included a series of randomization tests that were conducted to determine possible statistical differences between the mean of basic characteristics (age, BMI, weight, HbA1C, fasting plasma glucose, fasting insulin, triglycerides, LDL, HDL, and total cholesterol levels) of the control group and the PDM/T2DM group. Secondly, 2-way ANOVA statistical analyses were conducted to determine the interaction between sex and diabetes status on caloric intake, macronutrient distribution, quality of fat intake, visceral adipose tissue (VAT), and inflammatory biomarkers. We found there was a significant difference in fasting plasma glucose (FPG) and hemoglobin A1C (HbA1C) between the control group and the PDM/T2DM group. We did not find a statistically significant difference in caloric intake, macronutrient distribution, quality of fat intake, visceral adipose tissue (VAT), and inflammatory biomarkers between the PDM/T2DM and control group. Due to the lack of studies that include adults with PDM, we concluded additional future research needs to focus on blood biochemistry values, dietary intake, body composition, and inflammatory markers health-risk factors in both adults with PDM and T2DM since these values can improve diagnosis and treatment of T2DM.

Bakgrund: Diabetes typ 2 innebär ökad risk för kognitiv sjukdom. Forskning visar att båda sjukdomarna kommer öka markant de kommande 20 åren, framför allt på grund av en allt äldre befolkning men också av den kraftig ökningen av livsstilssjukdomar som fetma och insulinresistens. Distriktssköterskor har en viktig roll när det kommer till att begränsa den utvecklingen. Genom det hälsofrämjande och sjukdomsförebyggande arbetet kan distriktssköterskan synliggöra hälsoproblem, ta hänsyn till patientens unika livssituation med copingstrategier och därefter tillsammans med patienten utarbeta en plan för förändringsarbete mot en mer hälsosam livsstil. Samarbetet och det delade ansvaret stärker patientens position och självkänsla. Under förändringsarbetet kan sjuksköterskan finnas för att ge stöd och råd för att personen ska komma vidare i adaptionsprocessen. En framgångsrik modell som kan användas för ett personcentrerat sjukdomsförebyggande arbete är Riktade hälsosamtal. Syfte: Syftet med studien var att undersöka förekomsten av diabetes typ 2 och/eller kognitiv dysfunktion hos personer över 60 år i SNAC-B-studien, om det finns ett samband mellan sjukdomarna samt vilka riskfaktorer som har stor betydelse för att förebygga sjukdomarna. Metod: Studien var en deskriptiv tvärsnittsstudie med kvantitativ ansats som utgått från data ur SNAC-B (The Swedish National study on Aging and Care) i Blekinge. Resultat: Studien visade inget statistiskt samband mellan diabetes typ 2 och kognitiv dysfunktion men det finns ett antal riskfaktorer som har stor betydelse för respektive sjukdom och flera av dessa är kopplade till levnadsvanor. Slutsats: Ohälsosamma levnadsvanor ökar risken för diabetes typ 2 och kognitiv dysfunktion. Högt långtidsblodsocker, visceralt fett och övervikt ökar risken mest för diabetes typ 2. Utöver ålder och utbildningsnivå var det alkoholvanor, fysisk aktivitet och högt långtidsblodsocker som mest ökar risken för kognitiv dysfunktion. / Background: Type-2 diabetes implies an increased risk of cognitive disease. Research shows that both diseases will increase significantly over the next 20 years, primarily due to an increasingly elderly population, but also due to the considerable increase in lifestyle diseases such as obesity and insulin resistance. District nurses play an important role when it comes to limiting that development. By health promotion and disease prevention efforts, the district nurse can make health problems visible, take into account the patient's unique life situation with coping strategies and then, in cooperation with the patient, frame a plan for change towards a healthier lifestyle. The cooperation and the shared responsibility strengthen the patient's position and self-esteem. During the work for change, the nurse is able to be there to provide support and advice for the person to progress in the adaptation process. A successful model that can be used for person-centred disease prevention work is ‘Individual health dialogue’. Aim: The aim of the study was to investigate the occurrence of type-2 diabetes and/or cognitive dysfunction in people over 60 years of age in the SNAC-B study, whether there is a connection between the diseases and which risk factors are of great importance in preventing the diseases. Method: The study was a descriptive cross-sectional study with a quantitative approach, based on data from SNAC-B (The Swedish National study on Aging and Care) in Blekinge. Results: The study showed no statistical relationship between diabetes type-2 and cognitive dysfunction, but it showed a number of risk factors that are of great importance for the respective disease, and several of these are connected to lifestyle habits. Conclusion: Unhealthy lifestyles increase the risk of type-2 diabetes and cognitive dysfunction. High long-term blood sugar, visceral fat and obesity increase the risk of developing type-2 diabetes. In addition to age and education level, alcohol habits, physical activity and high long-term blood sugar increase the risk of cognitive dysfunction.

