ABSTRACT Background: Prediabetes is a precursor condition to type 2 diabetes mellitus. Previous research and clinical trials have shown that the onset of type 2 diabetes could be delayed or prevented through structured life style modifications such as dietary changes, modest weight loss and moderate-intensity exercise. This study examines U.S adults of different ethnicities that include non-Hispanic white, non-Hispanic black and Mexican Americans and whether their awareness of diabetes risk is associated with their participation in diabetes risk reduction behavior, a combination of physical activity, weight control and fat/calories intake. Methods: The 2007-2008 National Health and Nutrition Examination Survey, NHANES, was used to conduct a cross-sectional study of 4083 U.S. adults who were 20 years old and above and were aware of their diabetes risk. The association between the awareness of one’s diabetes risk and the adoption of diabetes risk reduction behavior were examined in present of other risk factors such as age, gender, ethnicity, education, annual family income, BMI, hypertension, mean systolic blood pressure, mean diastolic blood pressure, total cholesterol, LDL, HDL and triglyceride levels. Males and females were examined separately for all analyses performed. Cross tabulation was conducted and p-values were calculated by the Pearson’s chi-square test for the categorical variables which include gender, ethnicity, education, annual family income, adiposity and hypertension. One Way ANOVA and Tukey post hoc tests were conducted for the continuous variables which include age, mean systolic blood pressure, mean diastolic blood pressure, total cholesterol, LDL, HDL and triglyceride levels. Univariate and multivariate analyses were performed to determine the association between the main independent variable, awareness of one’s diabetes risk, and the dependent variable, adoption of diabetes risk reduction behavior, controlling for other risk factors. A p-value of <0.05 and 95% confidence intervals were used to determine statistical significance throughout all analyses performed. Results: After controlling for age, gender, race, education, annual family income, BMI, hypertension, mean systolic blood pressure, mean diastolic blood pressure, total cholesterol, LDL, HDL, and triglycerides, results from the multivariate analysis showed that subjects who were aware of their diabetes risk were more likely to adopt diabetes risk reduction behavior (OR= 1,734, 95 % CI=1.217-2.470). Females and non-Hispanic blacks, who were aware of their diabetes risk, were also more likely to adopt diabetes risk reduction behavior compared to males, non-Hispanic whites and Mexican Americans. An increase in the levels of education, annual family income and BMI was also associated with the adoption of diabetes risk reduction behavior. Stratification according to gender and ethnicity, showed that Mexican American males and females were more likely to engage in diabetes risk reduction behavior compared to non-Hispanic whites and non-Hispanic blacks (Mexican American males: OR: 2.496, CI: 0.792-7.868; Mexican American females: OR: 2.830, CI: 0.917-8.736). Conclusion: This study provides useful insights for health care providers and public health professionals who are developing health promotion and prevention interventions to address pre diabetes before it develops into type 2 diabetes. This study also allows the development of tailored interventions for specific genders and ethnic groups that are at risk. Results of this study indicate that Mexican Americans and females (in general) are more likely to adopt diabetes risk reduction behavior. Therefore, physicians and health care providers should develop culturally, linguistically and gender- specific education materials and programs for this particular gender and ethnic group. This in turn, may reduce the overall increasing prevalence of diabetes, reduce racial and gender disparities and may have a positive impact on the overall health of the U.S. population.

No description available.

