Building Toward a Population-Based Approach to Diabetes Screening and Prevention for US Adults
AbstractPurpose of reviewEvidence-based treatments for prediabetes can prevent and delay the development of type 2 diabetes in adults. In this review, we propose a framework for population-based diabetes prevention that links screening and prevention activities across key stakeholders. We also discuss gaps in current practice, while highlighting opportunities to improve diabetes screening and prevention efforts population-wide.Recent findingsAwareness of diabetes risk is low, and many adults with prediabetes are not identified through existing screening efforts. Accumulating evidence and policies support expansion of the D...
Source: Current Diabetes Reports - September 19, 2018 Category: Endocrinology Source Type: research

Advancing Measurement of Diabetes at the Population Level
AbstractPurposeThe measurement and estimation of diabetes in populations guides resource allocation, health priorities, and can influence practice and future research. To provide a critical reflection on current diabetes surveillance, we provide in-depth discussion about how upstream determinants, prevalence, incidence, and downstream impacts of diabetes are measured in the USA, and the challenges in obtaining valid, accurate, and precise estimates.FindingsCurrent estimates of the burden of diabetes risk are obtained through national surveys, health systems data, registries, and administrative data. Several methodological ...
Source: Current Diabetes Reports - September 19, 2018 Category: Endocrinology Source Type: research

Autonomic Regulation of Glucose Homeostasis: a Specific Role for Sympathetic Nervous System Activation
AbstractPurpose of ReviewCardiometabolic disorders such as obesity, metabolic syndrome and diabetes are increasingly common and associated with adverse cardiovascular outcomes. The mechanisms driving these developments are incompletely understood but likely to include autonomic dysregulation. The latest evidence for such a role is briefly reviewed here.Recent FindingsRecent findings highlight the relevance of autonomic regulation in glucose metabolism and identify sympathetic activation, in concert with parasympathetic withdrawal, as a major contributor to the development of metabolic disorders and an important mediator of...
Source: Current Diabetes Reports - September 19, 2018 Category: Endocrinology Source Type: research

Rethinking Bile Acid Metabolism and Signaling for Type 2 Diabetes Treatment
AbstractPurpose of ReviewHerein, we review the role of FXR and TGR5 in the regulation of hepatic bile acid metabolism, with a focus on how our understanding of bile acid metabolic regulation by these receptors has evolved in recent years and how this improved understanding may facilitate targeting bile acids for type 2 diabetes treatment.Recent FindingsBile acid profile is a key regulator of metabolic homeostasis. Inhibition of expression of the enzyme that is required for cholic acid synthesis and thus determines bile acid profile,Cyp8b1, may be an effective target for type 2 diabetes treatment. FXR and, more recently, TG...
Source: Current Diabetes Reports - September 19, 2018 Category: Endocrinology Source Type: research

Issues in Defining the Burden of Prediabetes Globally
AbstractPurpose of ReviewUsing a global perspective, this review collates evidence on the heterogeneity of prediabetes definitions and diagnostic methods, their clinical and public health implications, and discusses possible options for improvement.Recent FindingsOur review notes that the concept of prediabetes is increasingly recognized worldwide, but against a background of non-uniform definition and diagnostic criteria. This results in widely varying burden estimation.SummaryCurrent evidence shows a variety of prediabetes phenotypes. This reflects biological and diagnostic heterogeneity, resulting from the use of differ...
Source: Current Diabetes Reports - September 19, 2018 Category: Endocrinology Source Type: research

Enteroviral Infections as a Trigger for Type 1 Diabetes
AbstractPurpose of ReviewTo provide an overview of studies that have detected enteroviruses (EV) in samples from people with type 1 diabetes (T1D), the techniques they have used, and which challenges they have encountered.Recent FindingsRecent studies have detected EVs in serum, blood, stools, nasal swabs, and pancreas of people with T1D before or around clinical onset of disease, indicating that an association between EV infections and T1D exists. However, definitive evidence for its role as disease triggers is lacking. Recent access to human samples is starting to provide the necessary tools to define their role in disea...
Source: Current Diabetes Reports - September 19, 2018 Category: Endocrinology Source Type: research

