Purpose The purpose of the study was to (1) characterize leptin in Mexican Americans with poorly controlled type 2 diabetes, (2) examine relationships among leptin and indicators of diabetes status (body mass index and A1C), and (3) explore the effects of a culturally tailored diabetes self-management education intervention on leptin.

Methods In Starr County, an impoverished Texas-Mexico border community, 252 Mexican Americans with type 2 diabetes were recruited to test a diabetes self-management education intervention culturally tailored in terms of language, dietary recommendations, social emphasis, family participation, and incorporation of cultural health beliefs. Groups of 8 participants were randomized to experimental or wait-listed control conditions. Outcomes were measured at 3, 6, and 12 months; by 12 months, 109 had complete leptin data. Read More

Purpose The purpose of this cross-sectional, descriptive study was to explore the characteristics of herbal remedy use for diabetes among Latinos/Hispanics with type 2 diabetes.

Methods A convenience sample of 75 Latino/Hispanic adults with type 2 diabetes was recruited from community-based settings in North Carolina. Data were collected through face-to-face bilingual interviews. Measures included a demographic questionnaire; the Traditional, Complementary, and Alternative Practices Questionnaire; and biophysical indicators of A1C and body mass index. Read More

OBJECTIVE To compare a modified fixed meal dosing strategy to flexible meal dosing in hospitalized patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS Patients (N = 126) with refractory hyperglycemia or requiring at least 20 units of insulin per day were randomly assigned to fixed meal dosing (including withholding the dose if less than half of the meal tray was consumed) or flexible meal dosing based upon carbohydrate intake. The inpatient diabetes management team made all treatment adjustments. Outcomes included day 3 mean glucose, 72-h glucose trend analysis, hypoglycemia (<3.9 mmol/L), and inpatient diabetes treatment satisfaction. Read More

Background The childhood obesity epidemic has been accompanied by an increasing prevalence of type 2 diabetes (T2D), particularly in minority children. 20-30% of obese youth have “pre-diabetes” a precursor to diabetes marked by insulin resistance, β-cell dysfunction and impaired glucose tolerance (IGT). The Diabetes Prevention Program (DPP) demonstrated that T2D could be prevented/delayed by intensive lifestyle modification in adults with pre-diabetes, but efficacy of similar interventions in youth has not been established. Therefore, we evaluated the effects of the Bright Bodies Healthy Lifestyle Program on 2-hr OGTT glucose in comparison to adolescents receiving standard of care.

Methods Parallel-group randomized controlled trial comparing Bright Bodies (BB) with standard clinical care (CC) in obese adolescents (10-16 yo, Tanner stage >2) with elevated OGTT 2-hr blood glucose (130-199 mg/dl) from a racial/ethnically diverse population. OGTTs, including cardiovascular and anthropometric assessments, were conducted at baseline and 6 months. Children attended BB twice per week for exercise and nutrition/behavior modification and CC group received clinical care from their pediatrician. Read more

Diabetes Care: September 23, 2013

OBJECTIVE Fasting is not routinely recommended for renal function tests, despite the known effects of cooked meat on creatinine. We therefore studied variation in creatinine and estimate glomerular filtration rate (eGFR) following a standardised cooked meat meal in 80 subjects: healthy volunteers, diabetes patients with chronic kidney disease (CKD) stages 1 & 2, 3A, 3B and 4 (n=16/group).

RESEARCH DESIGN AND METHODS The interventions were a standardised cooked meat and a non-meat meal, each providing approximately 54g protein, together with 250 mls of water, on separate days. Fasting and post-prandial blood samples at 1, 2, and 4 hours were drawn for creatinine measurement using kinetic alkaline picrate assay on an Olympus AU640 analyser. The modified 4-variable MDRD equation traceable to isotope dilution mass spectrometry creatinine was used to calculate eGFR. Read More

SAGE: 9/19/13

Purpose The purpose of this study was to evaluate the effectiveness of a Community Health Worker (CHW)–led diabetes self-management education (DSME) program and to understand how CHWs and primary care providers (PCPs) work together to provide comprehensive diabetes care.

Methods A quantitative pre- and postassessment of change in patients’ blood glucose levels (A1C), blood pressure, and body mass index was performed to determine the clinical effectiveness of the program. Qualitative, semi-structured interviews with 5 CHWs and 7 PCPs were conducted to assess how CHWs were incorporated into clinical teams and their impact on care delivery and diabetes-related outcomes. Read More

OBJECTIVE Elevated plasma free fatty acids (FFAs) are one important link between excess visceral adiposity, insulin resistance, and the development of type 2 diabetes. Effects of lifestyle interventions on FFA metabolism are poorly known. This open-label study was conducted to test the effects of a 1-year healthy eating/physical activity intervention program on plasma FFA homeostasis in 117 viscerally obese men with dyslipidemia associated with insulin resistance (waist circumference ≥90 cm, triglycerides ≥1.69 mmol/L, and/or HDL-cholesterol <1.03 mmol/L).

RESEARCH DESIGN AND METHODS Body weight, body composition, and fat distribution were assessed by dual-energy X-ray absorptiometry/computed tomography. Oral loads of lipid (60 g fat/m² body surface area) and glucose (75 g) were measured before and after the intervention. Read more