Bakgrund Det finns många olika varianter av diabetes men av alla personer som har diagnostiserats med sjukdomen så har 80-90% typ 2 diabetes (T2D). Sjukdomen kan uppstå av ärftliga faktorer och förekommer ofta i äldre åldrar men kan utvecklas i samband med en ohälsosam livsstil. Vid behandling av T2D är en livsstilsförändring viktigast och sker främst genom förändrade kost- och träningssvanor. Traditionellt har länge måttligt intensiv uthållighetsträning (MICT) i 150 min/vecka rekommenderats till målgruppen som träningsform. Syfte Syftet med studien är att undersöka effektiviteten av högintensiv intervallträning som behandling för vuxna människor med typ 2 diabetes eller prediabetes. Metod Studien är en deskriptiv systematisk litteraturöversikt som innebär att tillgänglig forskning sammanställs inom ett specifikt ämnesområde för att skapa förståelse för forskningsområdet. Sökningar har skett i databaserna PubMed och samlingsdatabasen Discovery där MeSH termer och friasökningar har kombinerats för att täcka en så stor del av forskningsfältet som möjligt. Resultat 11 artiklar valdes ut och resultatet delades upp i tre olika kategorier mellan glykemisk kontroll, högintensiv intervallträning (HIIT) i jämförelse med MICT och genomförbarheten av HIIT med self-efficiency theory som utgångspunkt. HIIT gav liknande eller bättre effekter på glykemisk kontroll (HbA1c) jämfört med MICT. I studier där genomförbarheten av ett HIIT protokoll nämns så visade samtliga positiva resultat oavsett interventionens längd. Slutsats Liknande eller bättre förbättringar på glykemisk kontroll går att uppnå genom en lägre träningsvolym än de traditionellt rekommenderade 150 min/vecka med måttlig intensitet och HIIT skulle kunna rekommenderas som behandlingsmetod för typ 2 diabetiker samt personer med prediabtes inom vården.

Background: One-third of the U.S. population has prediabetes, but 90% remain undiagnosed because healthcare providers are not screening for this condition. Objective: The purpose of this quality improvement project was to monitor prediabetes screening and identification, and implement evidence-based recommendations including registered dietician referral. Methods: This project involved using an evidence-based screening tool to measure individual risk of prediabetes. Aggregate data was collected to evaluate screening implementation, evidence-based recommendations offered by providers, and assess patient risk factors. Results: The percentage of patients at risk for prediabetes was 41.3% (n = 111). The most frequent risks were identified as overweight, history of hypertension, family history of type 2 diabetes mellitus (T2DM), and older age. Providers offered education on weight loss 68.5% (n = 76) and exercise 76.6% (n = 85) but referred 33.3% (n = 37) patients for nutrition education. The screening rates were 52.3% (n = 176) and 72.5% (n = 244) in clinics A and B respectively. Conclusions: A gap remains in using evidence-based recommendations to decrease risk of prediabetes. Prediabetes screening identified a greater percentage of persons in this population. Implications for Nursing: There is a need for consistent practice of evidence-based recommendations. This project set the benchmark for future efforts to educate, encourage, and measure providers successes.

Type 2 diabetes mellitus (T2DM) is a chronic condition recognized as the inability to maintain glucose homeostasis, typically presenting with insulin resistance and systemic inflammation. With the prevalence of T2DM and major risk factors such as prediabetes and obesity increasing each year, there is a crucial need to identify strategies for the management and prevention of this condition. Addressing lifestyle-related risk factors through consumption of a well-balanced, nutritious diet and maintaining regular moderate- to high-intensity physical activity may provide a strategy for improving glycemic control, improving metrics of body composition, and decreasing the inflammatory response associated with metabolic dysregulation. Twenty-two overweight to obese adults with a medical diagnosis of T2DM, indicators of prediabetes, or who were metabolically healthy participated in Cal Poly’s Nutrition and Exercise in Type 2 Diabetes (CPNET) study. The study protocol included adherence to a Mediterranean-style diet, daily consumption of a high-quality whey protein supplement, and adherence to the Physical Activity Guidelines for Americans for 16 weeks. Body composition data, via dual-energy X-ray absorptiometry (DXA), and fasting blood samples were collected at baseline and following the intervention. Due to restrictions associated with the global COVID-19 pandemic, only 13 participants were able to return for the second data collection following the 16-week intervention. The prediabetic and T2DM groups exhibited reductions in fasting plasma glucose to that of normal and prediabetic levels, respectively, while the T2DM group also showed improvement in hemoglobin A1c to the prediabetic level. Additionally, the metabolically healthy, overweight group demonstrated significant improvements in adiposity, while the obese prediabetic and T2DM groups showed non-significant improvements in all measured metrics of body composition. No changes were observed in inflammatory biomarkers. Thus, our results suggest that adherence to a well-balanced nutritious diet and regular physical activity may improve parameters of glycemic control and provide benefits to body composition that help manage and prevent the development of T2DM.