Will Genetic Engineering Carry Xenotransplantation of Pig Islets to the Clinic?
AbstractPurpose of ReviewPorcine islets represent a potentially attractive beta-cell source for xenotransplantation into patients with type 1 diabetes, who are not eligible to islet allo-transplantation due to a lack of suitable human donor organs. Recent progress in genetic engineering/gene editing of donor pigs provides new opportunities to overcome rejection of xeno-islets, to improve their engraftment and insulin secretion capacity, and to reduce the risk for transmission of porcine endogenous retroviruses. This review summarizes the current issues and progress in islet xenotransplantation with special emphasis on gene...
Source: Current Diabetes Reports - September 18, 2018 Category: Endocrinology Source Type: research

Cardiovascular Outcomes Trials Update: Insights from the DEVOTE Trial
AbstractPurpose of ReviewThe DEVOTE study compared the cardiovascular safety of two basal insulins, degludec, and glargine U100 in patients with type 2 diabetes (T2D) at high risk for cardiovascular disease (CVD). In this review, we summarize the results of DEVOTE and provide a clinical perspective.Recent FindingsDEVOTE was a phase 3b, multicenter, international, treat-to-target, double-blind, event-driven trial. Patients with T2D>  50 years of age with prior CVD or>  60 years of age with CVD risk factors were randomly assigned to receive either degludec (n = 3818) or insulin glarg...
Source: Current Diabetes Reports - September 18, 2018 Category: Endocrinology Source Type: research

Red Meat Consumption (Heme Iron Intake) and Risk for Diabetes and Comorbidities?
AbstractPurpose of ReviewTo examine the role of red meat consumption, especially heme iron intake, and risk for diabetes and its comorbidities.Recent FindingsStudies consistently show that consumption of red meat has been contributory to a multitude of chronic conditions such as diabetes, CVD, and malignancies. There are various emerging reasons that strengthen this link —from the basic constituents of red meat like the heme iron component, the metabolic reactions that take place after consumption, and finally to the methods used to cook it. The causative links show that even occasional use raises the risk of T2DM.Su...
Source: Current Diabetes Reports - September 18, 2018 Category: Endocrinology Source Type: research

Vegetarian Diets and the Risk of Diabetes
AbstractPurpose of ReviewWorldwide, diabetes has increased steadily and in recent years, drastically. The majority of diabetes cases are type 2 (T2DM), caused by modifiable risk factors such as diet. Vegetarian diets have been studied over the past few decades for their preventative and therapeutic effects on diabetes and may be more beneficial than medication for diabetes management.Recent FindingsA vegetarian diet characterized by whole plant foods is most beneficial for diabetes prevention and management.SummaryVegetarian diets are inversely associated with risk of developing diabetes independent of the positive associa...
Source: Current Diabetes Reports - September 18, 2018 Category: Endocrinology Source Type: research

Preventing Type 2 Diabetes with Home Cooking: Current Evidence and Future Potential
AbstractPurpose of ReviewVarious dietary regimes have proven effective in preventing diabetes, yet its prevalence is growing. This review ’s goals are to examine the relationship between home cooking and diabetes and to present the literature on home cooking education programs as a novel strategy to improve adherence to healthy nutrition, thus decreasing the risk of diabetes.Recent FindingsConsumption of home-cooked food is linked to healthier nutrition and decreased risk of diabetes. Further, home cooking interventions have a short-term positive impact on nutritional intake of both children and adults, and on diabet...
Source: Current Diabetes Reports - September 14, 2018 Category: Endocrinology Source Type: research

Altered Gut Microbiota in Type 2 Diabetes: Just a Coincidence?
AbstractPurpose of ReviewIn the last decade many studies have suggested an association between the altered gut microbiota and multiple systemic diseases including diabetes. In this review, we will discuss potential pathophysiological mechanisms, the latest findings regarding the mechanisms linking gut dysbiosis and type 2 diabetes (T2D), and the results obtained with experimental modulation of microbiota.Recent FindingsIn T2D, gut dysbiosis contributes to onset and maintenance of insulin resistance. Different strategies that reduce dysbiosis can improve glycemic control.SummaryEvidence in animals and humans reveals differe...
Source: Current Diabetes Reports - September 13, 2018 Category: Endocrinology Source Type: research

