Diabetes Management in Older Adults With Chronic Kidney Disease
AbstractPurpose of ReviewOlder adults often live with chronic disease including diabetes and its complications. In this review, we examine the complexity and heterogeneity of older adults with diabetes and chronic kidney disease, explore the nuances in their diabetes-related monitoring, and discuss their best diabetes management.Recent FindingsAlthough there remains an overall lack of studies in older adults with diabetes and chronic kidney disease, recent reports have highlighted their vulnerabilities. These individuals face an increased risk of cognitive impairment and dementia, frailty, dysglycemia, polypharmacy, declin...
Source: Current Diabetes Reports - February 15, 2019 Category: Endocrinology Source Type: research

Type 2 Diabetes Self-Management in Non-Hispanic Black Men: a Current State of the Literature
This article discusses the state of type 2 diabetes (T2D) self-management research on non-Hispanic Black men with a focus on their knowledge of diabetes, factors that impact T2D self-management and intervention research that specifically targets non-Hispanic Black men with T2D.Recent FindingsStudies on T2D knowledge and barriers and facilitators to T2D self-management in non-Hispanic Black men are limited to small qualitative focus group and in-depth interviews. To date, few T2D interventions for non-Hispanic Black men have been developed and tested.SummaryResearch shows that non-Hispanic Black men ’s knowledge of T2...
Source: Current Diabetes Reports - February 11, 2019 Category: Endocrinology Source Type: research

Epigenetic Risk Profile of Diabetic Kidney Disease in High-Risk Populations
AbstractPurpose of ReviewEpigenetic variations have been shown to reveal vulnerability to diabetes and its complications. Although it has become clear that metabolic derangements, especially hyperglycemia, can impose a long-term metabolic memory that predisposes to diabetic complications, the underlying mechanisms remain to be understood. It has been suggested that epigenetics (e.g., histone modification, DNA methylation, and non-coding RNAs) help link metabolic disruption to aberrancies related to diabetic kidney disease (DKD). In this review, we discuss the key findings and advances made in the epigenetic risk profile of...
Source: Current Diabetes Reports - February 7, 2019 Category: Endocrinology Source Type: research

Diabetes in the Middle East: Government Health Care Policies and Strategies that Address the Growing Diabetes Prevalence in the Middle East
AbstractPurpose of reviewDiabetes is a primary public health concern and a challenge for health decision makers in this century. Though the number of people with diabetes is increasing all over the globe, the very high prevalence of diabetes in many Middle East countries has made this region one of the global diabetes hot spots. Due to rapid socioeconomic growth, lifestyle changes and increasing obesity prevalence, the number of people with diabetes is expected to double by 2045 in this region. This high prevalence of diabetes imposes a substantial socioeconomic impact on the individual and governments in this region. The ...
Source: Current Diabetes Reports - February 4, 2019 Category: Endocrinology Source Type: research

New Areas of Interest: Is There a Role for Omega-3 Fatty Acid Supplementation in Patients With Diabetes and Cardiovascular Disease?
AbstractPurpose of ReviewSummarize studies on omega-3 fatty acids in prevention of albuminuria in subjects with diabetes.Recent FindingsSeveral small, short-term trials suggested benefit on albuminuria in subjects with diabetes; however, results were not definitive. Welty et al. showed that eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) for 1  year slowed progression of early-stage albuminuria in subjects with diabetes with clinical coronary artery disease on an angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker, the majority of whom had an albumin/creatinine ratio (ACR)  &thins...
Source: Current Diabetes Reports - January 25, 2019 Category: Endocrinology Source Type: research

Adaptive Intervention Designs to Promote Behavioral Change in Adults: What Is the Evidence?
AbstractPurpose of ReviewAdaptive behavioral interventions tailor the type or dose of intervention strategies to individuals over time to improve saliency and intervention efficacy. This review describes the unique characteristics of adaptive intervention designs, summarizes recent diabetes-related prevention studies, which used adaptive designs, and offers recommendations for future research.Recent FindingsEight adaptive intervention studies were reported since 2013 to reduce sedentary behavior or improve weight management in overweight or obese adults. Primarily, feasibility studies were conducted. Preliminary results su...
Source: Current Diabetes Reports - January 25, 2019 Category: Endocrinology Source Type: research

