Sleep Extension: A Potential Target for Obesity Treatment
AbstractPurpose of ReviewSleep and obesity share a bidirectional relationship, and weight loss has been shown to enhance sleep. Aiming to extend sleep on its own or as part of a lifestyle intervention may attenuate health consequences of short sleep. This review highlights several sleep extension approaches, discusses feasibility of each, and summarizes findings relevant to obesity.Recent FindingsSleep extension in response to experimental sleep restriction demonstrates partial rescue of cardiometabolic dysfunction in some but not all studies. Adequate sleep on a nightly basis may be necessary for optimal health. While ini...
Source: Current Diabetes Reports - December 4, 2020 Category: Endocrinology Source Type: research
Use of Machine Learning Approaches in Clinical Epidemiological Research of Diabetes
AbstractPurpose of ReviewMachine learning approaches —which seek to predict outcomes or classify patient features by recognizing patterns in large datasets—are increasingly applied to clinical epidemiology research on diabetes. Given its novelty and emergence in fields outside of biomedical research, machine learning terminology, techniques, and r esearch findings may be unfamiliar to diabetes researchers. Our aim was to present the use of machine learning approaches in an approachable way, drawing from clinical epidemiological research in diabetes published from 1 Jan 2017 to 1 June 2020.Recent FindingsMachine learnin...
Source: Current Diabetes Reports - December 3, 2020 Category: Endocrinology Source Type: research
Evidence for Mental Health Contributions to Medical Care in Diabetes Management: Economic and Professional Considerations
AbstractPurpose of ReviewThis paper considers the potential contributions of behavioral health providers to interprofessional, collaborative treatment for diabetes. We have the following objectives: (1) review the behavioral health complications, risks, burdens, and costs associated with diabetes management and consider the role of behavioral health providers in treating mental health concerns specific to diabetes; (2) highlight two frameworks for incorporating behavioral health into diabetes treatment, and review the empirical support for each; and (3) consider the financial feasibility of integrating behavioral health se...
Source: Current Diabetes Reports - November 28, 2020 Category: Endocrinology Source Type: research
Impact of Type 2 Diabetes Mellitus and Antidiabetic Medications on Bone Metabolism
AbstractPurpose of ReviewThis review focuses on the complex interactions between hyperglycemia and bone fragility and the effects of antidiabetic medications on bone metabolism.Recent FindingsType 2 diabetes (T2D) is associated with increased risk of bone fracture even in those with increased or normal bone mineral density (BMD). The pathophysiology of diabetic bone disease is not completely understood, but it is thought to be multifactorial and associated with complex cross talk among factors such as AGEs, IGF-1, enteric hormones, and pro-inflammatory cytokines. Treatment for T2D may have an impact on bone metabolism.Summ...
Source: Current Diabetes Reports - November 27, 2020 Category: Endocrinology Source Type: research
Caring for Hospitalized Patients with Diabetes Mellitus, Hyperglycemia, and COVID-19: Bridging the Remaining Knowledge Gaps
AbstractPurpose of ReviewThis review discusses the interplay between coronavirus disease 2019 (COVID-19, caused by SARS-CoV-2 infection), diabetes mellitus, and hyperglycemia in the hospital setting. There are data emerging about diabetes and hyperglycemia, their prevalence, and potential risks in the setting of SARS-CoV-2 infection and COVID-19.Recent FindingsIt is known that viral infections exert effects on beta cell function and insulin resistance. Therefore, much can be learned about SARS-CoV-2/COVID-19 from examining these known relationships. Such pathophysiological underpinnings may unlock greater understanding as ...
Source: Current Diabetes Reports - November 26, 2020 Category: Endocrinology Source Type: research
The Role of Aspirin for Preeclampsia Prevention in Women with Diabetes
AbstractPurpose of ReviewA diagnosis of type I or type 2 diabetes confers heightened risk for virtually every obstetric and perinatal complication, with the incidence of superimposed preeclampsia representing a particularly high-risk scenario. Over the past three decades, studies have investigated the role of aspirin in preeclampsia prevention, yielding some promising results for certain at-risk groups, yet unconvincing evidence of benefit among women with pre-pregnancy diabetes. The purpose of this review is to present the current evidence base for aspirin use in pregnancy as a means of mitigating preeclampsia risk in the...
Source: Current Diabetes Reports - November 24, 2020 Category: Endocrinology Source Type: research
Does Weight Loss Improve Clinical Outcomes in Overweight and Obese Patients with Heart Failure?
AbstractPurpose of ReviewObesity increases the risk of new onset heart failure (HF), and particularly HF with preserved ejection fraction (HFpEF). Despite the observations of favorable clinical outcomes in HF patients with obesity in general, sometimes referred to as the “obesity paradox,” it is important to recognize that severe obesity is associated with worse clinical outcomes. This review summarizes the effects of obesity treatment on cardiovascular health and HF clinical outcomes.Recent FindingsTreatment for obesity utilizes a variety of modalities to achieve purposeful weight loss including lifestyle intervention...
Source: Current Diabetes Reports - November 24, 2020 Category: Endocrinology Source Type: research
Sodium-Glucose Cotransporter Type 2 (SGLT-2) Inhibitors and Ketogenesis: the Good and the Bad
AbstractPurpose of ReviewThe micro/macrovascular complications of diabetes cause considerable morbidity and premature mortality. The SGLT2 inhibitors are the first diabetes medications with significant benefits on microvascular disease (nephropathy) and macrovascular cardiovascular disease. In this review, we evaluate one of the potential mechanisms for these cardiorenal benefits —the production of ketones, their benefits, and risks.Recent FindingsIn recent cardiovascular outcome trials (CVOTs), the SGLT2 inhibitors demonstrated significant cardiorenal benefits and they are now approved to reduce CV events/death, heart f...