Metabolic Abnormalities in Diabetes and Kidney Disease: Role of Uremic Toxins
AbstractPurpose of ReviewChronic kidney disease (CKD) is characterized by the accumulation of uremic retention solutes (URS) and is associated with perturbations of glucose homeostasis even in absence of diabetes. The underlying mechanisms of insulin resistance, β cell failure, and increase risk of diabetes in CKD, however, remain unclear. Metabolomic studies reported that some metabolites are similar in CKD and diabetic kidney disease (DKD) and contribute to the progression to end-stage renal disease. We attempted to discuss the mechanisms involved in the disruption of carbohydrate metabolism in CKD by focusing on th...
Source: Current Diabetes Reports - September 8, 2018 Category: Endocrinology Source Type: research

Optimal Obstetric Management for Women with Diabetes: the Benefits and Costs of Fetal Surveillance
AbstractPurpose of ReviewTo elaborate on the risks and benefits associated with antenatal fetal surveillance for stillbirth prevention in women with diabetes.Recent FindingsWomen with pregestational diabetes have a 3- to 5-fold increased odds of stillbirth compared to women without diabetes. The stillbirth risk in women with gestational diabetes (GDM) is more controversial; while recent data suggest the odds for stillbirth are approximately 50% higher in women with GDM at term (37  weeks and beyond) than in those without GDM, it is unclear if this risk is seen in women with optimal glycemic control. Current profession...
Source: Current Diabetes Reports - September 7, 2018 Category: Endocrinology Source Type: research

Biomarkers in Islet Cell Transplantation for Type 1 Diabetes
AbstractPurpose of ReviewIslet transplantation, an important approach to achieve insulin independence for individuals with type 1 diabetes, is limited by the lack of accurate biomarkers to track beta-cell death post islet infusion. In this review, we will discuss existing and recently described biomarkers.Recent FindingsAs beta cells are killed by the immune system, fragments of beta cell-specific cell-free DNA and proteins are released into the periphery. Several different strategies to identify these fragments have been described. Some circulating, non-coding microRNAs, particularly miRNA-375 are also showing potential t...
Source: Current Diabetes Reports - September 5, 2018 Category: Endocrinology Source Type: research

Diabetes Treatment in the Elderly: Incorporating Geriatrics, Technology, and Functional Medicine
AbstractPurpose of ReviewThe current approach to diabetes in the elderly incorporates components from the comprehensive geriatric approach. The most updated guidelines from the American Diabetes Association reflect influence from the consensus made in 2012 with the American Geriatrics Society. Notably, the framework included the evaluation for geriatric syndromes (falls and urinary incontinence), functional and cognitive abilities. The goal for this review is to provide an updated summary of treatment strategies for community-dwelling older adults. We identified the need to expand our approach by addressing innovative appr...
Source: Current Diabetes Reports - September 5, 2018 Category: Endocrinology Source Type: research

Correction to: Metabolic Abnormalities in the Pathogenesis of Type 1 Diabetes
The original version of this article unfortunately contained a mistake in the author group section. Shuyao Zhang ’s family name was misspelled as “Zheng”. (Source: Current Diabetes Reports)
Source: Current Diabetes Reports - September 1, 2018 Category: Endocrinology Source Type: research

Cardiovascular Effects of Different GLP-1 Receptor Agonists in Patients with Type 2 Diabetes
AbstractPurpose of ReviewGlucagon-like peptide-1 receptor agonists (GLP-1 RAs) have positive effects on weight loss, blood pressure, hyperlipidemia, and glycemic control. They exhibit a broad range of effects on the cardiovascular system that are independent of changes in blood glucose. Cardiovascular outcome trials have demonstrated safety of GLP-1 RAs but results for cardiovascular efficacy were varied. The aim of the present review is the assessment of the effects of GLP-1 RAs on cardiovascular risk factors, and major cardiovascular events.Recent FindingsUse of GLP-1 RAs was associated with relative risk reduction in ca...
Source: Current Diabetes Reports - August 31, 2018 Category: Endocrinology Source Type: research

Immune Mechanisms and Pathways Targeted in Type 1 Diabetes
AbstractPurpose of ReviewThe immunosuppressive agent cyclosporine was first reported to lower daily insulin dose and improve glycemic control in patients with new-onset type 1 diabetes (T1D) in 1984. While renal toxicity limited cyclosporine ’s extended use, this observation ignited collaborative efforts to identify immunotherapeutic agents capable of safely preserving β cells in patients with or at risk for T1D.Recent FindingsAdvances in T1D prediction and early diagnosis, together with expanded knowledge of the disease mechanisms, have facilitated trials targeting specific immune cell subsets, autoantigens, an...
Source: Current Diabetes Reports - August 30, 2018 Category: Endocrinology Source Type: research

