Exaggerated release and preserved insulinotropic action of glucagon-like peptide-1 underlie insulin hypersecretion in glucose-tolerant individuals after Roux-en-Y gastric bypass

Springer: December 2013

Aims/hypothesis

Roux-en-Y gastric bypass (RYGB) improves glycaemic control in part by increasing postprandial insulin secretion through exaggerated glucagon-like peptide (GLP)-1 release. However, it is unknown whether islet cell responsiveness to i.v. glucose, non-glucose (arginine) and incretin hormones, including GLP-1, is altered.

Methods

Eleven severely obese glucose-tolerant individuals underwent three hyperglycaemic clamps with arginine bolus and co-infusion of either GLP-1, glucose-dependent insulinotropic polypeptide (GIP) or saline before, and at 1 week and 3 months after RYGB. In addition, an OGTT was performed before and 3 months after surgery. Read More

Start of insulin therapy in patients with type 2 diabetes mellitus promotes the influx of macrophages into subcutaneous adipose tissue

Springer: December 2013

Aims/hypothesis

Insulin therapy in patients with type 2 diabetes mellitus is accompanied by weight gain characterised by an increase in abdominal fat mass. The expansion of adipose tissue mass is generally paralleled by profound morphological and inflammatory changes. We hypothesised that the insulin-associated increase in fat mass would also result in changes in the morphology of human subcutaneous adipose tissue and in increased inflammation, especially when weight gain was excessive.

Methods

We investigated the effects of weight gain on adipocyte size, macrophage influx, and mRNA expression and protein levels of key inflammatory markers within the adipose tissue in patients with type 2 diabetes mellitus before and 6 months after starting insulin therapy. Read More

Bardoxolone Methyl in Type 2 Diabetes and Stage 4 Chronic Kidney Disease

Nejm: 11/9/13

Impact of Conversation Map™ Education Tools Versus Regular Care on Diabetes-Related Knowledge of People With Type 2 Diabetes: A Randomized, Controlled Study

Diabetes Spectrum: November 2013

Objective. This study compared the effectiveness of Conversation Map™ (CM) education tools versus regular care of adults with type 2 diabetes.

Methods. Participants from Spain and Germany were randomized to either four CM education sessions or regular care. Data were collected at baseline (visit 1), immediately post-education (visit 2), and 6 months later (visit 3). The primary objective was to compare diabetes knowledge between education groups at visit 3, using the Audit of Diabetes Knowledge (ADKnowl) questionnaire (score range 0–100). Read More

Age at type 2 diabetes onset and glycaemic control: results from the National Health and Nutrition Examination Survey (NHANES) 2005–2010

Springer: December 2013

Aims/hypothesis

We tested the hypothesis that age younger than 65 years at type 2 diabetes diagnosis is associated with worse subsequent glycaemic control.

Methods

A cross-sectional analysis of data from participants in the 2005–2010 National Health and Nutrition Examination Survey was performed. For adults with self-reported diabetes, we dichotomised age at diabetes diagnosis as younger (<65 years) vs older (≥65 years). The primary outcome of interest was HbA_1c >9.0% (75 mmol/mol). Secondary outcomes were HbA_1c >8.0% (64 mmol/mol) and >7.0% (53 mmol/mol). We used multivariable logistic regression for analysis. Read more

NIH statement: Family support key to diabetes prevention, management

NIH: November 14, 2013

Diabetes does not strike a person alone. It strikes families and communities. It strikes our nation and the world. During today’s World Diabetes Day and National Diabetes Month this November, we at the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health, renew our efforts to prevent, manage and one day cure diabetes. As well, we encourage families to take steps to improve their health and work together to fight diabetes and its serious and sometimes fatal consequences.

Diabetes affects nearly 26 million Americans, and an estimated 79 million people are at risk for developing the disease. Worldwide, diabetes is on the rise, especially in Asia and the Middle East. For people living with diabetes or at risk for type 2 diabetes, family support is critical to staying healthy. NIDDK has taken important steps to curtail this epidemic, from funding research on diabetes and its complications to providing help through education. Read More

Insulin plus incretin agent combination therapy in type 2 diabetes: a systematic review

Informa Healthcare: November 13, 2013