Economic Impact of Diabetes in Africa
AbstractPurpose of ReviewThis review seeks to address knowledge gaps around the economic burden of diabetes in Africa. Africa is home to numerous endemic infections and also prevalent non-communicable diseases including diabetes. It is projected that the greatest increases in diabetes prevalence will occur in Africa. The importance of this review therefore lies in providing adequate knowledge on the economic challenges that diabetes poses to the continent and describe the way forward in tackling this epidemic.Recent FindingsDiabetes contributes to a huge amount of the global health expenditure in the world. There is a dear...
Source: Current Diabetes Reports - January 24, 2019 Category: Endocrinology Source Type: research

Mineralocorticoid Antagonism and Diabetic Kidney Disease
AbstractPurpose of ReviewType 2 diabetes (T2D) is associated with an increased risk of diabetic kidney disease (DKD), cardiovascular disease, and heart failure, in part through activation of the renin-angiotensin-aldosterone system (RAAS). Although recent cardiovascular outcome trials have identified newer therapeutic agents such as sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1)-receptor agonists that reduce the risk of these complications, patients still exhibit residual cardiorenal morbidity and mortality. Accordingly, the identification of pharmacological agents that attenuate mic...
Source: Current Diabetes Reports - January 23, 2019 Category: Endocrinology Source Type: research

Youth-Onset Type 2 Diabetes and the Developing Brain
AbstractPurpose of ReviewThis review describes the literature evaluating the potential adverse effects of youth-onset type 2 diabetes on the developing brain. A summary of recently published articles and the current state of knowledge are covered succinctly in this manuscript.Recent FindingsCurrent literature suggests both cognitive and brain structural differences are found in youth with type 2 diabetes. Studies have shown poorer scores in a number of neurocognitive domains, particularly in areas of executive functioning and memory. Additionally, imaging studies have found differences in brain gray matter volume, white ma...
Source: Current Diabetes Reports - January 21, 2019 Category: Endocrinology Source Type: research

Economic Impact of Diabetes in Japan
AbstractPurpose of reviewThe economic burden of diabetes in Japan is already serious and will become greater in the future. We review the economic impact of diabetes in Japan to examine viable options for mitigating its effects.Recent findingsMedical costs for diabetes have been increasing by US  $1 million annually, reaching US $11 million in 2009, of which US $7 million was accounted for by people aged 65 years or older. The quality of treatment of diabetes in Japan is higher than in other regions in the world. This can be more effective for achieving glycemic control, but is also m ore expensive com...
Source: Current Diabetes Reports - January 16, 2019 Category: Endocrinology Source Type: research

Breastfeeding and Type 2 Diabetes: Systematic Review and Meta-Analysis
AbstractPurpose of ReviewBreastfeeding has short- and long-term benefits for child health. In this systematic review, we updated a review on the association between breastfeeding and type 2 diabetes.Recent FindingsA meta-analysis published in 2015 reported that breastfeeding protects against type 2 diabetes (pooled odds ratio, 0.65 (95% confidence interval, 0.48; 0.86)). In the present update, we identified three recently published studies. An internet-based study reported that at a mean age of 25.6  years, exclusive breastfeeding in the first 6 months protected against type 2 diabetes (odds ratio, 0.63 (95% conf...
Source: Current Diabetes Reports - January 14, 2019 Category: Endocrinology Source Type: research

Innovations in Professional Inpatient Diabetes Education
AbstractPurpose of reviewIn the rapidly evolving and complex field of inpatient diabetes, complex care teams of physicians, nurse practitioners, physician assistants, nurses, and pharmacists are challenged to remain well informed of the latest clinical treatments and health care trends. Traditional continuing medical education (CME) and continuing education unit (CEU) strategies that require travel and/or time away from work pose a major barrier. With advancements in technology, there are media and other electronic strategies for delivering CME/ CEU that may overcome these current challenges.Recent FindingsElectronic and i...
Source: Current Diabetes Reports - November 21, 2018 Category: Endocrinology Source Type: research

Advancing Health Policy and Program Research in Diabetes: Findings from the Natural Experiments for Translation in Diabetes (NEXT-D) Network
AbstractPurpose of ReviewTo advance our understanding of the impacts of policies and programs aimed at improving detection, engagement, prevention, and clinical diabetes management in the USA, we synthesized findings from a network of studies that used natural experiments to evaluate diabetes health policies and programs.FindingsStudies from the Natural EXperiments for Translation in Diabetes (NEXT-D) network used rigorous longitudinal quasi-experimental study designs (e.g., interrupted time series) and analytical methods (e.g., difference-in-differences) to augment causal inference. Investigators partnered with health sys...
Source: Current Diabetes Reports - November 20, 2018 Category: Endocrinology Source Type: research

