Increased plasma non-esterified fatty acids (NEFAs) link obesity with insulin resistance and type 2 diabetes mellitus (T2DM). However, in contrast to the saturated FA (SFA) palmitic acid, the ...monounsaturated FA (MUFA) oleic acid elicits beneficial effects on insulin sensitivity, and the dietary palmitic acid:oleic acid ratio impacts diabetes risk in humans. Here we review recent mechanistic insights into the beneficial effects of oleic acid compared with palmitic acid on insulin resistance and T2DM, including its anti-inflammatory actions, and its capacity to inhibit endoplasmic reticulum (ER) stress, prevent attenuation of the insulin signaling pathway, and improve β cell survival. Understanding the molecular mechanisms of the antidiabetic effects of oleic acid may contribute to understanding the benefits of this FA in the prevention or delay of T2DM.
Substituting SFAs by oleic acid in the diet improves insulin sensitivity in humans.
Preclinical studies have shed light on the molecular mechanisms by which oleic acid prevents palmitic acid-induced inflammation and insulin resistance in adipose tissue, liver, skeletal muscle, and pancreas.
The hypothalamus also senses oleic acid, where it activates a neuronal network that suppresses VLDL-TAG secretion in liver.
Oleic acid protects against cardiovascular insulin resistance and the atherosclerotic process.
Some of the effects of oleic acid are mediated by preventing the reduction in palmitic acid-mediated AMPK activity, resembling the action of metformin.
The established role of disturbances in the microbiota-gut-brain axis in the development of diabetic cognitive impairment (DCI) has long been recognized. It has shown the potential of Akkermansia ...muciniphila (A. muciniphila) in improving metabolic disorders and exerting anti-inflammatory effects. However, there remains a lack of comprehensive understanding regarding the specific effects and mechanisms underlying the treatment of DCI with A. muciniphila. This study aimed to evaluate the potential of A. muciniphila in alleviating DCI in db/db mice. Eleven-week-old db/db mice were administered either live or pasteurized A. muciniphila (5 × 109 CFU/200 μL) for a duration of eight weeks. Administering live A. muciniphila significantly ameliorated cognitive impairments, improved the synaptic ultrastructure, and inhibited hippocampal neuron loss in the CA1 and CA3 subregions in db/db mice. Both live and pasteurized A. muciniphila effectively mitigated neuroinflammation. Moreover, live A. muciniphila increased the relative abundance of Lactococcus and Staphylococcus, whereas pasteurized A. muciniphila increased the relative abundance of Lactobacillus, Prevotellaceae_UCG_001, and Alistipes. Supplementation of A. muciniphila also induced alterations in serum and brain metabolites, with a particular enrichment observed in tryptophan metabolism, glyoxylate and dicarboxylate metabolism, nitrogen metabolism, and pentose and glucuronate interconversions. Correlation analysis further demonstrated a direct and substantial correlation between the altered gut microbiota and the metabolites in the serum and brain tissue. In conclusion, the results indicate that live A. muciniphila demonstrated greater efficacy compared to pasteurized A. muciniphila. The observed protective effects of A. muciniphila against DCI are likely mediated through the neuroinflammation and microbiota-metabolites-brain axis.
•Supplementation of live A. muciniphila ameliorated cognitive and behavioral deficit of db/db mice.•Supplementation of A. muciniphila ameliorated T2DM-associated gut microbiota dysbiosis and regulated the metabolomics of serum and brain tissue.•The protective effects of A. muciniphila against DCI correlate with neuroinflammation.
Mobile health is the use of mobile technology in developing healthcare, with the aim of reminding and motivating patients to adopt a healthy lifestyle. We conducted a systematic review assessing the ...effectiveness of text-messaging interventions on HbA1c in patients with Type 2 diabetes mellitus (T2DM).
Two authors independently searched MEDLINE, Embase, CINAHL, Cochrane Register of Randomized Control Trials and PsychInfo. The review included randomized control trials with at least 4 weeks follow up, evaluating the effect of text messaging on HbA1c, in patients with T2DM. Trials involving participants with Type 1 diabetes mellitus, pre-diabetes or gestational diabetes, or other forms of telemedicine were excluded. Studies employing bi-directional messaging were excluded.
208 papers were identified as meeting inclusion criteria and their abstracts reviewed. Of these, we examined the full text article of forty-four studies. Eleven randomized controlled trials were included in the final review, with a total of 1710 participants. One study focused on medication adherence only, while the remaining had educational and motivational messages. Five studies showed a significant improvement in HbA1c with the intervention. The remaining studies demonstrated a trend to improvement in HbA1c. Our meta-analysis on 9 of the 11 studies found an overall reduction in HbA1c of 0.38% (−0.53; −0.23, p-value <0.001).
Lifestyle-focused text messaging is a low cost initiative aimed at motivating patients with T2DM to adhere to a healthy lifestyle. We demonstrate that lifestyle focused text messaging is effective, with a significant improvement in HbA1c in the meta-analysis.
