Aims
Food addiction (FA) is conceptualized as a behavioral pattern that is similar in some ways to addictions to alcohol and other substances. This disorder has not been well studied among patients ...with type 2 diabetes (T2DM). We aimed to analyze if there is any relationship between FA and clinical or psychological variables among patients with T2DM.
Methods
Three hundred patients with T2DM were analyzed cross-sectionally. Participants were evaluated for the presence of FA by completing the Yale Food Addiction Scale 2.0 questionnaire.
Results
29.3% of patients screened positive for FA. Patients with FA had a greater BMI (33.41 ± 7.5 vs. 31.6 ± 5.9 kg/m
2
;
p
= 0.04). HbA1c was higher among individuals with FA (7.9 ± 4.4 vs. 7.6 ± 1.4%,
p
= 0.008). The proportion of subjects with diabetic retinopathy, neuropathy and nephropathy was greater among patients with criteria for FA compared with patients without this condition (25% vs. 13.2%, 29.5% vs. 21.8% and 32% vs. 22.3%;
p
= 0.03,
p
= 0.05 and
p
= 0.05, respectively). The percentage of patients with FA with significant depressive symptoms was also greater (36.4% vs. 18.5%;
p
= 0.002).
Conclusions
The presence of FA among T2DM patients implied a worse glycaemic control. Microvascular complications and depressive symptoms were higher among these patients.
Reply letter to the editor by Dr. Kawada Nicolau, Joana; Romerosa, Juan Manuel; Rodríguez, Irene ...
Acta diabetologica,
10/2020, Letnik:
57, Številka:
10
Journal Article
Crises and health policies to tackle them can increase health inequalities. We explored the scope and usefulness of helplines set up during the COVID-19 crisis and characterised the vulnerability of ...their users. This study explored the geographic and socioeconomic effects of the telephone helplines set up by the Balearic Islands Government and aimed to characterise the vulnerability of their users.
Telephonic survey combined with a geographical analysis of a sample of calls made between 15th of March and 30th of June of 2020 to five helplines: COVID-19 general information; psychological, social (minimum vital income), labour (temporary employment regulation), and housing (rental assistance) helps. The questionnaire included sociodemographic and housing characteristics, type of problem, and if it was solved or not. We used multinomial regression to explore factors associated with having solved the problem. We calculated the standardised rate of calls by municipality using Chi-squared and
-test to test differences.
1,321 interviews from 2,678 selected (231 excluded, 608 untraceable, and 518 refusals). 63.8% of women, 48.7% were born in another country. They had no internet at home in 3.1%, only on the phone in 17.3%. The 23.5% had no income at home. The Problem was solved in 25.4%, and partly in 30.9%. Factors associated with not solving the problem were not having income at home (
= 0.021), labour (
= 0.008), economic (
= 0.000) or housing (
= 0.000) problems. People from 55 of 67 municipalities did at least one call. The highest rates of calls were from coastal tourist municipalities.
Helplines reached most of the territory of the Balearic Islands and were used mainly in tourist municipalities. It probably has not been helpful for families with more significant deprivation. Digital inequalities have emerged.
Progressive degeneration of neuroretinal tissue with maintained elevated intraocular pressure (IOP) to simulate chronic glaucoma was produced by intracameral injections of poly (lactic-co-glycolic) ...acid (PLGA) microspheres (Ms) in rat eyes. The right eye of 39 rats received different sizes of PLGA-Ms (2 µL suspension; 10%
/
): 14 with 38-20 µm Ms (Ms38/20 model) and 25 with 20-10 µm particles (Ms20/10 model). This novel glaucoma animal model was compared to the episcleral vein sclerosis (EPI) model (25 eyes). Injections were performed at baseline, two, four and six weeks. Clinical signs, IOP, retina and optic nerve thicknesses (using in vivo optical coherence tomography; OCT), and histological studies were performed. An IOP increment was observed in all three groups, however, the values obtained from the PLGA-Ms injection resulted lower with a better preservation of the ocular surface. In fact, the injection of Ms20/10 created a gentler, more progressive, and more sustained increase in IOP. This IOP alteration was correlated with a significant decrease in most OCT parameters and in histological ganglion-cell count for the three conditions throughout the eight-week follow-up. In all cases, progressive degeneration of the retina, retinal ganglion cells and optic nerve, simulating chronic glaucoma, was detected by OCT and corroborated by histological study. Results showed an alternative glaucoma model to the well-known episcleral vein model, which was simpler to perform, more reproducible and easier to monitor in vivo.
•Emotional eating is highly frequent among patients with obesity.•Emotional eating has a negative impact on weight loss and maintenance.•Semaglutide improves significantly emotional eating at short ...term.
Emotional eating (EE) and other abnormal eating patterns are highly prevalent among people living with obesity (PWO). In this sense, semaglutide, by acting on areas of the brain involved in the reward system and emotion regulation, could have the potential to ameliorate these eating patterns.