The Impact of Childhood and Adolescent Obesity on Cardiovascular Risk in Adulthood: a Systematic Review
AbstractPurpose of ReviewAdult obesity and cardiovascular diseases are closely linked. Yet, the relationship of childhood and adolescent obesities with cardiovascular diseases in adulthood requires additional evidence. The goal of the review is to inspect the relationship between childhood- and adolescent-increased body mass index (BMI) and cardiovascular risk factors, fatal and non-fatal cardiovascular diseases in adulthood.Recent FindingsCardiovascular diseases in adulthood are linked by most of the studies to childhood and adolescent obesities.SummaryStudies showed that childhood and adolescent obesities increased the i...
Source: Current Diabetes Reports - August 30, 2018 Category: Endocrinology Source Type: research

Advances in Closed-Loop Insulin Delivery Systems in Patients with Type 1 Diabetes
AbstractPurpose of ReviewTo provide a current review of closed-loop insulin delivery or artificial pancreas (AP) as therapy for people with type 1 diabetes mellitus (T1D)Recent FindingsThe Medtronic Minimed 670G AP system has been in use in clinical practice since March 2017. Currently, Medtronic is conducting a large randomized clinical trial to evaluate its efficacy further in T1D. Simultaneously, the NIH has funded four research consortia to accelerate progress to approval of other AP and decision support systems. Several research groups are currently developing next-generation AP systems, with a number of companies mov...
Source: Current Diabetes Reports - August 29, 2018 Category: Endocrinology Source Type: research

Early-Life Exposures and Risk of Diabetes Mellitus and Obesity
AbstractPurpose of ReviewType 2 diabetes is a growing concern worldwide with increasing incidence in youth. Development of preventive strategies in earlier stages of life is crucial. We aimed to examine epidemiological evidence of early-life exposures and their associations with childhood and later risk of obesity and diabetes, and to discuss potential mechanisms.Recent FindingsParental obesity and diabetes in the preconception period may influence offspring ’s obesity risk via epigenetic mechanisms influencing gametogenesis and early development that could have significant transgenerational effects. A more comprehen...
Source: Current Diabetes Reports - August 29, 2018 Category: Endocrinology Source Type: research

Designing the Glucose Telemetry for Hospital Management: From Bedside to the Nursing Station
AbstractPurpose of the ReviewHospitalized patients with diabetes are monitored with point-of-care glucose testing. Continuous glucose monitoring (CGM) devices represent an alternative way to monitor glucose values; however, the in-hospital CGM use is still considered experimental. Most inpatient studies used “blinded” CGM properties and only few used the real-time/unblinded CGM features. One major limitation of the CGM devices is that they need to be placed at the patients’ bedside, limiting any therapeutic interventions. In this article, we review the real-time/unblinded CGM use and share our tho ughts a...
Source: Current Diabetes Reports - August 29, 2018 Category: Endocrinology Source Type: research

The Potential Role of Fatty Acids in Treating Diabetic Neuropathy
AbstractPurpose of reviewThis review will summarize recent findings of the effect of supplemental fatty acids, with an emphasis on omega-3 polyunsaturated fatty acids, as a treatment for diabetic peripheral neuropathy.Recent findingsPre-clinical studies have provided evidence that treating diabetic rodents with δ linolenic acid (omega-6 18:3) and to a greater extent with eicosapentaenoic and docosahexaenoic acids (omega-3 20:5 and 22:6, respectively) improve and even reverse vascular and neural deficits. Additional studies have shown resolvins, metabolites of eicosapentaenoic and docosahexaenoic acids, ca n induce ne...
Source: Current Diabetes Reports - August 25, 2018 Category: Endocrinology Source Type: research

Lifestyle Management of Diabetes: Implications for the Bone-Vascular Axis
AbstractPurpose of ReviewTo describe the main pathways involved in the interplay between bone and cardiovascular disease and to highlight the possible impact of physical activity and medical nutrition therapy on the bone-vascular axis.Recent FindingsDiabetes increases the risk of both cardiovascular disease and bone fragility fractures, sharing common pathogenic pathways, including OPG/RANK/RANKL, the FGF23/Klotho axis, calciotropic hormones, and circulating osteogenic cells. This may offer new therapeutic targets for future treatment strategies. As lifestyle intervention is the cornerstone of diabetes treatment, there is ...
Source: Current Diabetes Reports - August 18, 2018 Category: Endocrinology Source Type: research