Source: Current Diabetes Reports - November 23, 2020 Category: Endocrinology Source Type: research
Diabetes Risk and Control in Multi-ethnic US Immigrant Populations
AbstractPurpose of ReviewThe goal of this review is to assess current evidence on diabetes risk and control among adult immigrants in the USA.Recent FindingsPatterns of diabetes risk in US immigrants may reflect global diabetes trends. Asian, Black, and Latinx immigrants all see a diabetes disadvantage relative to US-born Whites. Diabetes risk in Asian immigrants also surpasses US-born Asians. Relative diabetes risk among all groups increases with time in the USA. Research to explain patterns in diabetes risk and control among immigrants has broadened from lifestyle factors to include multi-level, life course influences on...
Source: Current Diabetes Reports - November 20, 2020 Category: Endocrinology Source Type: research
Pancreas-on-a-Chip Technology for Transplantation Applications
AbstractPurpose of ReviewHuman pancreas-on-a-chip (PoC) technology is quickly advancing as a platform for complex in vitro modeling of islet physiology. This review summarizes the current progress and evaluates the possibility of using this technology for clinical islet transplantation.Recent FindingsPoC microfluidic platforms have mainly shown proof of principle for long-term culturing of islets to study islet function in a standardized format. Advancement in microfluidic design by using imaging-compatible biomaterials and biosensor technology might provide a novel future tool for predicting islet transplantation outcome....
Source: Current Diabetes Reports - November 18, 2020 Category: Endocrinology Source Type: research
Implementation of Technology-Delivered Diabetes Self-care Interventions in Clinical Care: a Narrative Review
This article provides an overview of the methods and results of studies examining the implementation of technology-delivered diabetes self-care interventions into clinical care. We focus specifically on patient-facing behavioral interventions delivered with technology (e.g., text messaging, apps, websites).Recent FindingsEleven articles were included in the review. Most studies (n = 9) examined barriers and facilitators to implementation, while about half (n = 5) integrated the intervention into clinical care and evaluated implementation and/or effectiveness. Only six studies applied a theory or framework. The most...
Source: Current Diabetes Reports - November 18, 2020 Category: Endocrinology Source Type: research
Review of Intravenous and Subcutaneous Electronic Glucose Management Systems for Inpatient Glycemic Control
AbstractPurpose of ReviewThe goal of this review is to summarize current literature on electronic glucose management systems (eGMS) and discuss their benefits and disadvantages in the inpatient setting.Recent FindingsWe review different versions of commercially available eGMS: Glucommander ™ (Glytec, Greenville, SC), EndoToolR (MD Scientific LLC, Charlotte, NC), GlucoStabilizer ™ (Medical Decision Network, Charlottesville, VA), GlucoCare™ (Pronia Medical Systems, KY), and discuss advantages such as reducing rates of hypoglycemia, hyperglycemia, and glycemic variability. In addition, eCGMs offer a uniform standard of ...
Source: Current Diabetes Reports - November 9, 2020 Category: Endocrinology Source Type: research
A Question of Tolerance —Antigen-Specific Immunotherapy for Type 1 Diabetes
AbstractPurpose of ReviewAntigen-specific immunotherapy (ASI) is a long sought-after goal for type 1 diabetes (T1D), with the potential of greater long-term safety than non-specific immunotherapy. We review the most recent advances in identification of target islet epitopes, delivery platforms and the ongoing challenges.Recent FindingsIt is now recognised that human proinsulin contains a hotspot of epitopes targeted in people with T1D. Beta-cell neoantigens are also under investigation as ASI target epitopes. Consideration of the predicted HLA-specificity of the target antigen for subject selection is now being incorporate...
Source: Current Diabetes Reports - November 9, 2020 Category: Endocrinology Source Type: research
Genetic Studies of Gestational Diabetes and Glucose Metabolism in Pregnancy
We describe these studies in the context of the larger body of literature on type 2 diabetes (T2D) and glycemic trait genomics.Recent FindingsWe reviewed 23 genetic association studies for GDM and performed a meta-analysis, which revealed variants at eight T2D loci significantly associated with GDM after the Bonferroni correction. These studies suggest that GDM and T2D share a number of genetic risk loci. Only two unbiased genome-wide association studies (GWASs) have successfully revealed genetic associations for GDM and related glycemic traits in pregnancy. A GWAS for GDM in Korean women identified two loci (nearCDKAL1 an...
Source: Current Diabetes Reports - November 9, 2020 Category: Endocrinology Source Type: research
Social Determinants of Poor Management of Type 2 Diabetes Among the Insured
AbstractPurpose of ReviewEven with insurance coverage increasing over time among the population with diabetes, a large proportion continues to have poorly controlled disease. The purpose of this narrative literature review is to describe the social determinants of poor management of type 2 diabetes among the insured population and illustrate drivers of poor outcomes beyond insurance coverage.Recent FindingsDespite the provision of health insurance, social determinants play a significant role in shaping diabetes outcomes, especially for economic instability (employment, out-of-pocket expenses associated with diabetes manage...
Source: Current Diabetes Reports - November 5, 2020 Category: Endocrinology Source Type: research