To investigate the relationship between short-term glycemic variability in patients with T2DM and the vulnerability of intracranial atherosclerotic plaques using HR-MR-VWI.
In total, 203 patients ...with acute ischemic stroke (AIS)/transient ischemia (TIA) combined with T2DM were enrolled. All of them underwent HR-MR-VWI during the period between July 2020 and July 2023. 203 patients were divided into groups with higher (1,5-AG≤ 30.7 μmol/L) and lower (1,5-AG> 30.7 μmol/L) short-term glycemic variability. Patients were also divided into the T1WI and non-T1WI hyperintensity groups. Associated factors(FBG, HbA1c, and 1,5-AG)for the T1WI hyperintensity were analyzed by binary logistic regression. We used the area under the curve (AUC), while the sensitivity and specificity were calculated at the optimal threshold. The Delong test was employed to compare the quality of the AUC of the predictors.
The group with higher short-term glycemic variability had a higher incidence of the hyperintensity on T1WI, higher degree of enhancement, higher degree of stenosis and smaller lumen area (P < 0.05). The T1WI hyperintensity group had higher HbA1c levels, higher hemoglobin levels and lower 1,5-AG levels(P < 0.05). 1,5-AG (OR = 0.971, 95 % CI: 0.954∼0.988, P = 0.001), HbA1c (OR=1.305, 95 % CI: 1.065∼1.598, P = 0.01) and male sex (OR = 2.048, 95 % CI: 1.016∼4.128, P = 0.045)/(OR=2.102, 95 % CI: 1.058∼4.177, P = 0.034) were independent risk factors for the hyperintensity on T1WI. 1,5-AG demonstrated enhanced performance and yielded the highest AUC of the receiver operator characteristic curve (AUC = 0.726), with sensitivity and specificity values of 0.727 and 0.635 respectively.
1,5-AG, HbA1c and male sex are independent predictors of intracranial plaques with T1WI hyperintensity, the greater short-term glycemic variability, the higher incidence of vulnerable plaques.
The formation and accumulation of methylglyoxal (MGO), a highly reactive dicarbonyl compound, has been implicated in the pathogenesis of type 2 diabetes, vascular complications of diabetes, and ...several other age-related chronic inflammatory diseases such as cardiovascular disease, cancer, and disorders of the central nervous system. MGO is mainly formed as a byproduct of glycolysis and, under physiological circumstances, detoxified by the glyoxalase system. MGO is the major precursor of nonenzymatic glycation of proteins and DNA, subsequently leading to the formation of advanced glycation end products (AGEs). MGO and MGO-derived AGEs can impact on organs and tissues affecting their functions and structure. In this review we summarize the formation of MGO, the detoxification of MGO by the glyoxalase system, and the biochemical pathways through which MGO is linked to the development of diabetes, vascular complications of diabetes, and other age-related diseases. Although interventions to treat MGO-associated complications are not yet available in the clinical setting, several strategies to lower MGO have been developed over the years. We will summarize several new directions to target MGO stress including glyoxalase inducers and MGO scavengers. Targeting MGO burden may provide new therapeutic applications to mitigate diseases in which MGO plays a crucial role.
OBJECTIVETo evaluate the therapeutic efficacy of lifetide biofeedback intervention in patients with type 2 diabetes mellitus (T2DM). METHODSWe analyzed the changes in average blood glucose, estimated ...glycosylated hemoglobin (HbA1c), fasting blood glucose and HbA1c levels in 5 patients with T2DM undergoing lifetide biofeedback intervention without the use of hypoglycemic drugs. A transient blood glucose monitoring system was used for drug withdrawal management during the intervention. RESULTSCompared with those before the intervention, the average blood glucose and fasting blood glucose and HbA1c levels showed no significant changes after the intervention without using hypoglycemic drugs (P>0.05), but the estimated HbA1c was significantly decreased after the intervention (P<0.05). Two patients achieved complete remission, two showed partial remission, and one had substantially improved blood glucose levels. One patient showed a marked increase in extremity temperature after the intervention (P<0.05). Another p
The prevalence of non-alcoholic fatty liver disease (NAFLD) is strongly increasing and may put patients at increased risk for atherosclerotic cardiovascular disease (asCVD). Both disease phenotypes ...often co-occur, in the case of obesity, insulin resistance, diabetes mellitus type 2, and the metabolic syndrome. We explore the pathogenesis of NAFLD, the epidemiology of asCVD in NAFLD patients, shared drivers of both phenotypes, and factors caused by NAFLD that contribute to asCVD. Genetic studies support that NAFLD may drive asCVD through mixed hyperlipidemia. Next, we discuss the prospects of lifestyle improvement and pharmacological treatment of NAFLD for asCVD risk reduction. Finally, we point out that earlier identification of patients with NAFLD should be pursued by increasing awareness of the association of these two phenotypes and collaboration between the involved physicians.