Genetics of Severe Obesity
AbstractPurpose of ReviewThis review aims to present current information on genes underlying severe obesity, with the main emphasis on the three genesLEP,LEPR andMC4R.Recent FindingsThere is a substantial amount of evidence that variants in at least ten different genes are the cause of severe monogenic obesity. The majority of these are involved in the leptin-melanocortin signalling pathway. Due to the frequency of some of the identified variants, it is clear that monogenic variants also make a significant contribution to common obesity.SummaryThe artificial distinction between rare monogenic obesity and common polygenic o...
Source: Current Diabetes Reports - August 18, 2018 Category: Endocrinology Source Type: research

Prevention and Management of Severe Hypoglycemia and Hypoglycemia Unawareness: Incorporating Sensor Technology
AbstractPurpose of ReviewIn addition to assisting in achieving improved glucose control, continuous glucose monitoring (CGM) sensor technology may also aid in detection and prevention of hypoglycemia. In this paper, we report on the current scientific evidence on the effectiveness of this technology in the prevention of severe hypoglycemia and hypoglycemia unawareness.Recent FindingsRecent studies have found that the integration of CGM with continuous subcutaneous insulin infusion (CSII) therapy, a system known as sensor-augmented pump (SAP) therapy, very significantly reduces the occurrence of these conditions by providin...
Source: Current Diabetes Reports - August 18, 2018 Category: Endocrinology Source Type: research

The Epidemiology of Sleep and Diabetes
AbstractPurpose of ReviewTo provide an overview of the mechanistic and epidemiologic evidence linking sleep-related exposures, such as short sleep duration, obstructive sleep apnea, shift work, and insomnia, with type 2 diabetes risk in adults.Recent FindingsBoth poor sleep habits and sleep disorders are highly prevalent among adults with type 2 diabetes. In observational studies, short sleep duration, obstructive sleep apnea, shift work, and insomnia are all associated with higher risk of incident type 2 diabetes and may predict worse outcomes in those with existing diabetes. However, interventional studies addressing sle...
Source: Current Diabetes Reports - August 17, 2018 Category: Endocrinology Source Type: research

Adjuvant Pharmacotherapies to Insulin for the Treatment of Type 1 Diabetes
AbstractPurpose of ReviewInsulin therapy alone fails to achieve target glycemic control in the majority of individuals with type 1 diabetes (T1D), motivating the investigation of additive medications. This review focuses on the recent findings on the use of adjunctive pharmacotherapy in T1D.Recent FindingsMetformin and glucagon-like peptide-1 receptor agonists have been associated with weight reduction and decrease in daily insulin requirements without sustainable improvement in glycemic control. Sodium-glucose cotransporter (SGLT)-2 inhibitors, dual SGLT-1/2 inhibitors, and pramlintide have been shown to reduce hemoglobin...
Source: Current Diabetes Reports - August 17, 2018 Category: Endocrinology Source Type: research

Emerging Role of AMPK in Brown and Beige Adipose Tissue (BAT): Implications for Obesity, Insulin Resistance, and Type 2 Diabetes
AbstractPurpose of ReviewThe global prevalence of type 2 diabetes (T2D) is escalating at alarming rates, demanding the development of additional classes of therapeutics to further reduce the burden of disease. Recent studies have indicated that increasing the metabolic activity of brown and beige adipose tissue may represent a novel means to reduce circulating glucose and lipids in people with T2D. The AMP-activated protein kinase (AMPK) is a cellular energy sensor that has recently been demonstrated to be important in potentially regulating the metabolic activity of brown and beige adipose tissue. The goal of this review ...
Source: Current Diabetes Reports - August 17, 2018 Category: Endocrinology Source Type: research

An Overview of Safety Issues on Use of Insulin Pumps and Continuous Glucose Monitoring Systems in the Hospital
AbstractPurpose of ReviewSummarize safety issues related to patients using insulin pump therapy and continuous glucose monitoring systems (CGMS) in the outpatient setting when they are hospitalized and to review steps that can be taken to mitigate risk associated with use or discontinuation of these devices.Recent FindingsTwo recent consensus conferences were held on the topics of inpatient use of insulin pumps and CGMS devices. In addition to commonly known safety issues (e.g., device malfunction, infection), cybersecurity and the vulnerability of contemporary technology to hacking have emerged. CGMS capabilities offer th...
Source: Current Diabetes Reports - August 17, 2018 Category: Endocrinology Source Type: research