Background: Diabetes type 2 is a growing public disease worldwide that is primarily acquired through lifestyle habits, which is why self-care plays a large role in treatment. Untreated type 2 diabetes can lead to serious complications for the patient, which is why the nurse's work is focused on a person-centered approach in education, treatment and communication to support the patient in performing self-care.Aim: To describe how nurses can promote health in patients with type 2 diabetes.Method: General literature review based on a thematic analysis based on nine scientific articles, six quantitative and three qualitative studies.Results: Categories identified in the analysis included person-centered approach, increased self-efficacy and reduced risk of complications.Conclusion: Diabetes type 2 is an already widespread public disease where incidence estimates show a continuous and alarming increase worldwide. In addition, type 2 diabetes poses enormous costs to society. The authors therefore recommend that all nurses, already during basic education, should acquire broader competence in lifestyle and MI in order to more easily meet the growing population of patients with type 2 diabetes. However, research is needed into whether an implementation would be possible.

Contexte : Le diabète de type 2 (DT2) et le prédiabète sont considérablement liés au mode de vie, et sont un fardeau considérable pour les patients et les systèmes de santé. Bien que les interventions sur les habitudes de vie soient reconnues comme le traitement initial pour le prédiabète et le DT2, leur mise en œuvre efficace est rarement observée dans les soins cliniques de routine. Le fait d'atteindre une rémission de ces conditions à l'aide de telles interventions est encore plus rare. Méthodes : Nous présentons une analyse rétrospective de données issues d’une clinique d’intervention structurée et multidomaine sur le mode de vie, d’une durée de 12 mois, offerte à des patients atteints de prédiabète et de DT2. L’intervention consistait en des conseils éducatifs et nutritionnels guidés par des experts, combinés à une prescription personnalisée d’exercices physiques, dans le but principal d’améliorer la santé métabolique (perte de poids, diminution de l’hémoglobine glyquée, HbA1c), ainsi que d’atteindre la rémission du diabète, définie comme un retour de l'HbA1c à 6 mois à < 6,5 % (ou < 5,7 % pour le prédiabète) et persistant pendant au moins 3 mois en l'absence d’agents anti-diabétiques oraux. Résultats : À la suite d'une intervention sur les habitudes de vie de 117 participants avec prediabète ou diabète (âge moyen de 67,8 ± 9,5 ans, 63 % d'hommes, poids initial moyen de 92,7 ± 20,2 kilogrammes, HbA1c initiale moyenne de 6,9 % ± 0,8) une amélioration statistiquement significative de leur profil métabolique a été notée. La perte moyenne de poids à 12 mois était de - 4,9 kilogrammes (95% CI : - 4,0 à - 5,7, p<0,001), et la réduction moyenne de l'HbA1c à 12 mois était de - 0,6 % (95% CI : - 0,4 à - 0,7, p<0,001). Pour les participants atteints de DT2, 50 % d’entre eux ont atteint un taux d'HbA1c < 6,5 % après 6 mois d'intervention. De plus, 20 % des participants atteints de prédiabète et 12 % des participants atteints de DT2 ont atteint les critères de rémission. Conclusions : Cette première expérience de notre institution démontre comment une clinique d'intervention multidomaine sur le mode de vie peut être utile pour améliorer la santé métabolique et normaliser les valeurs glycémiques d’individus avec prédiabète ou DT2, même au point, pour certains, d'atteindre les critères de rémission. Suite à ces observations, nous proposons une étude prospective interventionnelle intitulée DIABEPIC1, qui examinera la faisabilité et l'efficacité d'un programme de réadaptation cardiaque amélioré combinant l'entraînement physique avec une intervention de réduction des aliments ultra-transformés, un régime méditerranéen et le jeûne intermittent, afin d’inverser le prédiabète jusqu'à la normalisation de la glycémie. L'impact de cette étude sur la mise en place de programmes