Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although physical activity is widely reported to reduce the risk of type 2 diabetes in individuals with prediabetes, few studies have examined this issue independently of other lifestyle modifications. The aim of this review is to conduct a systematic review of controlled trials to determine the independent effect of exercise on glucose levels and risk of type 2 diabetes in people with prediabetes (IGT and/or IFG). A detailed search of MEDLINE (1966-2006) and EMBASE (1980-2006) found 279 potentially relevant studies, eight of which met the inclusion criteria for this review. All eight studies were controlled trials in individuals with impaired glucose tolerance. Seven studies used a multi-component lifestyle intervention that included exercise, diet and weight loss goals and one used a structured exercise training intervention. Four studies used the incidence of diabetes over the course of the study as an outcome variable and four relied on 2-h plasma glucose as an outcome measure. In the four studies that measured the incidence of diabetes as an outcome, the risk of diabetes was reduced by approximately 50% (range 42-63%); as these studies reported only small changes in physical activity levels, the reduced risk of diabetes is likely to be attributable to factors other than physical activity. In the remaining four studies, only one reported significant improvements in 2-h plasma glucose even though all but one reported small to moderate increases in maximal oxygen uptake. These results indicate that the contribution of physical activity independent of dietary or weight loss changes to the prevention of type 2 diabetes in people with prediabetes is equivocal.
 ...
PMID:The role of physical activity in the management of impaired glucose tolerance: a systematic review. 1772 76

The current study aimed to evaluate whether individuals with fasting plasma glucose (FPG) of 5.6-6.0 mmol/l has a similar risk profiles for diabetes or impaired glucose tolerance (IGT) to those with FPG of 6.1-6.9 mmol/l. A community-based cross-sectional survey in Chinese adults (20-74 years) was conducted during April-July in 2002. Participants without a prior history of diabetes underwent a standardized 2-h 75 g oral glucose tolerance test. Positive likelihood ratios were calculated to estimate the odds of having diabetes or IGT for subjects with different FPG levels. Among 1856 participants, prevalence of IFG increased from 12.4 to 28.2% with the cut-off value of FPG lowered from 6.1 to 5.6 mmol/l. Individuals with FPG of 6.1-6.9 mmol/l were more obese and insulin resistant than those with FPG of 5.6-6.0 mmol/l. The positive likelihood ratio for diabetes and IGT were 1.83 (1.28-2.61) and 2.60 (1.96-3.44) in subjects with FPG of 6.1-6.9 mmol/l, and 0.54 (0.30-0.95) and 1.47 (1.11-1.95) for those with FPG of 5.6-6.0 mmol/l, respectively. In conclusion, the likelihood of diabetes and IGT was lower in subjects with FPG of 5.6-6.0 mmol/l than in those with FPG of 6.1-6.9 mmol/l. The clinical and social implication of labelling more individuals with impaired fasting glucose needs to be further studied.
Diabetes Res Clin Pract 2008 Jan
PMID:The likelihood of diabetes based on the proposed definitions for impaired fasting glucose. 1782 38

In healthy individuals, the ability of the pancreatic islets to sense and respond appropriately to changes in plasma glucose levels maintains plasma glucose levels within a narrow range despite broad fluctuations in nutrient intake and variable "demand" for insulin imposed by changes in insulin sensitivity. This ability of the pancreatic islets is lost in type 2 diabetes (T2DM). For studies on the pathophysiology of T2DM, methods for analyzing islet function are therefore required. Many methods of varying degrees of complexity have been developed and used to measure pancreatic beta-cell function in humans and to characterize the defects existing in patients with T2DM or precursors thereof (impaired fasting glucose [IFG] and impaired glucose tolerance [IGT]). Significant, although perhaps less progress has been made toward development of methods to characterize alpha-cell function. This work presents an overview of clinical measures of islet function, from simple static measures such as HOMA-beta to the more complex dynamic measures such as those utilizing stepped hyperglycemic clamps and acute administration of arginine to obtain more detailed information regarding the interaction of glucose and non-glucose secretagogues. We emphazise the need for accurate measures of alpha-cell function, and we discuss the strengths and limitations of the various methods, highlighting the many aspects of both alpha- and beta-cell function that become impaired during development of T2DM.
Curr Diabetes Rev 2008 May
PMID:Clinical measures of islet function: usefulness to characterize defects in diabetes. 1847 60

