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Patterns Of Insulin Concentration During The OGTT Predict The Risk Of Type 2 Diabetes In Japanese Americans

Patterns of Insulin Concentration During the OGTT Predict the Risk of Type 2 Diabetes in Japanese Americans

Patterns of Insulin Concentration During the OGTT Predict the Risk of Type 2 Diabetes in Japanese Americans

OBJECTIVE To examine whether the patterns of insulin concentration during the oral glucose tolerance test (OGTT) predict type 2 diabetes.
RESEARCH DESIGN AND METHODS We followed 400 nondiabetic Japanese Americans for 10–11 years. Insulin concentrations at 30, 60, and 120 min during a 2-h 75-g OGTT at baseline were used to derive the following possible patterns of insulin: pattern 1 (30-min peak, higher insulin level at 60 than at 120 min), pattern 2 (30-min peak, lower or equal level at 60 vs. 120 min), pattern 3 (60-min peak); pattern 4 (120-min peak, lower level at 30 than at 60 min), and pattern 5 (120-min peak, equal or higher level at 30 vs. 60 min). Insulin sensitivity was estimated by homeostasis model assessment of insulin resistance (HOMA-IR) and Matsuda index. Insulin secretion was estimated by the insulinogenic index (IGI) [Δinsulin/Δglucose (30–0 min)] and disposition index (IGI/HOMA-IR).
RESULTS There were 86 incident cases of type 2 diabetes. The cumulative incidence was 3.2, 9.8, 15.4, 47.8, and 37.5% for patterns 1, 2, 3, 4, and 5, respectively. Compared with pattern 1, patterns 4 and 5, characterized by a lasting late insulin response, were associated with significantly less insulin sensitivity as measured by the Matsuda index and lower early insulin response by the disposition index. The multiple-adjusted odds ratios of type 2 diabetes were 12.55 (95% CI 4.79–32.89) for pattern 4 and 8.34 (2.38–29.27) for pattern 5 compared with patterns 1 and 2. This association was independent of insulin secretion and sensitivity.
CONCLUSIONS The patterns of in Continue reading

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New Strains of Rice May Help Fight China's Diabetes Scourge

New Strains of Rice May Help Fight China's Diabetes Scourge

Scientists hunt for new strains that avoid raising blood-sugar
Diabetes risks afflicting 151 million people in China by 2040
With a stack of small, brown envelopes in hand, Li Jianyue trudges through a rice field in southern China to gather grain specimens she hopes might one day fight diabetes.
The obesity-linked disease is on a tear in China, and rice -- the country’s favorite staple -- is showing up in studies as an important contributor. The black kernels Li pinches off mature stalks with her fingers and drops into paper sachets have been bred to avoid causing the high spikes in blood-sugar when eaten that can eventually lead to type-2 diabetes.
China tops the world in the number of adults living with diabetes: 109.6 million as of 2015. Another 40 million could join the ranks by 2040 unless preventative steps are taken. Refined white rice is seen as an obvious target because the majority of the nation’s 1.4 billion people consume it at least once a day, and eating it has a similar effect on blood-sugar levels as gorging on white bread.
“The number of people with diabetes is surging,” said Li, a professor of life and environment sciences at Shanghai Normal University, treading between muddy rows of rice in green rubber boots. Still, healthier rice alone won’t tackle the problem -- it has to taste good too, she said. “So, we’re also trying to improve the texture.”
The rice experiments Li is working on -- under a giant bird net at a plant-breeding site about 20 kilometers (12 miles) from Sanya city, on the southern tip of Hainan island -- are part of an int Continue reading

International efforts to develop rice varieties to combat China’s diabetes epidemic

International efforts to develop rice varieties to combat China’s diabetes epidemic

