The Rise of San Antonio as A Center for Diabetes Research

Silicon Hills News: 12/27/13

In July of 2011, San Antonio Mayor Julian Castro led a delegation to Israel on an economic study mission. The mission included signing an agreement withBioJerusalem to promote further cooperation between Israel and San Antonio’s biomedical ecosystem.
Last month, I had the honor to make a mission from Tel Aviv to Geekdomin San Antonio where we held a series of market research and user feedback studies on a new diabetic management platform known as Dario that will soon be launching in the U.K., Australia, and New Zealand.. Read More

A 5-Day High-Fat, High-Calorie Diet Impairs Insulin Sensitivity in Healthy, Young South Asian Men but Not in Caucasian Men

Diabetes: January 2014

South Asians (SAs) develop type 2 diabetes at a younger age and lower BMI compared with Caucasians (Cs). The underlying cause is still poorly understood but might result from an innate inability to adapt to the Westernized diet. This study aimed to compare the metabolic adaptation to a high-fat, high-calorie (HFHC) diet between both ethnicities. Twelve healthy, young lean male SAs and 12 matched Cs underwent a two-step hyperinsulinemic-euglycemic clamp with skeletal muscle biopsies and indirect calorimetry before and after a 5-day HFHC diet. Hepatic triglyceride content (HTG) and abdominal fat distribution were assessed using magnetic resonance imaging and spectroscopy. At baseline, SAs had higher insulin clamp levels than Cs, indicating reduced insulin clearance rate. Despite the higher insulin levels, endogenous glucose production was comparable between groups, suggesting lower hepatic insulin sensitivity in SAs. Read more

Sequence variants in SLC16A11 are a common risk factor for type 2 diabetes in Mexico

Nature: December 25, 2013

Performing genetic studies in multiple human populations can identify disease risk alleles that are common in one population but rare in others1, with the potential to illuminate pathophysiology, health disparities, and the population genetic origins of disease alleles. Here we analysed 9.2 million single nucleotide polymorphisms (SNPs) in each of 8,214 Mexicans and other Latin Americans: 3,848 with type 2 diabetes and 4,366 non-diabetic controls. In addition to replicating previous findings2, 3, 4, we identified a novel locus associated with type 2 diabetes at genome-wide significance spanning the solute carriers SLC16A11 and SLC16A13 (P = 3.9 × 10−13; odds ratio (OR) = 1.29). The association was stronger in younger, leaner people with type 2 diabetes, and replicated in independent samples (P = 1.1 × 10−4; OR = 1.20). The risk haplotype carries four amino acid substitutions, all in SLC16A11; it is present at ~50% frequency in Native American samples and ~10% in east Asian, but is rare in European and African samples. Read More

Independent roles of country of birth and socioeconomic status in the occurrence of type 2 diabetes

Biomedcentral: December 23, 2013

Background

There is strong evidence based on previous studies that ethnicity and socioeconomic status are important determinants of diversity in the occurrence of diabetes. However, the independent roles of socioeconomic status, country of birth and lifestyle factors in the occurrence of type 2 diabetes have not been clearly identified. This study investigated the relationships between socioeconomic status, country of birth and type 2 diabetes in a large diverse sample of residents of New South Wales, Australia, and aged 45 years and over.

Methods

The analysis used self-reported baseline questionnaire data from 266,848 participants in the 45 and Up Study. Educational attainment, work status and income were used as indicators of socioeconomic status. Logistic regression models were built to investigate associations between socioeconomic status, country of birth and type 2 diabetes. Read More

Body fat partitioning does not explain the inter-ethnic variation in insulin sensitivity among Asian ethnicity: the Singapore Adults Metabolism Study (SAMS)

Diabetes December 18, 2013

We previously showed that ethnicity modifies the association between adiposity and insulin resistance. We sought to determine whether differential body fat partitioning or abnormalities in muscle insulin signaling associated with higher levels of adiposity might underlie this observation. We measured insulin sensitivity index (ISI), %body fat, visceral (VAT) and subcutaneous (SAT) adipose tissue, liver fat and intramyocellular lipids (IMCL) in 101 Chinese, 82 Malays and 81 South Asians as well as p-Akt levels in cultured myoblasts from Chinese and South Asians. Lean Chinese and Malays had higher ISI than South Asians. Although ISI was lower in all ethnic groups when %body fat was higher, this association was stronger in Chinese and Malays such that, in overweight individuals, no ethnic differences were observed. These ethnic differences were observed even when %body fat was replaced with fat in other depots. Myoblasts obtained from lean South Asians had lower p-Akt levels than those from lean Chinese. Read more

Prevention of Diabetes With Mediterranean Diets: A Subgroup Analysis of a Randomized Trial

Annals: January 7, 2014

Background: Interventions promoting weight loss can reduce the incidence of type 2 diabetes mellitus. Whether dietary changes without calorie restriction also protect from diabetes has not been evaluated.

Objective: To assess the efficacy of Mediterranean diets for the primary prevention of diabetes in the Prevención con Dieta Mediterránea trial, from October 2003 to December 2010 (median follow-up, 4.1 years).

Design: Subgroup analysis of a multicenter, randomized trial. (Current Controlled Trials: ISRCTN35739639)

Setting: Primary care centers in Spain.

Participants: Men and women without diabetes (3541 patients aged 55 to 80 years) at high cardiovascular risk.

Intervention: Participants were randomly assigned and stratified by site, sex, and age but not diabetes status to receive 1 of 3 diets: Mediterranean diet supplemented with extra-virgin olive oil (EVOO), Mediterranean diet supplemented with nuts, or a control diet (advice on a low-fat diet). No intervention to increase physical activity or lose weight was included. Read More

Clinic-Based Versus Outsourced Implementation of a Diabetes Health Literacy Intervention

Springer: January 2014

We compared two implementation approaches for a health literacy diabetes intervention designed for community health centers.

METHODS

A quasi-experimental, clinic-randomized evaluation was conducted at six community health centers from rural, suburban, and urban locations in Missouri between August 2008 and January 2010. In all, 486 adult patients with type 2 diabetes mellitus participated. Clinics were set up to implement either: 1) a clinic-based approach that involved practice re-design to routinely provide brief diabetes education and counseling services, set action-plans, and perform follow-up without additional financial resources [CARVE-IN]; or 2) an outsourced approach where clinics referred patients to a telephone-based diabetes educator for the same services [CARVE-OUT]. The fidelity of each intervention was determined by the number of contacts with patients, self-report of services received, and patient satisfaction. Intervention effectiveness was investigated by assessing patient knowledge, self-efficacy, health behaviors, and clinical outcomes. Read More