Lifestyle Interventions for Diabetes Prevention in South Asians: Current Evidence and Opportunities
AbstractPurpose of ReviewThis review summarizes the burden of diabetes in South Asian populations and reviews recent evidence for diabetes prevention through lifestyle modification among South Asians worldwide. We indicate important gaps in the current literature and point to opportunities for additional research in this area.Recent FindingsRandomized, controlled, efficacy studies and implementation research show that lifestyle intervention can be an effective, cost-effective, and feasible method for reducing diabetes risk, improving cardiometabolic health, and improving lifestyle behaviors in South Asian populations, a po...
Source: Current Diabetes Reports - June 7, 2021 Category: Endocrinology Source Type: research

Advances, Challenges, and Cost Associated with Continuous Glucose Monitor Use in Adolescents and Young Adults with Type 1 Diabetes
AbstractPurpose of ReviewContinuous glucose monitors (CGM) are transforming diabetes management, yet adolescents and young adults (AYA) with type 1 diabetes (T1D) do not experience the same benefits seen with CGM use in adults. The purpose of this review is to explore advances, challenges, and the financial impact of CGM use in AYA with T1D.Recent FindingsCGM studies in young adults highlight challenges and suggest unique barriers to CGM use in this population. Recent studies also demonstrate differences in CGM use related to race and ethnicity, raising questions about potential bias and emphasizing the importance of patie...
Source: Current Diabetes Reports - May 15, 2021 Category: Endocrinology Source Type: research

Harnessing Metabolomics to Describe the Pathophysiology Underlying Progression in Diabetic Kidney Disease
AbstractPurpose of ReviewDiabetic kidney disease (DKD), a leading cause of end-stage kidney disease, is the result of metabolic network alterations in the kidney. Therefore, metabolomics is an effective tool for understanding its pathophysiology, finding key biomarkers, and developing a new treatment strategy. In this review, we summarize the application of metabolomics to DKD research.Recent FindingsAlterations in renal energy metabolism including the accumulation of tricarboxylic acid cycle and glucose metabolites are observed in the early stage of DKD, and they finally lead to mitochondrial dysfunction in advanced DKD. ...
Source: Current Diabetes Reports - May 11, 2021 Category: Endocrinology Source Type: research

The Role of Programmed Death-1 in Type 1 Diabetes
AbstractPurpose of ReviewProgrammed death-1 (PD-1) is an inhibitory receptor that controls T and B cell proliferation and function through interacting with its ligand PD-L1 or PD-L2. PD-1/PD-L1 blockade reboots anti-tumor immunity and is currently used to treat> 15 different types of cancer. However, the response rate is not at 100% and some patients relapse. Importantly, up to 37% of patients treated with PD-1/PD-L1 blocking antibodies develop immune-related adverse events, including overt autoimmunity, such as type 1 diabetes (T1D). Herein, we discuss the role of PD-1, PD-L1, and PD-L2 signaling in pre-clinical models...
Source: Current Diabetes Reports - May 6, 2021 Category: Endocrinology Source Type: research

Immunological Monitoring in Beta Cell Replacement: Towards a Pathophysiology-Guided Implementation of Biomarkers
AbstractPurpose of reviewGrafted beta cells are lost because of recurrence of T1D and/or allograft rejection, two conditions diagnosed with pancreas graft biopsy, which is invasive and impossible in case of islet transplantation. This review synthetizes the current pathophysiological knowledge and discusses the interest of available immune biomarkers.Recent findingsDespite the central role of auto-(recurrence of T1D) and allo-(T-cell mediated rejection) immune cellular responses, the latter are not directly monitored in routine. In striking contrast, there have been undisputable progresses in monitoring of auto and alloant...
Source: Current Diabetes Reports - April 25, 2021 Category: Endocrinology Source Type: research

PPAR γ and Diabetes: Beyond the Genome and Towards Personalized Medicine
AbstractPurpose of ReviewFull and partial synthetic agonists targeting the transcription factor PPAR γ are contained in FDA-approved insulin-sensitizing drugs and used for the treatment of metabolic syndrome-related dysfunctions. Here, we discuss the association betweenPPARG genetic variants and drug efficacy, as well as the role of alternative splicing and post-translational modifications as contributors to the complexity of PPAR γ signaling and to the effects of synthetic PPARγ ligands.Recent FindingsPPAR γ regulates the transcription of several target genes governing adipocyte differentiation and glucose and lipid m...
Source: Current Diabetes Reports - April 18, 2021 Category: Endocrinology Source Type: research