Non-alcoholic Fatty Liver Disease (NAFLD) and atherosclerotic cardiovascular disease (asCVD) often co-occur.Large epidemiological studies, genetics studies, and studies of subclinical atherosclerosis, support the relation between NAFLD and asCVD.NAFLD–non-alcoholic steatohepatitis (NASH) may directly contribute to asCVD and atherothrombotic events in the hepatic secretion of atherogenic lipoproteins and procoagulant factors.Genetic studies support the relationship between NAFLD and asCVD, notably via increased VLDL secretion. In particular, they support that genetic variants affecting both liver fat and plasma lipid levels have an effect on asCVD risk, while variants with an effect on liver fat only do not affect asCVD.Factors that may drive both NAFLD and asCVD are insulin resistance, hypertension, and potentially chronic periodic hypoxia, as observed in obstructive sleep apnea, and intestinal dysbiosis and chronic low grade inflammation.
Obesity is an epidemic disease characterized by chronic low-grade inflammation associated with a dysfunctional fat mass. Adipose tissue is now considered an extremely active endocrine organ that ...secretes cytokine-like hormones, called adipokines, either pro- or anti-inflammatory factors bridging metabolism to the immune system. Leptin is historically one of most relevant adipokines, with important physiological roles in the central control of energy metabolism and in the regulation of metabolism-immune system interplay, being a cornerstone of the emerging field of immunometabolism. Indeed, leptin receptor is expressed throughout the immune system and leptin has been shown to regulate both innate and adaptive immune responses. This review discusses the latest data regarding the role of leptin as a mediator of immune system and metabolism, with particular emphasis on its effects on obesity-associated metabolic disorders and autoimmune and/or inflammatory rheumatic diseases.
The rapidly increasing incidence of Diabetes Mellitus (DM) has shown that DM is a serious disease that endangered human life in all parts of the world. The late stage of Type-II DM (T2DM) in ...particular is accompanied by complex complications. Healthcare systems with various data mining algorithms can help the endocrinologist to find whether patients have diabetes in the early detection of T2DM. In the present research, a novel and efficient binary logistic regression (BLR) is proposed founding on feature transformation of XGBoost (XGBoost-BLR) for accurately predicting the specific type of T2DM, and making the model adaptive to more than one dataset. In order to raise the identification ratio, the databases are executed by series of preprocessing procedures which include removing outliers, normalization, and missing value processing. We select features that have a more significant effect on the results by χ2 test (CST). Then, the selected features are projected into high-dimensional feature space by XGBoost. Finally, the high-dimensional features generated can be modeled by the BLR application. The proposed XGBoost-BLR achieved a 94% and 98% identification rate for diabetes prediction in Pima Indians Diabetes Database (PIDD) and Early-Stage Diabetes Risk Prediction Database (ESDRPD).
•An intelligent diagnosis system can be used to help physicians with diabetes diagnosis, which is time saving and efficient.•In order to accomplish of this aim, we improve the validity and rationality of the dataset with preprocessing method.•Given clinical significance of type 2 Diabetes Mellitus, 10 features that have more significant effects on the results are selected by Chi-Square Test.•The model is indicated to be useful for the early screening T2DM.
•The T allele of the rs2230806 in ABCA1 gene is associated with higher risk of MI in Slovenian T2DM subjects.•The A allele of the rs1800977 in ABCA1 gene conferred protection against MI in Slovenian ...T2DM subjects.•Further studying associations between ABCA1 SNPs and acute vascular events rather than solely extent of atherosclerosis is needed to fully understand clinical impact of ABCA1.
The adenosine triphosphate-binding cassette transporter A1 (ABCA1) is closely linked to various aspects of the regulation of whole-body cholesterol metabolism and atherosclerosis formation. The object of the study was to investigate the association between rs1800977 and rs2230806 polymorphisms in the ABCA1 gene and myocardial infarction (MI) in Slovenian subjects with type 2 diabetes mellitus (T2DM).
1590 T2DM patients (484 subjects with MI and 1106 controls) were included in this retrospective cross-sectional case–control study. After genotyping, Pearson χ2 test was used to compare the distribution of genotypes and alleles among the two groups. Logistic regression analysis adjusted for several risk factors for MI was performed.
Genotype distribution showed significant association with MI in T2DM subjects for both selected polymorphisms in ABCA1 gene (p = 0.009 for rs2230806 and p = 0.042 for rs1800977). After applying corrections for confounding variables like age, waist circumference, diastolic blood pressure, serum high-density lipoprotein levels, gender and smoking several genetic models still showed significant associations with MI (dominant model for rs2230806 and dominant, overdominant and co-dominant for rs1800977).
Our study showed that presence of the T allele of the rs2230806 ABCA1 gene is associated with higher risk of MI, while the A allele of the rs1800977 conferred protection against MI in Slovenian T2DM subjects.
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