Chronic subclinical inflammation may be involved in the pathogenesis of Type 2 diabetes. We examined whether elevated WBC count, a marker of inflammation, was associated with worsening of glucose tolerance among Chinese population aged 40 years and over. Based on the 75g OGTT, 1016 subjects aged from 40 to 88 years were classified into four groups: NFG/NGT (n=299), isolated IFG (n=213), IGT (n=213) and Type 2 diabetes (n=291). We compared the WBC count among the four groups and investigated relevant variables associated significantly with the WBC count. The IGT and Type 2 diabetes groups had a significantly higher WBC count than the NFG/NGT and isolated IFG groups. By stepwise regression analyses, we found that waist circumference, DBP, total cholesterol, HDL cholesterol and 2-h PG showed an independent association with the WBC count. In the analysis stratified by sex and smoking status, WBC count was independently associated with age and triglycerides in males, whereas it was associated with BMI, SBP, triglycerides and 2-h PG in females. BMI, SBP, triglycerides and 2-h PG showed an independent association with WBC count in subjects who never smoked. We concluded that an increase in WBC count was associated with the deterioration of glucose tolerance. WBC count was associated with lipid metabolism in males and with various components of the metabolic syndrome in females and subjects who never smoked.
Diabetes Res Clin Pract 2008 Oct
PMID:Association of WBC count and glucose metabolism among Chinese population aged 40 years and over. 1869 86

Atypical antipsychotic drugs (AADs) induce weight gain and truncal adiposity, and even the metabolic syndrome (MetS), which may progress to IFG/IGT or DM. AAD effects in lean schizophrenic patients without MetS have not been documented, especially in terms of weight gain and changes in insulin sensitivity (S), beta-cell function (beta) and adiponectinaemia. We prospectively determined the effects of nine-month therapy with AADs on anthropometrics, metabolism and adiponectinaemia, including homoeostasis model assessment (HOMA) modelling of S, beta and betaxS (hyperbolic product, assessing individual beta adjusted for S). We analyzed 36 schizophrenic subjects (M/F: 24/12; Caucasian: n=23, North African: n=12, South Asian: n=1) aged 35+/- years (mean+/-one S.D.) free of MetS (NCEP-ATPIII), of whom 19 study completers were evaluated following AAD treatment. S, beta, betaxS and adiponectin were measured at zero, three and nine months. At nine months, BMI had risen from 22+/-2 to 25+/-2kg/m(2) (P<0.001) and waist circumference from 85+/-8 to 91+/-11cm (P<0.001), while adiponectin decreased from 10.4+/-5.1 to 7.4+/-3.8mug/mL (P<0.001). Blood pressure and lipids were unaffected. S decreased from 138+/-49 to 110+/-58% (P=0.006) and beta increased from 83+/-24 to 100+/-40% (P=0.034). As a result, betaxS decreased from 106+/-19 to 91+/-27% (P=0.015). Fasting glycaemia rose from 89+/-5 to 96+/-9mg/dL (P=0.007). On study completion, 21% had IFG. Long-term use of AADs in lean, drug-naive, schizophrenics initially free of MetS induced weight gain and truncal fat accumulation associated with decreases in adiponectin and hyperbolic product, explaining the increased fasting glycaemia and impaired fasting glucose seen in predisposed individuals.
Diabetes Metab 2008 Nov
PMID:Insulin sensitivity, adjusted beta-cell function and adiponectinaemia among lean drug-naive schizophrenic patients treated with atypical antipsychotic drugs: a nine-month prospective study. 1869 56