Genetics of Obesity in Diverse Populations
AbstractPurpose of ReviewThe prevalence of obesity continues to rise, fueling a global public health crisis characterized by dramatic increases in type 2 diabetes, cardiovascular disease, and many cancers. In the USA, several minority populations, who bear much of the obesity burden (47% in African Americans and Hispanic/Latinos, compared to 38% in European descent groups), are particularly at risk of downstream chronic disease. Compounding these disparities, most genome-wide association studies (GWAS) —including those of obesity—have largely been conducted in populations of European or East Asian ancestry. In ...
Source: Current Diabetes Reports - November 19, 2018 Category: Endocrinology Source Type: research

Phenotypic and Genetic Characteristics of Lipodystrophy: Pathophysiology, Metabolic Abnormalities, and Comorbidities
This article focuses on recent progress in understanding the genetics of lipodystrophy syndromes, the pathophysiology of severe metabolic abnormalities caused by these syndromes, and causes of severe morbidity and a possible signal of increased mortality associated with lipodystrophy. An updated classification scheme is also presented.Recent findingsLipodystrophy encompasses a group of heterogeneous rare diseases characterized by generalized or partial lack of adipose tissue and associated metabolic abnormalities including altered lipid metabolism and insulin resistance. Recent advances in the field have led to the discove...
Source: Current Diabetes Reports - November 8, 2018 Category: Endocrinology Source Type: research

The Evolving Role of the Cardiologist in the Management of Type 2 Diabetes
AbstractPurpose of ReviewTo evaluate the treatment of type 2 diabetes from a cardiologist ’s view.Recent FindingsA new era in the treatment of type 2 diabetes began for the cardiologist in 2015 with the publication of the EMPA-REG outcome trial finding a significant reduction in CV death with empagliflozin (oral sodium-glucose co-transporter-2 [SGLT2] inhibitor) in patients with type 2 diabetes at increased cardiovascular risk. Shortly thereafter, the injectable glucagon-like peptide agonists (GLP-1) liraglutide and semaglutide found a significant reduction in composite major cardiovascular events (CV death, non-fata...
Source: Current Diabetes Reports - November 8, 2018 Category: Endocrinology Source Type: research

Implications of the CANVAS Study in Reducing Cardiovascular Outcomes
AbstractPurpose of ReviewIn recent years, Cardiovascular Outcome Event Trials (CVOTs) in type 2 diabetes mellitus (T2DM) have demonstrated that sodium glucose transporter 2 inhibitors (SGLT2i) could reduce major adverse cardiovascular events (MACE) and cardiovascular mortality independent of a glucose lowering mechanism. SGLT2i trials reported significant results that have generated biologically plausible theories with regard to the macrovascular benefit. In this review, we have summarized and discussed the results of the CANVAS program.Recent FindingsThe CANVAS program is unique as it is an analysis of two aggregated coho...
Source: Current Diabetes Reports - November 5, 2018 Category: Endocrinology Source Type: research

Genetics of Monogenic Diabetes: Present Clinical Challenges
AbstractPurpose of ReviewMonogenic forms of diabetes have specific treatments that differ from the standard care provided for type 1 and type 2 diabetes, making the appropriate diagnosis essential. In this review, we discuss current clinical challenges that remain, including improving case-finding strategies, particularly those that have transethnic applicability, and understanding the interpretation of genetic variants as pathogenic, with clinically meaningful impacts.Recent FindingsBiomarker approaches to the stratification for genetic testing now appear to be most effective in identifying cases of monogenic diabetes, an...
Source: Current Diabetes Reports - October 30, 2018 Category: Endocrinology Source Type: research

Update on Therapeutic Options in Lipodystrophy
AbstractPurpose of ReviewThe purpose of this review is to summarize the therapeutic approach for lipodystrophy syndromes with conventional treatment options and metreleptin therapy in detail and to point out the current investigational treatments in development.Recent FindingsThe observation of leptin deficiency in patients with lipodystrophy and the potential of leptin replacement to rescue metabolic abnormalities in animal models of lipodystrophy were followed by the first clinical study of leptin therapy in patients with severe lipodystrophy. This and several other long-term studies demonstrated important benefits of re...
Source: Current Diabetes Reports - October 29, 2018 Category: Endocrinology Source Type: research