Prediabetes is a condition affecting 35% of US adults and about 50% of US adults age 65+. Foods rich in polyphenols, including flavanols and other flavonoids, have been studied for their putative beneficial effects on many different health conditions including type 2 diabetes mellitus and prediabetes. Studies have shown that some flavanols increase glucagon-like peptide 1 (GLP- 1) levels. GLP-1 is a feeding hormone that increases insulin secretion after carbohydrate consumption and increased GLP-1 levels may be responsible for some of the beneficial effects on glycemic control after flavanol consumption. The present study explored the effects of grape powder consumption on metrics of glycemic health in normoglycemic and prediabetic C57BL/6J mice; additionally, the mechanism of action of grape powder was investigated. Grape powder significantly reduced (p<0.01) blood glucose levels following oral glucose gavage after GLP-1 receptor antagonism by exendin-3 (9-39) compared to sugar-matched control; indicating that it was able to attenuate the hyperglycemic effects of GLP-1 receptor antagonism. Grape powder was employed in acute (1.6 g grape powder/kg bodyweight) and long-term high fat diet (grape powder incorporated into treatment diets at 5% w/w) feeding studies in normoglycemic and prediabetic (diet-induced obesity) mice; grape powder did not improve glycemic control in these studies versus sugar-matched control. The mechanisms by which grape powder ameliorates the deleterious effects of GLP-1 receptor antagonism warrants further study. / Master of Science in Life Sciences

<p dir="ltr">Accumulating evidence suggests a potential role for almond consumption in ameliorating post-prandial glycemia. Yet their effect on HbA1c, an indicator of long-term glycemic control, is mixed. The purpose of this study was to examine the potential of sustained almond consumption to reduce HbA1c concentrations among individuals with elevated HbA1c concentrations. A 16-week randomized, parallel-arm, controlled trial was conducted. Eighty-one adults with elevated HbA1c concentrations (>5.7%) were randomly assigned to incorporate two servings (2 oz) of raw almonds (A group; N=39) or energy-matched snacks (pretzels C group; N=42) into their daily diets. Half of these intervention foods were to be ingested at breakfast and the other half as a replacement for either a mid-morning or mid-afternoon snack. Throughout the intervention period, measurements were made of body weight, body composition, plasma lipids, HbA1c, alpha and gamma-tocopherol, glycemia (by meal tolerance test) and continuous glucose monitoring, dietary intake, and hedonic responses to test foods at stipulated time points. Participants consuming almonds ingested 253 kcal/d more than participants in the control group (p=0.02), but this did not result in a significant difference in body weight (A: 0.2kg SEM ±0.5, C: 0.4kg SEM ±0.5); p>0.05). No statistically significant differences were observed in HbA1c concentrations (A: 0.1% SEM ±0.1, C: 0% SEM ±0.1; p>0·05), blood chemistries, body composition, or glycemia over time or between groups. However, Healthy Eating Index scores improved within the almond group as compared to the control group (A: 8.3 points SEM ±1.9, C: -2.3 points SEM ±2.1; p<0.001). Additionally, the hedonic rating of almonds did not decline within the almond group in comparison to the control group's reduced liking of the pretzel snack. Alpha-tocopherol increased significantly, and gamma-tocopherol tended to decrease in the almond group, indicating compliance with the dietary intervention. Overall, daily ingestion of 2 oz of raw almonds in a regular diet for 16 weeks did not alter short-term or longer-term glycemia or HbA1c concentrations in adults with elevated HbA1c concentrations, but they were well-tolerated and improved diet quality without promoting weight gain.</p>