Glucose Targets and Insulin Choice in Pregnancy: What Has Changed in the Last Decade?
AbstractPurpose of ReviewTo review current glycaemic targets and the potential use of newer insulin formulations in pregnancy.Recent FindingsThe impact of stricter glycaemic control on perinatal outcomes remains controversial, showing conflicting results. Current ongoing randomised trials investigating the role of tighter glucose targets in pregnancy should help clarify the benefit of tighter glucose control. Optimal timing for self-monitoring blood glucose (SMBG) remains debatable. Data suggest that post-prandial SMBG, particularly at 1  h, offers the best prediction of adverse perinatal outcome. To achieve these tar...
Source: Current Diabetes Reports - August 16, 2018 Category: Endocrinology Source Type: research

Prediction and Prevention of Type 2 Diabetes in Women with a History of GDM
AbstractPurpose of the ReviewWomen with a history of gestational diabetes mellitus (GDM) have an alarmingly high risk of developing type 2 diabetes (T2D); yet, mechanisms underlying this progression are largely unknown.Recent FindingsClinical characteristics of a GDM pregnancy and postpartum metabolomics may contribute to risk prediction of T2D to identify those women at highest risk of progression and need for intervention. Evidence for effective postpartum lifestyle interventions from observational studies include adherence to a healthy dietary pattern, increasing physical activity, and maintaining a healthy body weight....
Source: Current Diabetes Reports - August 16, 2018 Category: Endocrinology Source Type: research

Inpatient Glycemic Management in the Setting of Renal Insufficiency/Failure/Dialysis
AbstractPurpose of this ReviewChronic diabetic nephropathy and renal dysfunction from other causes are common in hospitalized patients with diabetes. Available diabetes management guidelines aim to reduce hyperglycemia and hypoglycemia, both independent risk factors for hospital outcomes. Renal dysfunction, which increases the risk of hypoglycemia, adds a layer of complexity in diabetes management. Therefore, modified glucose goals and treatment regimens may be required.Recent FindingsRecent prospective and retrospective studies provide direction on safe insulin therapy for diabetes inpatients with renal compromise. Studie...
Source: Current Diabetes Reports - August 15, 2018 Category: Endocrinology Source Type: research

Updates on Diabetic Foot and Charcot Osteopathic Arthropathy
AbstractPurpose of ReviewDiabetes mellitus affects approximately 30.8 million people currently living in the USA. Chronic diabetes complications, including diabetic foot complications, remain prevalent and challenging to treat. We review clinical diagnosis and challenges providers may encounter when managing diabetic foot ulcers and Charcot neuroarthropathy.Recent FindingsMechanisms controlling these diseases are being elucidated and not fully understood. Offloading is paramount to heal and manage diabetic foot ulcers and Charcot neuroarthropathy. Diabetic foot ulcers recur and the importance of routine surveillance and mu...
Source: Current Diabetes Reports - August 15, 2018 Category: Endocrinology Source Type: research

Inpatient Glycemic Management of the Pregnant Patient
AbstractPurpose of ReviewThere is a rising prevalence of type 1 diabetes (T1DM), type 2 diabetes (T2DM), and gestational diabetes (GDM) in pregnancy. Reaching and maintaining glycemic targets during and after this time are important for both the health of the mother and her baby.Recent FindingsBased on recently published guidelines from various societies, we review the diagnosis of diabetes in pregnancy, types of therapies available to maintain euglycemia, important keys to management of T1DM, T2DM, and GDM, and strategies for reaching inpatient glycemic targets during the peripartum period. Care for pregnant patients with...
Source: Current Diabetes Reports - August 15, 2018 Category: Endocrinology Source Type: research

Branched Chain Amino Acids in Metabolic Disease
AbstractPurpose of ReviewElevations in circulating branched chain amino acids (BCAAs) have gained attention as potential contributors to the development of insulin resistance and diabetes.Recent FindingsEpidemiological evidence strongly supports this conclusion. Suppression of BCAA catabolism in adipose and hepatic tissues appears to be the primary drivers of plasma BCAA elevations. BCAA catabolism may be shunted to skeletal muscle, where it indirectly leads to FA accumulation and insulin resistance, via a number of proposed mechanisms.SummaryBCAAs have an important role in the development of IR, but our understanding of h...
Source: Current Diabetes Reports - August 15, 2018 Category: Endocrinology Source Type: research

