Background: Previous studies have suggested an association between impaired pancreatic exocrine function and diabetes, but the evidence is weak because the invasive nature of the tests used to define ...exocrine function has led to small studies on selected patients. The availability of faecal elastase 1 as a non-invasive test has aided the detection of impaired exocrine function in population studies. We describe the association between levels of faecal elastase 1 and Type 2 diabetes. Methods:
Measures of research productivity have become widely used for obtaining tenure, third-party funding, and additional resources from universities. However, previous studies indicate that men might have ...a higher research output than women, with mixed conclusions about the factors that drive these differences. This study explores to what extent the research productivity of psychology professors in Germany is related to gender and, furthermore, how any gender gaps can be explained by controlling for individual and organizational factors. In addition, three publication dimensions (publications in top 10% journals, journal articles, and book and collection chapters) are distinguished to determine the effect of gender on research productivity as precisely as possible. A unique data set based on all full professors in psychology in Germany and their publication record in 2013 and 2014 is used (
N
authors
= 294;
N
articles
= 2252,
N
chapters
= 439). Thus, this study provides a current overview of the state of research productivity in an entire discipline after researchers receive tenure and external restrictions are lessened. Our research helps to further locate the point at which gender differences in publication numbers occur. As we are the first to systematically to analyze different publication types, we are able to show that there is no difference in publication numbers for less-prestigious book chapters. However, we find significant gender differences for research productivity in academic journals that are more important for career advancement and peer recognition, even after we control for the most important individual and organizational factors that might explain gender differences. Our results point to the direction that women do research and write manuscripts, but may have different publication patterns: instead of submitting to competitive journals, they may be satisfied with less-prestigious book chapters. As publications in peer-reviewed journals are especially important for career advancement as well as peer recognition, this publication pattern may be disadvantageous for women. Overall, we conclude that additional research to understand these developments is needed that focuses on the motives and beliefs of researchers, both to improve gender equality in academia and to give women better chances to gain recognition and prestige.
This article analyses the current state of the debate over competition for land use, by means of an index of the main arguments in favor and against the production of liquid biofuels and the impacts ...on food production. Based on this index, an analytic framework is constructed to establish the causal relations indicated by the existing studies on this competition. We find that the emergence of agro-energy has altered the land use dynamic, albeit not yet significantly, with a shift of areas traditionally used to grow foods over to crops to produce biofuels. This has been contributing to raise food prices in the short run. However, it is probable that this is not the only factor determining this trend, nor will it last over the long run. The challenge is to conciliate the production of biofuels with the production of foods in sustainable form.
Aims/hypothesis
The aim of this work was to investigate diabetes incidence after infection with coronavirus disease-2019 (Covid-19). Individuals with acute upper respiratory tract infections (AURI), ...which are frequently caused by viruses, were selected as a non-exposed control group.
Methods
We performed a retrospective cohort analysis of the Disease Analyzer, which comprises a representative panel of 1171 physicians’ practices throughout Germany (March 2020 to January 2021: 8.8 million patients). Newly diagnosed diabetes was defined based on ICD-10 codes (type 2 diabetes: E11; other forms of diabetes: E12–E14) during follow-up until July 2021 (median for Covid-19, 119 days; median for AURI 161 days). Propensity score matching (1:1) for sex, age, health insurance, index month for Covid-19/AURI and comorbidity (obesity, hypertension, hyperlipidaemia, myocardial infarction, stroke) was performed. Individuals using corticosteroids within 30 days after the index dates were excluded. Poisson regression models were fitted to obtain incidence rate ratios (IRRs) for diabetes.
Results
There were 35,865 individuals with documented Covid-19 in the study period. After propensity score matching, demographic and clinical characteristics were similar in 35,865 AURI controls (mean age 43 years; 46% female). Individuals with Covid-19 showed an increased type 2 diabetes incidence compared with AURI (15.8 vs 12.3 per 1000 person-years). Using marginal models to account for correlation of observations within matched pairs, an IRR for type 2 diabetes of 1.28 (95% CI 1.05, 1.57) was estimated. The IRR was not increased for other forms of diabetes.