de réadaptation cardiaque pour les patients atteints de prédiabète pourrait être important. En effet, si elle s'avère réalisable, elle pourrait améliorer la fonction cardiovasculaire après un événement coronarien aigu, améliorer la santé métabolique et en inverser un facteur de risque important et causal. (Identifiant de l’étude: NCT05459987). / Background: Type 2 diabetes (T2D) and prediabetes are predominantly related to lifestyle, representing a substantial burden to patients and the healthcare system. Effective implementation of lifestyle interventions as a first-line treatment for prediabetes and T2D is rarely seen in routine clinical care. Achieving remission of these conditions with such interventions is even more uncommon. Methods: We present a retrospective analysis of a 12-month single-center structured multidomain lifestyle intervention clinic offered to patients living with prediabetes and T2D. The intervention consisted of expert-guided educational and nutritional counseling combined with personalized physical training aiming at improving metabolic health and reaching remission. Remission of prediabetes and T2D were defined as a return of HbA1c at 6 months to < 6.5% (or < 5.7% for prediabetes) persisting for at least 3 months in the absence of glucose-lowering pharmacotherapy. Results: Following the multidomain expert-guided lifestyle intervention, 117 participants participants with prediabetes or T2D (mean age of 67.8 ± 9.5 years, 63% male, mean initial weight of 92.7± 20.2 Kilograms, mean initial HbA1c of 6.9% ± 0.8), significantly improved their metabolic profiles: mean weight loss at 12 months was – 4.9 kilograms (95% CI: - 4.0 to – 5.7, p<0.001), and mean reduction in HbA1c at 12 months was of – 0.6 % (95% CI: - 0.4 to - 0.7, p<0.001). 20% of participants with prediabetes and 12% of participants with type 2 diabetes achieved the remission criteria. In addition, 50% of all participants with T2D achieved HbA1c <6.5% after 6 months of intervention, demonstrating that tailored counseling and regular monitoring can improve the success of lifestyle treatments. Conclusions: After this initial experience from our institution showing how a multidomain lifestyle intervention clinic can be useful to improve metabolic health and normalize glycemic values in patients with prediabetes or T2D, even to the point of reaching criteria of remission, we propose a prospective interventional study entitled DIABEPIC1, which will examine the feasibility and effectiveness of an enhanced cardiac rehabilitation program combining exercise training with an ultra-processed food reduction intervention, a Mediterranean diet, and time-restricted dietary counseling to reverse prediabetes to normal glucose concentrations. The impact of this study on the delivery of cardiac rehabilitation programs for patients with prediabetes is significant. If proven feasible, it could improve cardiovascular function after an acute coronary event, enhance metabolic health and reverse a key causal cardiovascular risk factor. (Identifier of the study: NCT05459987)

Background Type 2 diabetes mellitus (T2DM) is a globally prevalent disease anticipated to double from 500 million diagnosed cases in 2021 to more than one billion by 2050. The investigation of the potentially protective effects of skeletal muscle mass on glucose intolerance may lead to the development of more precise screening protocols. Purpose This thesis aimed to address the lack of clear consensus in existing literature by exploring the relationship between skeletal muscle mass and glucose intolerance. Methods Fifteen healthy young adults were recruited to partake in a prospective correlational study. The participants underwent anthropometric measurements and an oral glucose tolerance test (OGTT). Anthropometric data was collected using an bioelectrical impedance analysis (BIA) scale. Blood glucose levels were measured using capillary sampling before and after ingestion of a 75 g/200 mL glucose solution. Statistical analysis included Spearman’s rank correlation test and Pearson’s