Medicinal Plants with Multiple Effects on Diabetes Mellitus and Its Complications: a Systematic Review
AbstractPurpose of ReviewThis systematic review describes evidence concerning medicinal plants that, in addition to exerting hypoglycemic effects, decrease accompanying complications such as nephropathy, neuropathy, retinopathy, hypertension, and/or hyperlipidemia among individuals with diabetes mellitus (DM).Recent FindingsStudies on the antidiabetic mechanisms of medicinal plants have shown that most of them produce hypoglycemic activity by stimulating insulin secretion, augmenting peroxisome proliferator-activated receptors (PPARs), inhibiting α-amylase or α-glucosidase, glucagon-like peptide-1 (GLP-1) secre...
Source: Current Diabetes Reports - August 13, 2018 Category: Endocrinology Source Type: research

Stress Hyperglycemia in Patients with Tuberculosis Disease: Epidemiology and Clinical Implications
AbstractPurpose of ReviewThe intersection of tuberculosis (TB) disease and type 2 diabetes mellitus is severely hindering global efforts to reduce TB burdens. Diabetes increases the risk of developing TB disease and negatively impacts TB treatment outcomes including culture conversion time, mortality risk, and TB relapse. Recent evidence also indicates plausible mechanisms by which TB disease may influence the pathogenesis and incidence of diabetes. We review the epidemiology of stress hyperglycemia in patients with TB and the pathophysiologic responses to TB disease that are related to established mechanisms of stress hyp...
Source: Current Diabetes Reports - August 9, 2018 Category: Endocrinology Source Type: research

Practical Tips for Implementing the Diabetes Prevention Program in Clinical Practice
AbstractPurpose of ReviewThe Diabetes Prevention Program (DPP) is an evidence-based lifestyle change program for prediabetes that is associated with a 58% reduction in 3-year diabetes incidence, and it has been supported by the American Medical Association and the Centers for Disease Control and Prevention. However, 9 in 10 patients are unaware they have the condition.Recent FindingsWith the passage of the Affordable Care Act (ACA) and broadened coverage for preventive services, the DPP has emerged as an accessible intervention in patients at risk. In 2018, Medicare began to cover the DPP, making it widely available for th...
Source: Current Diabetes Reports - August 8, 2018 Category: Endocrinology Source Type: research

Gender and Sex Differences in Adipose Tissue
AbstractPurpose of ReviewAs the ongoing epidemic of adult and childhood obesity grows, it puts a greater burden on individuals and the healthcare system due to increased prevalence of obesity-associated diseases. An important area that has gained much attention recently is the sex and gender difference related to obesity and associated complications. Basic science and clinical studies have now improved our understanding of obesity and have discovered adipose tissue biology to be key in metabolism.Recent FindingsThere is evidence related to the sex dichotomy in obesity in a variety of areas including adipocyte function, sex...
Source: Current Diabetes Reports - July 30, 2018 Category: Endocrinology Source Type: research

Ethnic Disparities in Gestational Diabetes
AbstractPurpose of ReviewEthnicity has long been described as a major risk factor for the development of gestational diabetes mellitus (GDM), and it is widely recognised that women from ethnicities other than Europids are at higher risk of developing GDM. There are also described differences between ethnicities in key GDM pregnancy outcomes. This review describes some of the factors that relate to the ethnic disparities in GDM.Recent FindingsThe global prevalence of GDM has been steadily increasing and estimated to be 16.2% from the International Diabetes Federation extrapolation. Reported prevalence rates may understate t...
Source: Current Diabetes Reports - July 23, 2018 Category: Endocrinology Source Type: research

Simultaneous Pancreas-Kidney Transplantation Versus Living Donor Kidney Transplantation Alone: an Outcome-Driven Choice?
AbstractPurpose of ReviewThe choice of optimum transplant in a patient with type 1 diabetes mellitus (T1DM) and chronic kidney disease stage V (CKD V) is not clear. The purpose of this review was to investigate this in more detail —in particular the choice between a simultaneous pancreas-kidney transplantation (SPKT) and living donor kidney transplantation (LDKT), including recent evidence, to aid clinicians and their patients in making an informed choice in their care.Recent FindingsAnalyses of large databases have recently shown SPKT to have better survival rates than a LDKT in the long-term, despite an early incre...
Source: Current Diabetes Reports - July 20, 2018 Category: Endocrinology Source Type: research