Progress in Defining the Genetic Contribution to Type 2 Diabetes in Individuals of East Asian Ancestry
AbstractPurpose of ReviewPrevalence of type 2 diabetes (T2D) and progression of complications differ between worldwide populations. While obesity is a major contributing risk factor, variations in physiological manifestations, e.g., developing T2D at lower body mass index in some populations, suggest other contributing factors. Early T2D genetic associations were mostly discovered in European ancestry populations. This review describes the progression of genetic discoveries associated with T2D in individuals of East Asian ancestry in the last 10 years and highlights the shared genetic susceptibility between the population ...
Source: Current Diabetes Reports - April 13, 2021 Category: Endocrinology Source Type: research

The Prevalence of Diabetic Microvascular Complications in China and the USA
AbstractPurpose of ReviewDiabetes can lead to development of devastating microvascular complications, such as nephropathy, retinopathy, and peripheral sensory and autonomic neuropathy. While China and the USA both face the threat of this major public health challenge, the literature is limited in describing similarities and differences in the prevalence, and risk factors for the development, of diabetic microvascular complications between these two countries.Recent FindingsThe current review discusses the following: (1) the most recent evidence on prevalence of diabetic microvascular complications in China and the USA (inc...
Source: Current Diabetes Reports - April 9, 2021 Category: Endocrinology Source Type: research

The Relationship Between Type 2 Diabetes, NAFLD, and Cardiovascular Risk
AbstractPurpose of ReviewNonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are strongly associated. Both also associate with an increased risk of cardiovascular disease (CVD).Recent FindingsSeveral studies have provided evidence that NAFLD could be an independent CVD risk factor. Given the strong association between NAFLD and T2DM, assessing the independent CV effect of these two conditions remains challenging. However, patients with T2DM and NAFLD exhibit higher risk of CVD compared with T2DM without NAFLD suggesting a potential synergistic increase of CV risk in patients with both T2DM and NAFL...
Source: Current Diabetes Reports - March 19, 2021 Category: Endocrinology Source Type: research

Diabetes in People with HIV
AbstractPurpose of ReviewTo discuss the diagnosis, treatment, and complications of diabetes in people with HIV (PWH) and to review HIV-related factors that may contribute to the development of diabetes or alter decisions in the care and treatment of PWH with diabetes.Recent FindingsFor those patients with atherosclerotic cardiovascular disease, heart failure, and/or chronic kidney disease, GLP-1 receptor agonists and SGLT-2 inhibitors should be considered for use. Evidence for this recommendation is, however, based on studies that were not conducted in populations consisting solely of PWH.SummaryDiabetes is a significant c...
Source: Current Diabetes Reports - March 17, 2021 Category: Endocrinology Source Type: research

Body Composition Methods in Adults with Type 2 Diabetes or at Risk for T2D: a Clinical Review
AbstractPurpose of ReviewThe aim of this study is to summarize anthropometric and advanced methods used to assess body composition in adults diagnosed with type 2 diabetes (T2D) or at risk for T2D that provide clinically relevant information about T2D disease-related complications or risk factors.Recent FindingsAnthropometry is commonly used in clinical settings; however, provides unreliable estimates of fat mass, fat-free mass, and body fat distribution for metabolic health assessments compared to advanced techniques such as bioelectrical impedance analysis (BIA), dual-energy x-ray absorptiometry (DXA), computerized tomog...
Source: Current Diabetes Reports - March 17, 2021 Category: Endocrinology Source Type: research

Brain Health in Children with Type 1 Diabetes: Risk and Protective Factors
AbstractPurpose of ReviewTo synthesize findings from studies of neurocognitive complications in children with type 1 diabetes (T1D) and highlight potential risk and protective factors.Recent FindingsEmerging evidence suggests that hyperglycemia and time in range may be more important for brain development than episodes of hypoglycemia. Further, diabetic ketoacidosis (DKA) at the time of T1D diagnosis appears to be a particular risk factor for neurocognitive complications, particularly deficits in executive function skills and memory, with differences in cerebral white matter microstructure seen via advanced magnetic resona...
Source: Current Diabetes Reports - March 14, 2021 Category: Endocrinology Source Type: research