Abstract Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting reproductive aged women, with reproductive, metabolic and cardiovascular implications across the life span. The typical features of PCOS include irregular menstruation, androgen excess and polycystic ovaries in ultrasonography. The majority of women with PCOS are overweight or obese, and, at least partly, obesity-driven metabolic abnormalities often coexist with PCOS. Despite intensive research, it has remained unclear whether PCOS per se is a risk factor of metabolic abnormalities, and cardiovascular disease and events. The main aim of the current work was to investigate whether PCOS is an independent risk factor of metabolic abnormalities and cardiovascular diseases. The study population consisted of the prospective population-based Northern Finland Birth Cohort 1966, and we used data collected at ages 14, 31 and 46. The definition of PCOS was based on self-reported PCOS symptoms at age 31 and/or PCOS diagnosis by age 46. The results revealed that weight gain in early life was a risk factor for the development of PCOS. As for metabolic outcomes, at age 46, normal-weight women with PCOS did not display increased odds of abnormal glucose metabolism. However, weight gain during early adulthood was significantly associated with abnormal glucose metabolism in women with PCOS by age 46. Interestingly, PCOS per se was already associated with elevated blood pressure at age 31 and hypertension at age 46, independently of obesity. Women with PCOS also displayed reduced cardiac vagal activity, which was associated with metabolic abnormalities and hypertension. Furthermore, even though no major anatomical or functional impairments were observed in echocardiography, women with PCOS displayed a significantly greater prevalence of myocardial infarction and a two-fold higher prevalence of cardiovascular events than controls. In conclusion, our findings indicate that even though PCOS is an independent risk factor of metabolic derangements, related obesity is a major metabolic risk factor in these women. The role of PCOS in cardiovascular events per se remains controversial and requires follow-up of this cohort. Given all this, maintaining normal weight and preventing weight gain, especially during early adulthood, should be the main priority in the prevention of adverse metabolic changes in women with PCOS. / Tiivistelmä Munasarjojen monirakkulaoireyhtymä (polycystic ovary syndrome, PCOS) on lisääntymisikäisten naisten yleisin hormonaalinen häiriö aiheuttaen runsaasti sairastavuutta ja terveydenhuollon kustannuksia. PCOS:n diagnostisiin kriteereihin kuuluvat epäsäännöllinen kuukautiskierto, lisääntynyt miessukupuoli-hormonivaikutus sekä monirakkulaiset munasarjat. Merkittävä osa oireyhtymää sairastavista naisista on ylipainoisia tai lihavia ja oireyhtymän kanssa yhtä aikaa esiintyykin useita, ainakin osittain ylipainosta johtuvia, metabolisia häiriöitä. Lukuisista tutkimuksista huolimatta on kuitenkin epäselvää, altistaako PCOS itsessään metabolisille häiriöille sekä sydän- ja verisuonisairauksille. Väitöskirjatutkimuksen tavoitteena oli selvittää, onko PCOS itsenäinen metabolisten ja sydän- ja verisuonisairauksien riskiä lisäävä tekijä. Tutkimus pohjautui Pohjois-Suomen syntymäkohortti 1966 tutkimuksen 14-, 31- ja 46-vuotisseurantoihin. PCOS luokittelu perustui 31- ja 46-vuotiskyselyissä itse ilmoitettuihin tyypillisiin PCOS oireisiin ja/tai diagnoosiin. Tutkimuksessa havaittiin, että 14- ja 31-ikävuoden välillä tapahtuva painonnousu oli yhteydessä PCOS diagnoosiin myöhemmällä iällä. 46-vuotiaana normaalipainoisilla PCOS naisilla ei ollut suurentunut tyypin 2 diabetes riski, mutta painonnousu varhaisaikuisuudessa oli merkittävästi yhteydessä sokeriaineenvaihdunnan häiriöön PCOS naisilla. PCOS oli yhteydessä kohonneeseen verenpaineeseen 31-vuotiaana ja hypertensioon 46-vuotiaana ylipainosta riippumatta. Oireyhtymään liittyvät metaboliset häiriöt olivat tärkein sydämen autonomisen hermoston säätelyyn vaikuttava tekijää, kun taas PCOS itsessään ei vaikuttanut autonomisen hermoston toimintaan. PCOS:ään sairastavien naisten sydämen rakenne ja funktio eivät merkitsevästi poikenneet kontrolloiden vastaavista muuttujista. Kuitenkin suhteellisen nuoresta iästä huolimatta PCOS naisilla esiintyi enemmän sydäninfarkteja ja kaksi kertaa enemmän sydän- ja verisuonitapahtumia, kuin kontrolleilla. Tutkimuksen tulokset osoittavat, että vaikkakin PCOS on itsenäinen riskitekijä metabolisille häiriöille, oireyhtymään liittyvä ylipaino vaikuttaa merkittävästi metabolisten häiriöiden esiintymiseen. PCOS:n ja sydän- ja verisuonitautitapahtumien yhteyden tarkempi tutkiminen vaatii kohortin jatkoseurantaa. Painonhallinnan tukemisen tulisi olla PCOS:ää sairastavien naisten hoidon kulmakivi.