THE number of diabetes patients is rising all across China and groups of scientists all over the world are working to develop new rice strains to prevent more people from succumbing to the disease.
China registered the highest number of cases in the world in 2016 – 109.6 million adults were recorded to suffer from diabetes, and by 2040, another 40 million could join their ranks. According to the World Health Organization (WHO), 90 percent of that number comprises sufferers of type-2 diabetes, which is largely a result of lifestyle choices.
It’s a shocking number when you consider as many as half of China’s adult population is already pre-diabetic and are at high-risk of developing the preventable type-2 diabetes, as well as other cardiovascular diseases.
The landscape of diabetes innovation is changing and China is rising to the top of the leaderboard. More at https://t.co/zfvKO6mqtX pic.twitter.com/sdutLfqR4D
— Resolute Innovation (@team_resolute) May 2, 2017
Chinese companies have been at the forefront of a series of inventions aimed at helping patients with diabetes or those seeking to prevent the disease in the first place. Chinese companies have overtaken German ones for the first time as the leader of diabetes innovations sector.
A researcher from East China Normal University, HYe Haifeng , has produced a device that marries telecommunications technology with cell-based therapy and optogenetics. It can work through a smartphone to control engineered cells to produce insulin when needed.
But some scientists are taking a more preventive approach to help with Chi Continue reading

Can You Reverse a Type-2 Diabetes Diagnosis? Isn't it controversial?

Can You Reverse a Type-2 Diabetes Diagnosis? Isn't it controversial?

Reversing diabetes may not be entirely up to you, but actually doing it is entirely up to you (with support).
Our first post about the possibility of reversing diagnosis of type-2 diabetes generated some of the skepticism—in some cases blowback—we thought it might. Discussion is good.
We were careful in our word choice backing up our principal assertion, namely, that “There is hard evidence that type-2 diabetes does not have to be seen as an irreversible, necessarily progressive condition in everyone diagnosed with it.” We remain clear in our provisos:
It’s probably not possible for all people who have been correctly diagnosed with type-2 diabetes. Nothing is that simple.
The pancreases of people who have lived with type-2 diabetes for years, and who have treated it only with medication, are unlikely to get back to normal functioning.
Obesity, “tummy fat” in particular, poses a high risk for progression to type-2 diabetes. As everyone who has fought the fat knows, it’s one thing to get it off and another thing altogether to keep it off.
Physical inactivity aggravated by obesity heightens the problem.
A serious attempt to reverse type-2 diabetes entails working out a precise eating plan, in consultation with your doctor and, ideally, a professional dietician—and sticking to it.
It also entails, for all of those for whom this is in any way possible, a regimen of physical exercise, usually of an aerobic variety, amounting to a total of 150 to 175 minutes of exercise a week, with a maximum of two “days off.”
Perhaps most important, it is not, literally, a Continue reading

Sodium-Glucose Co-Transporter-2 Inhibitors: An Update on the Evidence for Treatment of Type 2 Diabetes

Sodium-Glucose Co-Transporter-2 Inhibitors: An Update on the Evidence for Treatment of Type 2 Diabetes

Introduction
Sodium-glucose co-transporter-2 (SGLT-2) inhibitors are a class of antihyperglycemic agents that can be used to improve glycemic control in the treatment of type 2 diabetes (T2D). SGLT-2 inhibitors block SGLT-2–mediated reabsorption of glucose into circulation. By this mechanism, plasma glucose levels are reduced and glucose is excreted in the urine. Not only do SGLT-2 inhibitors have glucose-lowering effects, but their efficacy in nonglycemic clinical parameters, such as lowering blood pressure and helping in weight loss, may be beneficial for patients with T2D.1
Within the family of sodium-dependent glucose transporters, sodium-glucose co-transporter-1 (SGLT-1) and SGLT-2 transporters are key regulators of glucose reabsorption filtered by the kidney, with expression on 2 regions of the renal proximal convoluted tubule. The majority of glucose reabsorption (90%) is attributed to SGLT-2 within the S1 segment, and the SGLT-1 receptor aids in glucose reabsorption downstream from SGLT-2 in the S3 segment.2 In patients with T2D, an increased filtered load of glucose increases its reabsorption through the SGLT-2 transporters of the kidney. Instead of excreting excess filtered glucose in urine, increased reabsorption causes elevated plasma glucose, thereby leading to the hyperglycemic state.
The American Association of Clinical Endocrinologists (AACE) and American College of Endocrinology (ACE) currently recommend that an SGLT-2 inhibitor may be used as first-line therapy in the management of T2D for patients with glycated hemoglobin (A1C) <7.5%, although stronger Continue reading

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