Weight Management in Patients with Type 2 Diabetes: a Multidisciplinary Real-world Approach
AbstractPurpose of ReviewObesity and type 2 diabetes (T2D) are closely linked metabolic diseases. Most individuals with T2D are overweight or obese, which raises their cardiovascular risk. The etiology of both diseases is multifaceted, thus requiring a multidisciplinary approach to control them. This review describes the most effective multidisciplinary approach to weight management in patients with T2D in real-world clinical practice.Recent FindingsWeight management programs in real-world clinical settings lead to long-term weight loss for up to 5  years.SummaryMultidisciplinary approach to manage obesity and T2D thr...
Source: Current Diabetes Reports - July 17, 2018 Category: Endocrinology Source Type: research

Disparities in Care Delivery and Outcomes in Young Adults With Diabetes
AbstractPurpose of ReviewThis review summarizes the literature on care and outcome disparities in young adults (YA) with type 1 and type 2 diabetes, and outlines remaining needs and suggestions to reduce disparities and improve care.Recent FindingsDespite well-documented disparities and data from large national and international diabetes populations, the role that social determinants of health play in disease management is largely unstudied. Further, mechanisms of how these risk factors interact with the unique developmental needs of racial-ethnic minority and economically vulnerable young adults with diabetes remain unkno...
Source: Current Diabetes Reports - July 14, 2018 Category: Endocrinology Source Type: research

Should Metformin Remain First-Line Medical Therapy for Patients with Type 2 Diabetes Mellitus and Atherosclerotic Cardiovascular Disease? An Alternative Approach
This article will review the evidence for CV effects of antihyperglycemic agents (AHAs), and propose an evidence-based treatment algorithm for patients with T2DM and ASCVD. (Source: Current Diabetes Reports)
Source: Current Diabetes Reports - July 14, 2018 Category: Endocrinology Source Type: research

SGLT2 Inhibitors and Cardiovascular Outcomes: Current Perspectives and Future Potentials
AbstractPurpose of ReviewSodium-glucose cotransporter 2 inhibitors (SGLT2i) have been shown to exert benefit on cardiac outcomes. In this review, we provide updates on available clinical data, studies on potential mechanisms for the CV effects, as well as discuss potential clinical implications of these new findings.Recent FindingsSince the publications of the EMPA-REG and CANVAS trials, large multi-national cohort studies have further shown the cardioprotective effects of SGLT2i. Moreover, new studies examining SGLT2i action on sodium-hydrogen exchanger proteins in both the heart and the kidney, on myocardial energetics a...
Source: Current Diabetes Reports - July 11, 2018 Category: Endocrinology Source Type: research

Neighborhood Environments and Diabetes Risk and Control
The objective of this review is to highlight the evidence on the association between contextual characteristics of residential environments and type 2 diabetes, to provide an overview of the methodological challenges and to outline potential topics for future research in this field.Recent FindingsThe link between neighborhood socioeconomic status or deprivation and diabetes prevalence, incidence, and control is robust and has been replicated in numerous settings, including in experimental and quasi-experimental studies. The association between characteristics of the built environment that affect physical activity, other as...
Source: Current Diabetes Reports - July 11, 2018 Category: Endocrinology Source Type: research

Emerging Approaches in Surveillance of Type 1 Diabetes
We present issues in type 1 diabetes surveillance, review previous and current methods, and present new initiatives.Recent FindingsFew diabetes surveillance systems distinguish between type 1 and type 2 diabetes. Most worldwide efforts have focused on registries and ages
Source: Current Diabetes Reports - July 11, 2018 Category: Endocrinology Source Type: research

Diabetes Among Non-Overweight Individuals: an Emerging Public Health Challenge
AbstractPurpose of ReviewOverweight and obesity are well-established risk factors for type 2 diabetes. However, a substantial number of individuals develop the disease at underweight or normal weight. In this review, we discuss the epidemiology of type 2 diabetes in non-overweight adults; pose questions about etiology, pathophysiology, diagnosis, and prognosis; and examine implications for prevention and treatment.Recent FindingsIn population-based studies, the prevalence of type 2 diabetes ranged from 1.4 –10.9%. However, the prevalence of type 2 diabetes in individuals with BMI 
Source: Current Diabetes Reports - July 4, 2018 Category: Endocrinology Source Type: research