Comparison of Lipid-Lowering Medications and Risk for Cardiovascular Disease in Diabetes
AbstractPurpose of the ReviewTo summarize available evidence regarding lipid-lowering interventions for the prevention of cardiovascular disease in patients with diabetes.Recent FindingsStatins and non-statin therapies that act through upregulation of LDL receptor expression are associated with similar cardiovascular risk reduction per decrease in LDL cholesterol.SummaryIn subjects with diabetes, with or without established cardiovascular disease, each 39  mg/dl reduction in LDL cholesterol observed with statins is associated with a 21% relative reduction in the risk of major coronary events at 5 years. Statins r...
Source: Current Diabetes Reports - October 29, 2018 Category: Endocrinology Source Type: research

Non-Diabetic Hyperglycemia in the Pediatric Age: Why, How, and When to Treat?
AbstractPurpose of reviewNon-diabetic hyperglycemia (NDHY) is a pathological condition that is not yet well known. The aim of this review is to examine approaches for management of this condition.Recent findingsWhile it is well known that persistent hyperglycemia in diabetes affects immune response and risk for diabetes-related micro- and macrovascular complications, little is known about the biological effects of transient NDHY, particularly in the pediatric age group.SummaryStress HY (SHY) is typically defined as blood glucose>  8.33 mmol/L (150 mg/dL) during physical stress, resolving spontaneously after dissi...
Source: Current Diabetes Reports - October 29, 2018 Category: Endocrinology Source Type: research

Blood Pressure Variability and Autonomic Dysfunction
AbstractPurpose of ReviewThis review considers the relationship between abnormal blood pressure (BP) variability and autonomic dysfunction through an attempt to answer questions about its clinical relevance and pertinence to diabetes and cardiovascular autonomic neuropathy (CAN) and which therapeutic measures can lessen its cardiovascular impact.Recent FindingsOffice, ambulatory, and home BP monitoring identify posture-related, circadian, short-term, and long-term BP variabilities. Abnormal BP variability is a risk marker for organ damage, mortality, and cardiovascular events. Moreover, BP variability changes are common in...
Source: Current Diabetes Reports - October 25, 2018 Category: Endocrinology Source Type: research

The Environmental Determinants of Diabetes in the Young (TEDDY) Study: 2018 Update
AbstractPurpose of ReviewThe environmental triggers of islet autoimmunity leading to type 1 diabetes (T1D) need to be elucidated to inform primary prevention. The Environmental Determinants of Diabetes in the Young (TEDDY) Study follows from birth 8676 children with T1D risk HLA-DR-DQ genotypes in the USA, Finland, Germany, and Sweden. Most study participants (89%) have no first-degree relative with T1D. The primary outcomes include the appearance of one or more persistent islet autoantibodies (islet autoimmunity, IA) and clinical T1D.Recent FindingsAs of February 28, 2018, 769 children had developed IA and 310 have progre...
Source: Current Diabetes Reports - October 23, 2018 Category: Endocrinology Source Type: research

Revisiting the Diabetes-Heart Failure Connection
AbstractPurpose of the ReviewTo summarize current clinical data investigating the link between diabetes and heart failure pathophysiology, the association of glucose control with heart failure, and the impact of current antihyperglycemic drugs on heart failure.Recent FindingsAlthough heart failure is one of the most prevalent outcomes occurring in real life and cardiovascular outcome trials, insufficient attention was given to this condition in diabetes research over the last decades. With both beneficial and detrimental findings for heart failure hospitalization in the health authority –mandated outcome trials for n...
Source: Current Diabetes Reports - October 20, 2018 Category: Endocrinology Source Type: research

Who Will Win: Induced Pluripotent Stem Cells Versus Embryonic Stem Cells for β Cell Replacement and Diabetes Disease Modeling?
AbstractPurpose of ReviewEver since the reprogramming of human fibroblasts to induced pluripotent stem cells (hiPSCs), scientists have been trying to determine if hiPSCs can give rise to progeny akin to native terminally differentiated cells as human embryonic stem cells (hESCs) do. Many different somatic cell types have been successfully reprogrammed via a variety of methods. In this review, we will discuss recent studies comparing hiPSCs and hESCs and their ability to differentiate to desired cell types as well as explore diabetes disease models.Recent FindingsBoth somatic cell origin and the reprogramming method are imp...
Source: Current Diabetes Reports - October 20, 2018 Category: Endocrinology Source Type: research

