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Diabetes and insulin resistance
Abstract
Diabetes can be classified into four categories, type 1 diabetes (T1D), type 2 diabetes (T2D), gestational diabetes (GDM), and diabetes due to other causes. Insulin resistance is a physiological phenomenon that raises insulin levels and is primarily associated with T2D and GDM. T1D results from severe insulin deficiency and requires exogenous insulin therapy to manage the condition. In contrast, T2D and GDM are metabolic disorders characterized by hyperglycemia resulting from a combination of insulin resistance and impaired insulin secretion. Prevention and management include lifestyle interventions with and without medications that achieve normal glucose levels and reduce the risk of complications. The molecular basis of insulin resistance, its role in health and disease, and the optimal diet composition for improving insulin sensitivity present continuing challenges to research scientists around the world.
... Diabetes is a chronic disease of carbohydrate, fat, and protein metabolism due to defective insulin secretion, insulin action, or both and is characterized by chronic hyperglycemia. 1 Type 2 diabetes is one of the three primary types of diabetes, accounting for 90 to 95%, and is characterized by postprandial hyperglycemia. 2,3 The number of people aged 18 to 99 with diabetes is predicted to reach 693 million by 2045. 4 Asia, especially China and India, is the main region experiencing the global epidemic of type 2 diabetes. 5 Prolonged high sugar levels in the bloodstream can cause serious health problems including neuropathy, kidney disease, retinopathy, cardiovascular disease, and peripheral vascular disease. ...
... Phytosterols are a class of natural compounds widely found in vegetable oils that manifest a variety of biological activities, including decreases in low-density lipoprotein cholesterol and total cholesterol levels, 9 antiobesity, 10 antidiabetes, 11 and regulation of the endocannabinoid system. 12 They are generally divided into three groups depending on the number of CH 3 substituents at the C-4 position, namely, 4-desmethylsterols, 4monomethylsterols, and 4,4-dimethylsterols. 13 A mixture of 4desmethylsterols and 4,4-dimethylsterols was formed during the large-scale production of ferulic acid from γ-oryzanol, 14 an important source of 4,4-dimethylsterols. In recent years, the study of 4,4-dimethylsterols has aroused broad interests among scholars. ...
... Type 2 diabetes mellitus, primarily results from insulin resistance, an impaired target cell response to the biological effects of insulin [4]. Though a predominant feature of type 2 diabetes mellitus, insulin resistance has also been reported in patients with type 1 diabetes mellitus as evidenced by failure to restore whole body and hepatic insulin sensitivity following islet transplantation and intensive insulin treatment in these patients [5]. ...
Introduction
Evidence suggests that majority of patients with diabetes mellitus in Uganda have poor glycaemic control as well as periodontal disease. This study set out to determine the association between periodontitis and insulin resistance in adult patients with diabetes mellitus in Uganda using the triglyceride glucose index.
Methods
Two hundred and twenty-three adult study participants with confirmed diabetes mellitus were enrolled in a cross-sectional study. Oral examination was carried with the aid of a periodontal probe to determine the periodontal status and findings recorded using the WHO Oral Health Assessment Tool for Adults, 2013. We recorded clinical details for body mass index (BMI in kg/m ² ) and laboratory parameters including fasting blood sugar (mmol/L), glycated hemoglobin levels (HbA1c, %) and serum triglycerides (mmol/L) using a study questionnaire. Data were analyzed using R version 4.10. The glucose triglyceride index was used as a measure of insulin resistance. Logistic regression analysis carried out to determine the factors associated insulin resistance.
Results
The majority of the study participants was female (70%) with an average age of 48.5 years (SD+/- 11.1). The mean body mass index was 29.6 kg/m ² (SD+/- 5.82). The mean serum triglyceride index was 9.48 (SD+/- 0.675). Eighty-six-point 1% of the participants had periodontal disease. Bivariate analysis revealed high odds for male sex (OR = 1.31, 95% C.I = 0.44–4.84, p = 0.65) and periodontitis (OR = 3.65, 95% C.I = 0.79–26.15, p = 0.13) but low odds for a high BMI (OR = 0.45. 95% C.I = 0.07–1.67, p = 0.30). Multivariate regression revealed a significant association between insulin resistance and periodontitis. (AOR = 3.52, 95% C.I = 1.19–1.83, p = 0.03).
Conclusion
Insulin resistance is highly prevalent in patients with diabetes mellitus in Uganda and is associated with periodontitis and low body weight.
... Diabetes Mellitus (DM) is a metabolic disorder characterized by increased blood glucose, known as hyperglycemia [1]. The pathogenesis of DM is due to immune disorders or insulin resistance, generated by genetic predisposition or environmental factors [2], [3]. In general, risk factors associated with DM are first-degree relatives with the pathology or a high Body Mass Index (BMI). ...
Diabetes mellitus (DM) is a metabolic disorder characterized by increased blood glucose. The pathology can manifest itself with different conditions, including neuropathy, the main consequence of diabetic disease. Statistics show worrying figures worldwide, diagnosed an estimated 1.6 million people with DM by 2025. In this sense, alternative and automated methods are necessary to detect DM, allowing it to take the pertinent measures in its treatment and avoid critical complications, such as the diabetic foot. On the other hand, foot thermography is a promising tool that allows visualization of thermal patterns, patterns that are altered as a consequence of shear and friction associated with lower limb neuropathy. Based on these considerations, we explored different strategies to detect patients with DM from foot thermography in this research. Initially, the study focused on finding a classification index like Thermal Change Index (TCI). Subsequently, we used the deep convolutional neural networks paradigm, implementing 12 different data augmentation methods, of which four are conventional, and 8 are newly proposed methods. The results showed that the proposed and the conventional methods increased the network’s performance, where a 100% detection was achieved by weighting the DM probability percentages for both images of the feet. Finally, it was also possible to demonstrate the importance of transfer learning, which does not depend on the type of database, but on the data corpus with which the transfer was trained.
Aims:
The PREVIEW lifestyle intervention study (ClinicalTrials.gov Identifier: NCT01777893) is, to date, the largest, multinational study concerning prevention of type-2 diabetes. We hypothesized that the initial, fixed low-energy diet (LED) would induce different metabolic outcomes in men vs women.
Materials and methods:
All participants followed a LED (3.4 MJ/810 kcal/daily) for 8 weeks (Cambridge Weight Plan). Participants were recruited from 8 sites in Europe, Australia and New Zealand. Those eligible for inclusion were overweight (BMI ≥ 25 kg/m2 ) individuals with pre-diabetes according to ADA-criteria. Outcomes of interest included changes in insulin resistance, fat mass (FM), fat-free mass (FFM) and metabolic syndrome Z-score.
Results:
In total, 2224 individuals (1504 women, 720 men) attended the baseline visit and 2020 (90.8%) completed the follow-up visit. Following the LED, weight loss was 16% greater in men than in women (11.8% vs 10.3%, respectively) but improvements in insulin resistance were similar. HOMA-IR decreased by 1.50 ± 0.15 in men and by 1.35 ± 0.15 in women (ns). After adjusting for differences in weight loss, men had larger reductions in metabolic syndrome Z-score, C-peptide, FM and heart rate, while women had larger reductions in HDL cholesterol, FFM, hip circumference and pulse pressure. Following the LED, 35% of participants of both genders had reverted to normo-glycaemia.
Conclusions:
An 8-week LED induced different effects in women than in men. These findings are clinically important and suggest gender-specific changes after weight loss. It is important to investigate whether the greater decreases in FFM, hip circumference and HDL cholesterol in women after rapid weight loss compromise weight loss maintenance and future cardiovascular health.