Conclusions/interpretation
Covid-19 confers an increased risk for type 2 diabetes. If confirmed, these results support the active monitoring of glucose dysregulation after recovery from mild forms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
Graphical abstract
The aim of this work was to review studies in which genetic variants were assessed with respect to metabolic response to treatment with novel glucose-lowering drugs: dipeptidyl peptidase-4 inhibitors ...(DPP-4i), glucagon-like peptide-1 receptor agonists (GLP-1 RA) and sodium–glucose cotransporter 2 inhibitors (SGLT2i). In total, 22 studies were retrieved from the literature (MEDLINE). Variants of the GLP-1 receptor gene (
GLP1R
) were associated with a smaller reduction in HbA
1c
in response to DPP-4i. Variants of a number of other genes (
KCNQ1
,
KCNJ11
,
CTRB1/2
,
PRKD1
,
CDKAL1
,
IL6
promoter region,
TCF7L2
,
DPP4
,
PNPLA3
) have also been related to DPP-4i response, although replication studies are lacking. The
GLP1R
gene was also reported to play a role in the response to GLP-1 RA, with larger weight reductions being reported in carriers of
GLP1R
variant alleles. There were variants of a few other genes (
CNR1
,
TCF7L2
,
SORCS1
) described to be related to GLP-1 RA. For SGLT2i, studies have focused on genes affecting renal glucose reabsorption (e.g.
SLC5A2
) but no relationship between
SLC5A2
variants and response to empagliflozin has been found. The relevance of the included studies is limited due to small genetic effects, low sample sizes, limited statistical power, inadequate statistics (lack of gene–drug interactions), inadequate accounting for confounders and effects modifiers, and a lack of replication studies. Most studies have been based on candidate genes. Genome-wide association studies, in that respect, may be a more promising approach to providing novel insights. However, the identification of distinct subgroups of type 2 diabetes might also be necessary before pharmacogenetic studies can be successfully used for a stratified prescription of novel glucose-lowering drugs.
Graphical abstract
Denosumab initiation is related to a lower risk of type 2 diabetes than alendronate in anti-osteoporotic treatment-naïve users in primary care practices.Denosumab initiation is related to a lower ...risk of type 2 diabetes than alendronate in anti-osteoporotic treatment-naïve users in primary care practices.Links have been suggested between bone metabolism and glucose tolerance. Downregulation of the receptor activator of nuclear factor κ B ligand (RANKL) signaling improves glucose metabolism. Denosumab, a human monoclonal antibody against RANKL, may be associated with a lower risk of type 2 diabetes (T2D). The aim was to compare incidence rates of T2DM in primary care patients initiating denosumab or alendronate, which is a first-line therapy of osteoporosis. Alendronate as comparator enhances comparability of the two cohorts.PURPOSELinks have been suggested between bone metabolism and glucose tolerance. Downregulation of the receptor activator of nuclear factor κ B ligand (RANKL) signaling improves glucose metabolism. Denosumab, a human monoclonal antibody against RANKL, may be associated with a lower risk of type 2 diabetes (T2D). The aim was to compare incidence rates of T2DM in primary care patients initiating denosumab or alendronate, which is a first-line therapy of osteoporosis. Alendronate as comparator enhances comparability of the two cohorts.The IQVIA Disease Analyzer comprises a representative panel of general and specialist practices (Germany). A new-user comparative study was conducted among patients with denosumab or alendronate treatment (2010-2021) without history of diabetes and age ≥ 45 years. Incidence rates (per 1,000 person-years) and Cox proportional hazard ratios (HR; 95%CI) for T2DM were estimated.METHODThe IQVIA Disease Analyzer comprises a representative panel of general and specialist practices (Germany). A new-user comparative study was conducted among patients with denosumab or alendronate treatment (2010-2021) without history of diabetes and age ≥ 45 years. Incidence rates (per 1,000 person-years) and Cox proportional hazard ratios (HR; 95%CI) for T2DM were estimated.The cohorts consisted of 3,354 denosumab (age: 75 years; women: 87%) and 27,068 alendronate (76 years; 86%) users. Overall, 1,038 persons developed T2D during 54,916 person-years. T2DM incidence rates per 1,000 person-years were 11.9 (9.5-14.4) for denosumab and 20.1 (18.8-21.3) for alendronate users, respectively. Denosumab was associated with a reduced risk of T2DM compared to alendronate, adjusting for age, sex, index year, visits, obesity, comorbidities and statins (HR: 0.73; 0.58-0.89).RESULTSThe cohorts consisted of 3,354 denosumab (age: 75 years; women: 87%) and 27,068 alendronate (76 years; 86%) users. Overall, 1,038 persons developed T2D during 54,916 person-years. T2DM incidence rates per 1,000 person-years were 11.9 (9.5-14.4) for denosumab and 20.1 (18.8-21.3) for alendronate users, respectively. Denosumab was associated with a reduced risk of T2DM compared to alendronate, adjusting for age, sex, index year, visits, obesity, comorbidities and statins (HR: 0.73; 0.58-0.89).In this comparative study of older patients seen in routine practices, denosumab was associated with a lower risk of developing T2DM than alendronate.CONCLUSIONIn this comparative study of older patients seen in routine practices, denosumab was associated with a lower risk of developing T2DM than alendronate.
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