correlation coefficient test. Results All associations between skeletal muscle mass and glucose intolerance were of moderate strength. Skeletal muscle mass (SMM) correlated significantly with glucose concentrations two hours (2hPG) following ingestion of the glucose solution and an adjusted measure of SMM was significantly associated with glucose area under the curve (AUC). Statistical significance was also found between Sex and incremental glucose area under the curve (iAUC). Conclusion This thesis suggests an inverse relationship between skeletal muscle mass and glucose intolerance in a group of healthy young adults. The results imply the potential usefulness of incorporating muscle mass when determining the glucose load during an OGTT, especially in preventive contexts. Nevertheless, further research with larger samples is crucial to establish precise cutoff levels for clinical applications. / Bakgrund Typ 2 diabetes mellitus (T2DM) är en global sjukdom och antalet diagnostiserade individer förväntas fördubblas från 500 miljoner fall 2021 till över en miljard år 2050. En undersökning av muskelmassans potentiellt skyddande effekt på glukostolerans kan leda till utvecklandet av noggrannare screeningmetoder. Syfte Syftet med denna uppsats var att bemöta den bristfälliga konsensus som råder bland befintlig forskning genom att undersöka sambandet mellan muskelmassa och glukosintolerans. Metod Femton friska yngre vuxna rekryterades för att delta i en prospektiv korrelationsstudie. Deltagarna genomgick antropometriska mätningar samt ett oralt glukostoleranstest (OGTT). Antropometriska värden mättes med hjälp av en bioelektrisk impedansanalysvåg. Blodglukosnivåer mättes kapillärt före och efter intag av en 75 g/200 mL glukoslösning. Statistisk analys inkluderade Spearmans rangkorrelationstest och Pearsons korrelationskoefficientstest. Resultat Alla samband mellan muskelmassa och glukosintolerans var av måttlig styrka. Muskelmassa (SMM) korrelerade signifikant med blodglukos två timmar (2hPG) efter intag av glukoslösningen och ett justerat SMM-mått (adjSMM) var signifikant associerat med arean under glukoskurvan (AUC). Statistisk signifikans hittades även mellan kön och den inkrementella arean under glukoskurvan (iAUC). Slutsats Resultaten från denna uppsats antyder att ett omvänt samband existerar mellan muskelmassa och glukosintolerans hos en grupp friska yngre vuxna. Resultatet innebär en potentiell möjlighet att använda muskelmassan vid bestämmandet av mängden glukos som administreras vid ett OGTT, särskilt i preventiva syften. Ytterligare forskning med fler studiedeltagare är avgörande för att fastställa exakta gränsvärden för klinisk tillämpning.

Current screening tests for type 2 diabetes mellitus (T2DM) identify less than 50% of undiagnosed T2DM patients and provide no information about how the disease will develop in prediabetic patients. Here, twenty-nine protein glycation sites were quantified after tryptic digestion of plasma samples at the peptide level using tandem mass spectrometry and isotope-labelled peptides as internal standard. The glycation degrees were determined in three groups, i.e., 48 patients with a duration of T2DM exceeding ten years, 48 non-diabetic individuals matched for gender, BMI, and age, and 20 prediabetic men. In long-term controlled diabetic patients, 27 glycated peptides were detected at significantly higher levels, providing moderate diagnostic accuracies (ACCs) from 61 to 79%, allowing a subgrouping of patients in three distinct clusters. Moreover, a feature set of one glycated peptides and six established clinical parameters provided an ACC of 95%. The same number of clusters was identified in prediabetic males (ACC of 95%) using a set of eight glycation sites (mostly from serum albumin). All patients present in one cluster showed progression of prediabetic state or advanced towards diabetes in the following five years. Overall, the studied glycation sites appear to be promising biomarkers for subgrouping prediabetic patients to estimate their risk for the development of T2DM.