Chronic Care Management Services for Complex Diabetes Management: a Practical Overview
AbstractPurpose of ReviewFormalized chronic care management has the potential to improve the quality and cost-effectiveness of complex diabetes management in adults, but has historically not been sustainably supported by health care systems. This review discusses the application of the chronic care model in the care of complex diabetes and its translation in the current reimbursement structure designed by Centers for Medicare and Medicaid Services (CMS).Recent FindingsFollowing the introduction of Wagner ’s Chronic Care Model (CCM) in the late 1990s, evidence gathered over the past 2 decades has supported the shift i...
Source: Current Diabetes Reports - October 20, 2018 Category: Endocrinology Source Type: research

A Review of Data of Findings on Night Shift Work and the Development of DM and CVD Events: a Synthesis of the Proposed Molecular Mechanisms
AbstractPurpose of ReviewNight shift work has become highly prevalent in our 24/7 societies, with up to 18% of the US work force working alternate shift schedules. However, studies indicate that there may be adverse health effects of chronic night work across diverse populations. These effects are likely due to misalignment of the circadian system with work schedules, mediated by the system ’s primary marker melatonin as well as other downstream molecules.Recent FindingsMelatonin has multiple biologic actions that are relevant to cardiometabolic disease, including modulation of oxidative stress, inflammation, and (vi...
Source: Current Diabetes Reports - October 20, 2018 Category: Endocrinology Source Type: research

Inflammation Markers in Type 2 Diabetes and the Metabolic Syndrome in the Pediatric Population
We present our current knowledge concerning the potential relationship between these cytokines, inflammation, metabolic syndrome (MetS), and type 2 diabetes mellitus (T2DM) in the pediatric population.Recent FindingsPro-inflammatory cytokines related to insulin resistance and MetS in children are tumor necrosis factor-alpha(TNF- α), interleukin (IL)-6, IL-1β, interferon gamma, pigment epithelium-derived factor, chemerin, vaspin, and fetuin A. Anti-inflammatory cytokines associated with insulin resistance and MetS in children are leptin, adiponectin, omentin, fibroblast growth factor(FGF)-21, osteocalcin, and iri...
Source: Current Diabetes Reports - October 18, 2018 Category: Endocrinology Source Type: research

Effect of Health Information Technologies on Glycemic Control Among Patients with Type 2 Diabetes
This study was to present meta-analysis findings across selected clinical trials for the effect of health information technologies (HITs) on glycemic control among patients with type 2 diabetes.Recent FindingsHITs may be promising in diabetes management. However, findings on effect size of glycated hemoglobin level (HbA1c) yielded from HITs varied across previous studies. This is likely due to heterogeneity in sample size, adherence to standard quantitative method, and/or searching criteria (e.g., type of HITs, type of diabetes, specification of patient population, randomized vs. nonrandomized trials).SummaryWe systematica...
Source: Current Diabetes Reports - October 18, 2018 Category: Endocrinology Source Type: research

Gut Microbiome in Obesity, Metabolic Syndrome, and Diabetes
AbstractPurpose of ReviewObesity and diabetes are worldwide epidemics. There is also a growing body of evidence relating the gut microbiome composition to insulin resistance. The purpose of this review is to delineate the studies linking gut microbiota to obesity, metabolic syndrome, and diabetes.Recent findingsAnimal studies as well as proof of concept studies using fecal transplantation demonstrate the pivotal role of the gut microbiota in regulating insulin resistance states and inflammation.SummaryWhile we still need to standardize methodologies to study the microbiome, there is an abundance of evidence pointing to the...
Source: Current Diabetes Reports - October 18, 2018 Category: Endocrinology Source Type: research

Pathogenesis of Lipid Disorders in Insulin Resistance: a Brief Review
AbstractPurpose of reviewInsulin resistance (IR) is recognized to play an important role in the pathogenesis of dyslipidemia. This review summarizes the complex interplay between IR and dyslipidemia in people with and without diabetes.Recent findingsIR impacts the metabolism of triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and very low-density lipoprotein cholesterol (VLDL-C) by several mechanisms. Trials with insulin sensitizing therapies, including biguanides and thiazolidinediones, have provided inconsistent results on lipid lowering in people with and without ...
Source: Current Diabetes Reports - October 17, 2018 Category: Endocrinology Source Type: research