O pré-diabetes (PDM), da mesma forma que o diabetes mellitus (DM), associa-se com complicações micro e macrovasculares. Existem evidências de que existem anormalidades da homestoase da pressão arterial em indivíduos com PDM. Através da monitorização ambulatorial da pressão arterial (MAPA) é possível identificar o padrão de homeostase pressórica de indivíduos com diferentes graus de tolerância à glicose. Evidências demonstram que as medidas de pressão arterial (PA) obtidas por MAPA apresentam melhor associação com lesões de órgãos alvo se comparadas a medidas obtidas em consultório. Medidas de PA obtidas através de MAPA demonstram melhor correlação com complicações crônicas microvasculares do DM. Entretanto, dispõe-se de poucos dados na literatura sobre o comportamento da pressão arterial de 24 horas em indivíduos com PDM. Este trabalho é inicialmente constituído de uma revisão direcionada sobre homeostase pressórica em indivíduos com diferentes graus de tolerância à glicose seguido de um artigo original a respeito do tema. O artigo se trata de um estudo transversal que avaliou o padrão de homeostase pressórica de 24 horas em 138 indivíduos com diferentes graus de tolerância à glicose. O estudo demonstrou que através da MAPA é possível observar uma elevação dos níveis de pressão arterial ao longo de 24 horas de acordo com a piora da tolerância à glicose. / As diabetes mellitus (DM), prediabetes is associated with microvascular and macrovascular complications. There is evidence of presence of abnormalities in blood pressure (BP) homeostasis in individuals with prediabetes (PDM). Ambulatory blood pressure monitoring (ABPM) enables to identify the pattern of BP homeostasis in individuals with different degrees of glucose tolerance. Evidences have shown that BP measurements obtained by ABPM have a better association with target organ damage compared to measurements obtained in the office. Studies have also shown better correlation of BP measurements obtained by ABPM with microvascular chronic complications of DM. However, there are few data in literature about the behavior of 24 hours BP in subjects with prediabetes. This study consists of a review focused on BP homeostasis in subjects with different degrees of glucose tolerance and an original article about this issue. This is a cross-sectional study that evaluated how BP homeostasis behaves along 24 hours in 138 subjects with different degrees of glucose tolerance. The study demonstrated that through the ABPM is possible to observe an increase in blood pressure levels over 24 hours according to a worsening of glucose tolerance.

<p>Obesity is a globally increasing disease particularly in developing countries and among children. It is mainly caused by intake of diets high in fat and the lack of physical activity. Obesity is a risk factor for diseases such as type II diabetes, high blood pressure, high cholesterol and certain cancers. Prediabetes is a condition where blood glucose levels are above normal but have not&nbsp / reached those of diabetes. It is difficult to diagnose, as there are no signs or symptoms. Some type II diabetes patients bear no symptoms at all and the disease is discovered late. Proteomics is a field that can provide opportunities for early diagnosis of diseases through biomarker discovery. The early diagnosis of diabetes can assist in the prevention and treatment of diabetes. Therefore there is a need for the early diagnosis of diabetes. Twenty Wistar rats were used. The rats were initially fed a CHOW diet, which is the standard balanced diet for rats, for 4 weeks. The rats were then divided into 2 groups of 10 where 1 group was fed CHOW and another was fed a high fat (HF) diet in order to induce obesity. The two groups were fed their respective diets for 18 weeks. Rats were weighed. Rats were placed in metabolic chambers and 24 hour urine samples were collected. Ketone levels were measured by Ketostix. Urine proteins were precipitated by acetone, quantified and separated on both the 1D SDS-PAGE and the 2D SDS-PAGE. Protein expression changes between CHOW and HF fed rats were determined and identified using MALDI-TOF mass spectrometry. Protein spots intensities increased and decreased between the CHOW and HF fed rats. Transducin (beta)-like 3 was identified as the only differentially expressed protein, which might serve as a potential biomarker for prediabetes.</p>