Current reports estimate that type II diabetes (T2D) affects 5-8% of adults. Also recognized is a transitional group of patients whose fasting blood glucose is abnormal; yet, not considered high enough to be diagnosed as diabetes. Defined as "pre-diabetes" these individuals have impaired fasting glucose (IFG; fasting glucose 100-125 mg/dL), impaired glucose tolerance (IGT; 2 h glucose 140-199 mg/dL) or both. Two unifying features associated with IFG and IGT are their strong links to obesity and physical inactivity, which lead independently and collectively toward the erosion of various cellular processes affecting glucose control. In contrast, regular exercise positively influences IFG/IGT and obesity, thus representing an important therapy for preventing diabetes via the enhancement of several mechanisms of action. These include improved glucose metabolism, muscle respiratory capacity, mitochondrial respiratory chain activity and beta-oxidation. Contemporary exercise guidelines provided by various organizations recommend that exercise be performed at intensities ranging from 40% to 85% of maximal aerobic capacity. Unfortunately, little is known regarding the optimal intensity to best facilitate the physiological benefits associated with exercise. An evolving body of research shows that interval training produces greater changes in exercise capacity than traditional aerobic training. Interval training involves bouts of high exercise intensity (15s to 4 min; >90% VO(2max)) followed by a recovery period (40-50% VO(2max)) of equal or longer duration than the associated work interval. Though the net effect of interval training is aerobic, periodic excursions involving anaerobic energy pathways theoretically "push" the mitochondria to greater improvements in exercise capacity, mitochondrial biogenesis, enzymatic markers associated with glycolysis, aerobic metabolism and beta (beta)-oxidation. Though traditionally viewed as a training modality for athletes, a recent report has demonstrated that interval training is more effective than traditional aerobic exercise training in patients up to approximately 75 y of age and with low functional capacities (VO(2max) 13 ml/kg/min) by producing superior improvements in VO(2max), sub-maximal exercise tolerance, levels of peroxisome proliferator activator protein-gamma co-activator1alpha (PGC-1alpha), and quality of life indices more so than traditional aerobic exercise training. Erosion in these same markers is present in populations with pre-diabetes and T2D. The principal hypothesis of this paper is that interval training will provide a more powerful stimulus for improving insulin sensitivity than traditional low-to-moderate intensity aerobic conditioning. This theory further proposes that these affects will be due to greater changes in specific metabolic pathways associated with glycolysis, aerobic metabolism, beta-oxidation, and mitochondrial biogenesis.
 ...
PMID:Exercise interval training: an improved stimulus for improving the physiology of pre-diabetes. 1870 13

The aim of this study was to determine the prevalence of impaired glucose regulation status in Sherpa adults living in the Everest area and in Kathmandu valley. A cross-sectional survey was conducted in Chaurikharka village (Everest area) and Kathmandu city on 119 and 121 randomly selected individuals, aged 30-70 years. They were assessed on conventional risk factors for diabetes, and an oral glucose tolerance test was performed. Based on the 2003 American Diabetes Association criteria, the prevalence in the Kathmandu city and Everest region of any impaired glucose regulation (IGR), isolated impaired fasting plasma glucose (isolated IFG), isolated impaired glucose tolerance (isolated IGT), and combined isolated IFG and isolated IGT were 55.4% vs. 23.5%, 42.1% vs. 14.3%, 1.7% vs. 0.8%, 11.6 vs. 8.4%, respectively. Using the subjects with normal glucose tolerance as the referent group and after adjusting for age, sex, physical activity, calories, and waist circumference, the odds ratios for isolated IFG and combined isolated IFG and isolated IGT of living in the highland region were 0.19 (0.08-0.44) and 0.33 (0.09-1.18), respectively. Isolated IFG was more common among the lowland Sherpas. Unlike combined isolated IFG and isolated IGT, this isolated IFG difference could not be explained by the difference of conventional diabetes mellitus risk factors.
 ...
PMID:Impaired glucose regulation in a Sherpa indigenous population living in the Everest region of Nepal and in Kathmandu Valley. 1880 Sep 58

To examine the serum 1,5-anhydroglucitol (AG) levels as a surrogate measure of postprandial hyperglycemia (PPH) and insulin secretion in a wide range of hyperglycemia, we compared the relationship between the glycemic index during a 75g oral glucose tolerance test (OGTT) and the insulinogenic index and 1,5-AG according the overall glycemic state. Fasting serum 1,5-AG levels were lower in the type 2 diabetic group (18.0+/-7.0microg/mL) than in the normal glucose tolerance (NGT, 25.4+/-4.0microg/mL), impaired fasting glucose (IFG, 24.6+/-6.2microg/mL), and impaired glucose tolerance (IGT, 22.1+/-6.2microg/mL) groups and were clearly correlated with glycemic values from the OGTT. 120-min post-challenge plasma glucose (PPG(120)) emerged as an independent predictor for 1,5-AG levels after multiple linear regression analysis (beta=-0.554, P<0.001). Additionally, 1,5-AG levels were significantly correlated with PPG(120) in each quartile of A1C, and the coefficients increased with higher A1C quartiles. Subjects with low 1,5-AG levels had both increased insulin resistance and decreased insulin secretion. Decreased 1,5-AG levels are closely correlated with PPH and decreased insulin secretion capacity across a wide range of glycemia, even in relatively well-controlled diabetes.
Diabetes Res Clin Pract 2009 Apr
PMID:1,5-Anhydroglucitol reflects postprandial hyperglycemia and a decreased insulinogenic index, even in subjects with prediabetes and well-controlled type 2 diabetes. 1918 97