Fat Versus Carbohydrate-Based Energy-Restricted Diets for Weight Loss in Patients With Type 2 Diabetes
AbstractPurpose of ReviewThe prevalence of combined obesity and diabetes has increased dramatically in the last few decades. Although medical and surgical weight management are variably effective in addressing this epidemic, it is essential to parallel these strategies with a hypocaloric diet comprising the appropriate macronutrient composition to induce weight loss, enhance glycemic control, and improve cardiovascular risk factors. This review reports the current evidence of the role of carbohydrates and fat-based diets for weight management in patients with combined type 2 diabetes (T2D) and obesity.Recent FindingsLow-ca...
Source: Current Diabetes Reports - October 17, 2018 Category: Endocrinology Source Type: research

Beyond Statins: Who and When to Prescribe?
AbstractPurpose of ReviewStatins are the most evidence-based therapy to target LDL-C to reduce atherosclerotic events. Yet, many people are unable to achieve adequate reduction in this key atherogenic factor. Moreover, residual risk of cardiovascular events may persist even after “optimal” LDL-C due to elevations in triglyceride-rich lipoproteins. Therefore, additional therapies beyond statins are needed, particularly in patients with diabetes.Recent FindingsClinical trials with ezetimibe and PCSK9 inhibitors have reported further reductions in cardiovascular events, beyond statins. The latter are particularly ...
Source: Current Diabetes Reports - October 15, 2018 Category: Endocrinology Source Type: research

Diabetes and HIV
AbstractPurpose of ReviewThis review seeks to address the epidemiology and pathophysiological basis of the interaction between HIV infection and diabetes and the implication for treatment. Its importance stems from the current context of the growing burden of both conditions and the possible mechanisms of interactions that may exist but not yet sufficiently examined.Recent FindingsHIV infection is associated with increased risk of insulin resistance, and ART is associated with metabolic derangement and the occurrence of type 2 diabetes. The increasing survival among people with HIV infection in developing countries is para...
Source: Current Diabetes Reports - October 8, 2018 Category: Endocrinology Source Type: research

Pancreas Pathology During the Natural History of Type 1 Diabetes
AbstractPurpose of reviewWe provide an overview of pancreas pathology in type 1 diabetes (T1D) in the context of its clinical stages.Recent findingsRecent studies of pancreata from organ donors with T1D and non-diabetic donors expressing T1D-associated autoantibodies reveal pathological changes/disease mechanisms beyond the well-known loss of β cells and lymphocytic infiltrates of the islets (insulitis), including β-cell stress, dysfunction, and viral infections. Pancreas pathology evolves through disease stages, is asynchronous, and demonstrates a chronic disease that remains active years after diagnosis. Critic...
Source: Current Diabetes Reports - October 6, 2018 Category: Endocrinology Source Type: research

App-Based Insulin Calculators: Current and Future State
AbstractPurpose of ReviewTo perform a comprehensive literature review and critical assessment of peer-reviewed manuscripts addressing the efficacy, safety, or usability of insulin calculator apps.Recent FindingsManaging diabetes with insulin can be complex, and literacy and numeracy skills pose barriers to manual insulin dose calculations. App-based insulin calculators are promising tools to help people with diabetes administer insulin safely and have potential to improve glycemic control. While a large number of apps which assist with insulin dosing are available, there is limited data evaluating their efficacy, safety, a...
Source: Current Diabetes Reports - October 4, 2018 Category: Endocrinology Source Type: research

Ketosis-Prone Diabetes (Flatbush Diabetes): an Emerging Worldwide Clinically Important Entity
AbstractPurpose of ReviewKetosis-prone diabetes or Flatbush diabetes has been widely recognized as a clinical entity since 1984. Most of the early clinical studies focused on African American or Afro-Caribbean individuals. It is now being recognized as an important clinical entity in sub-Saharan Africans, Asian and Indian populations, and Hispanic populations. Major questions remain as to its pathogenesis and whether it is a unique type of diabetes or a subset of more severe type 2 diabetes with greater loss of insulin action in target tissues. This review summarizes the main clinical and mechanistic studies to improve the...
Source: Current Diabetes Reports - October 2, 2018 Category: Endocrinology Source Type: research

Epigenetics Variation and Pathogenesis in Diabetes
AbstractPurpose of ReviewGreat strides have recently been made in elucidating the role of genetic sequence variation in diabetes pathogenesis. Increasingly, studies are focusing on other factors that may contribute to the pathogenesis of diabetes, such as epigenetics, a term “traditionally” encompassing changes to the DNA that do not alter sequence and are heritable (primary methylation and histone modification) but often expanded to include microRNAs. This review summarizes latest findings on the role of epigenetics in diabetes pathogenesis.Recent FindingsRecent studies illustrate roles for methylation changes...
Source: Current Diabetes Reports - October 2, 2018 Category: Endocrinology Source Type: research

Can We Re-Engineer the Endocrine Pancreas?
AbstractPurpose of ReviewEngineering endocrine pancreatic tissue is an emerging topic in type 1 diabetes with the intent to overcome the current limitation of β cell transplantation. During islet isolation, the vascularized structure and surrounding extracellular matrix (ECM) are completely disrupted. Once implanted, islets slowly engraft and mostly are lost for the initial avascular phase. This review discusses the main building blocks required to engin eer the endocrine pancreas: (i) islet niche ECM, (ii) islet niche vascular network, and (iii) new available sources of endocrine cells.Recent FindingsCurrent approach...
Source: Current Diabetes Reports - October 2, 2018 Category: Endocrinology Source Type: research

Ketosis-Prone Diabetes (Flatbush Diabetes): an Emerging Worldwide Clinically Important Entity
AbstractPurpose of ReviewKetosis-prone diabetes or Flatbush diabetes has been widely recognized as a clinical entity since 1984. Most of the early clinical studies focused on African American or Afro-Caribbean individuals. It is now being recognized as an important clinical entity in sub-Saharan Africans, Asian and Indian populations, and Hispanic populations. Major questions remain as to its pathogenesis and whether it is a unique type of diabetes or a subset of more severe type 2 diabetes with greater loss of insulin action in target tissues. This review summarizes the main clinical and mechanistic studies to improve the...
Source: Current Diabetes Reports - October 2, 2018 Category: Endocrinology Source Type: research

Epigenetics Variation and Pathogenesis in Diabetes
AbstractPurpose of ReviewGreat strides have recently been made in elucidating the role of genetic sequence variation in diabetes pathogenesis. Increasingly, studies are focusing on other factors that may contribute to the pathogenesis of diabetes, such as epigenetics, a term “traditionally” encompassing changes to the DNA that do not alter sequence and are heritable (primary methylation and histone modification) but often expanded to include microRNAs. This review summarizes latest findings on the role of epigenetics in diabetes pathogenesis.Recent FindingsRecent studies illustrate roles for methylation changes...
Source: Current Diabetes Reports - October 2, 2018 Category: Endocrinology Source Type: research

Can We Re-Engineer the Endocrine Pancreas?
AbstractPurpose of ReviewEngineering endocrine pancreatic tissue is an emerging topic in type 1 diabetes with the intent to overcome the current limitation of β cell transplantation. During islet isolation, the vascularized structure and surrounding extracellular matrix (ECM) are completely disrupted. Once implanted, islets slowly engraft and mostly are lost for the initial avascular phase. This review discusses the main building blocks required to engin eer the endocrine pancreas: (i) islet niche ECM, (ii) islet niche vascular network, and (iii) new available sources of endocrine cells.Recent FindingsCurrent approach...
Source: Current Diabetes Reports - October 2, 2018 Category: Endocrinology Source Type: research

Diabetes, Depression, and Cognition: a Recursive Cycle of Cognitive Dysfunction and Glycemic Dysregulation
AbstractPurpose of ReviewThe study aims to examine the effects of diabetes and depression on executive functioning (EF) and to review the effects of EF deficits on diabetes management.Recent FindingsBoth type 2 diabetes and depression influence EF, and in turn, EF has an impact on diabetes management.SummaryIndividuals with both comorbidities (i.e., diabetes and depression) experience greater deficits in EF than individuals with just one of the morbidities (i.e., depression or diabetes). The disruption in EF results in poor diabetes management and poor emotion regulation which ultimately increases the probability of a recu...
Source: Current Diabetes Reports - September 28, 2018 Category: Endocrinology Source Type: research