OBJECTIVE Fibroblast growth factor (FGF)-21 is highly expressed in the liver and regulates hepatic glucose production and lipid metabolism in rodents. However, its role in the pathogenesis of type 2 diabetes in humans remains to be defined. The aim of this study was to quantitate circulating plasma FGF-21 levels and examine their relationship with insulin sensitivity in subjects with varying degrees of obesity and glucose tolerance. RESEARCH DESIGN AND METHODS Forty-one subjects (8 lean with normal glucose tolerance [NGT], 9 obese with NGT, 12 with impaired fasting glucose [IFG]/impaired glucose tolerance [IGT], and 12 type 2 diabetic subjects) received an oral glucose tolerance test (OGTT) and a hyperinsulinemic-euglycemic clamp (80 mU/m(2) per min) combined with 3-[(3)H] glucose infusion. RESULTS Subjects with type 2 diabetes, subjects with IGT, and obese subjects with NGT were insulin resistant compared with lean subjects with NGT. Plasma FGF-21 levels progressively increased from 3.9 +/- 0.3 ng/ml in lean subjects with NGT to 4.9 +/- 0.2 in obese subjects with NGT to 5.2 +/- 0.2 in subjects with IGT and to 5.3 +/- 0.2 in type 2 diabetic subjects. FGF-21 levels correlated inversely with whole-body (primarily reflects muscle) insulin sensitivity (r = -0.421, P = 0.007) and directly with the hepatic insulin resistance index (r = 0.344, P = 0.034). FGF-21 levels also correlated with measures of glycemia (fasting plasma glucose [r = 0.312, P = 0.05], 2-h plasma glucose [r = 0.414, P = 0.01], and A1C [r = 0.325, P = 0.04]). CONCLUSIONS Plasma FGF-21 levels are increased in insulin-resistant states and correlate with hepatic and whole-body (muscle) insulin resistance. FGF-21 may play a role in pathogenesis of hepatic and whole-body insulin resistance in type 2 diabetes.
Diabetes Care 2009 Aug
PMID:Circulating fibroblast growth factor-21 is elevated in impaired glucose tolerance and type 2 diabetes and correlates with muscle and hepatic insulin resistance. 1948 37

The concept of prediabetes has been discussed since the 1950's. After 1980, WHO expert guidelines on the classification of diabetes according to its stages of development became common. These guidelines also included statistically significant risk groups with diabetes likely to develop in the future. The term Impaired Glucose Tolerance (IGT) was officially introduced by WHO in 1979, with an additional category referring to changes in glucose metabolism to be included later on--the Impaired Fasting Glucose--IFG. The term prediabetes mellitus began to be used again after 2000, and after 2003 diagnostic criteria to delimit diabetes and prediabetes came into use. Progressively, evidence was gathered on the involvement of hyperglycaemia and other metabolic abnormalities in patients with type 2 diabetes in creating conditions for the development of atherosclerosis. The last decade saw re-emerging publications dealing with the abnormalities of glucose metabolism, and subsequent statements from ADA, IDF and other organisations proposing the techniques of screening, diagnosis, monitoring and/or therapy of prediabetes. Recently, the American Diabetes Association clearly specifes the diagnosis of prediabetes, whereby prediabetes is defined within the scope of the diabetic disease. Prediabetes/diabetes reflect the continuum of the risk of microvascular and macrovascular outcomes. For these reasons, methods have been developed to delay the progression of prediabetes to diabetes. An ADA panel suggests that individuals with prediabetes should be enrolled in a program of intensive lifestyle intervention, with a specific group of patients at risk to be considered for therapy with metformin. Additional methods of prevention will be introduced into practice on the basis of new studies.
 ...
PMID:[Prediabetes - 2009]. 1978 83


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>