Glycemic Outcomes of Islet Autotransplantation
AbstractPurpose of ReviewWhile there has been a growing utilization of total pancreatectomy with islet autotransplantation (TPIAT) for patients with medically refractory chronic pancreatitis over the past few decades, there remains a lack of consensus clinical guidelines to inform the counseling and management of patients undergoing TPIAT. In this article, we review the current clinical practice and published experience of several TPIAT centers, outline key aspects in managing patients undergoing TPIAT, and discuss the glycemic outcomes of this procedure.Recent FindingsAiming for lower inpatient glucose targets immediately...
Source: Current Diabetes Reports - September 28, 2018 Category: Endocrinology Source Type: research

The Role of Accessory Cells in Islet Homeostasis
AbstractPurposes of ReviewScattered throughout the pancreas, the endocrine islets rely on neurovascular support for signal relay to regulate hormone secretion and for maintaining tissue homeostasis. The islet accessory cells (or components) of neurovascular tissues include the endothelial cells, pericytes, smooth muscle cells, neurons (nerve fibers), and glia. Research results derived from experimental diabetes and islet transplantation indicate that the accessory cells are reactive in islet injury and can affect islet function and homeostasis in situ or in an ectopic environment.Recent FindingsRecent advances in cell labe...
Source: Current Diabetes Reports - September 28, 2018 Category: Endocrinology Source Type: research

Oral Agents for the Treatment of Gestational Diabetes
AbstractPurpose of ReviewTo review the current evidence of the safety and efficacy of the use of oral agents for treatment of gestational diabetes (GDM).Recent FindingsThe use of metformin and glyburide in pregnancy for treatment of GDM has dramatically increased since the early 2000s. Meta-analyses suggest that glyburide may increase the risk for large for gestational (LGA) infants and neonatal hypoglycemia. Conversely, metformin may potentially decrease rates of pregnancy-induced hypertension, LGA, neonatal hypoglycemia, and maternal weight gain. However, recent long-term offspring studies indicate a potential detrimenta...
Source: Current Diabetes Reports - September 28, 2018 Category: Endocrinology Source Type: research

Diabetes, Depression, and Cognition: a Recursive Cycle of Cognitive Dysfunction and Glycemic Dysregulation
AbstractPurpose of ReviewThe study aims to examine the effects of diabetes and depression on executive functioning (EF) and to review the effects of EF deficits on diabetes management.Recent FindingsBoth type 2 diabetes and depression influence EF, and in turn, EF has an impact on diabetes management.SummaryIndividuals with both comorbidities (i.e., diabetes and depression) experience greater deficits in EF than individuals with just one of the morbidities (i.e., depression or diabetes). The disruption in EF results in poor diabetes management and poor emotion regulation which ultimately increases the probability of a recu...
Source: Current Diabetes Reports - September 28, 2018 Category: Endocrinology Source Type: research

Glycemic Outcomes of Islet Autotransplantation
AbstractPurpose of ReviewWhile there has been a growing utilization of total pancreatectomy with islet autotransplantation (TPIAT) for patients with medically refractory chronic pancreatitis over the past few decades, there remains a lack of consensus clinical guidelines to inform the counseling and management of patients undergoing TPIAT. In this article, we review the current clinical practice and published experience of several TPIAT centers, outline key aspects in managing patients undergoing TPIAT, and discuss the glycemic outcomes of this procedure.Recent FindingsAiming for lower inpatient glucose targets immediately...
Source: Current Diabetes Reports - September 28, 2018 Category: Endocrinology Source Type: research

The Role of Accessory Cells in Islet Homeostasis
AbstractPurposes of ReviewScattered throughout the pancreas, the endocrine islets rely on neurovascular support for signal relay to regulate hormone secretion and for maintaining tissue homeostasis. The islet accessory cells (or components) of neurovascular tissues include the endothelial cells, pericytes, smooth muscle cells, neurons (nerve fibers), and glia. Research results derived from experimental diabetes and islet transplantation indicate that the accessory cells are reactive in islet injury and can affect islet function and homeostasis in situ or in an ectopic environment.Recent FindingsRecent advances in cell labe...
Source: Current Diabetes Reports - September 28, 2018 Category: Endocrinology Source Type: research