69 PWO attending an obesity clinic were evaluated baseline and after 3 months since the beginning of semaglutide. To rule out abnormal EE, the Emotional Eating Questionnaire was administered, and a structured interview was conducted. Results: 69 PWO (82.6%♀, 43.7 ± 1years, and 34.3 ± 6 kg/m2) were included. After 3 months of semaglutide, there was a significant reduction in weight (96.1 ± 20.9 vs 91.3 ± 19.7 kg; p < 0.001) and BMI (34.3 ± 6 vs 32.4 ± 5.6 kg/m2; p < 0.0001). The proportion of patients with EE (72.5% vs 11.5%; p < 0.001), external eating (27.5% vs 10.1%; p < 0.001) cravings (49.3% vs 21.7%; p < 0.001) and savory cravings (53.6% vs 14.5%; p < 0.001) was significantly reduced after 3 months of semaglutide. Also, the proportion of PWO with regular exercise was increased (15.9% vs 39.1%; p < 0.001). However, Logistic regression analysis showed that only sweet cravings at baseline were the only factor associated, although not significant, with a poorer weight loss (p = 0.05).
Semaglutide is an effective weight-loss treatment in PWO at short term. Moreover, semaglutide was highly effective in ameliorating EE and other abnormal eating patterns that exert a negative influence on weight.
Iron overload causes oxidative damage in the retina, and it has been involved in the pathogeny of diabetic retinopathy, which is one of the leading causes of blindness in the adult population ...worldwide. However, how systemic iron enters the retina during diabetes and the role of blood retinal barrier (BRB) in this process remains unclear.
The db/db mouse, a well-known model of type 2 diabetes, and a model of systemic iron overload induced by iron dextran intraperitoneal injection, were used. Perls staining and mass spectrophotometry were used to study iron content. Western blot and immunohistochemistry of iron handling proteins were performed to study systemic and retinal iron metabolism. BRB function was assessed by analyzing vascular leakage in fundus angiographies, whole retinas, and retinal sections and by studying the status of tight junctions using transmission electron microscopy and Western blot analysis.
Twenty-week-old db/db mice with systemic iron overload presented ferritin overexpression without iron increase in the retina and did not show any sign of BRB breakdown. These findings were also observed in iron dextran-injected mice. In those animals, after BRB breakdown induced by cryopexy, iron entered massively in the retina.
Our results suggested that BRB protects the retina from excessive iron entry in early stages of diabetic retinopathy. Furthermore, ferritin overexpression before iron increase may prepare the retina for a potential BRB breakdown and iron entry from the systemic circulation.
•BMI positively correlates with the presence of weight stigma.•The presence of weight stigma does not exert a significant influence on weight loss.•Inflammatory markers are greater with the presence ...of weight stigma among subjects living with obesity.
Weight stigma (WS) and prejudice are one of the most prevalent ways of discrimination among adults, comparable with rates of racial discrimination. Exposure to WS among patients with obesity (PWO) may make the adoption of healthy dietary patterns and regular physical activity even more challenging and, therefore, the achievement of weight loss. Additionally, WS could also induce physiological responses such as increased levels of inflammatory markers, due to stress exposure.
Subjects attending two obesity clinics were evaluated at baseline and after a minimum follow-up of six months. The weight Bias Internalization Scale (WBIS) and the Stigmatizing Situations Inventory (SSI) were administered to evaluate WS. Also, anthropometric and inflammatory markers, including cortisol, ferritin and C-reactive protein (CRP), were recorded at baseline.
79 PWO (87.3%♀, 45.5 ± 1.3 years, 35.9 ± 6.3 kg/m2) were included. At baseline, 72.2% started liraglutide as anti-obesity drug. Baseline body mass index (BMI) correlated positively with both WBIS (r = 0.23; p = 0.03) and SSI (r = 0.25; p = 0.02) scores. Mean percentual weight loss after a mean follow-up of six months was -7.28%. However, there was a negative, but not statistically significant, correlation between weight loss and both WBIS (r=-0.14; p = 0.2) and SSI (r=-0.19; p = 0.08). Regarding inflammatory markers, plasma cortisol levels at baseline correlated positively with WBIS (p = 0.005) and SSI (p = 0.02). CRP at baseline also presented a positive correlation with SSI (p = 0.03). No significant correlations were found for stigma tests and ferritin levels.
As weight increases among PWO, so does stigma. Despite we did not find a significant negative association between the presence of WS and weight loss outcomes, there was an increase in inflammatory markers among PWO who experienced higher levels of WS.
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One of the potential negative effects of a lockdown are changes in dietary and lifestyle patterns, which can lead to weight gain. Our objective was to assess the changes on dietary habits and eating ...patterns in a lockdown situation and their impact on weight. We aimed to determine whether the treatment with GLP1 analogues (aGLP1) could impact on these parameters.
100 overweight/obese patients were consecutively recruited for a review at the end of the lockdown. A structured interview was designed to see changes in dietary habits, routines and exercise.
52% patients gained weight during lockdown. The percentage of subjects with an active history of depression or anxiety was higher among the group of patients who gained weight. The percentage of patients who worsened their hyperphagia was higher in those who gained weight (71.2% vs. 10.6%; P<0.0001); similar results were observed with binge eating (92% vs. 10.6%; p<0.0001) and cravings, both sweet and salty (69.2% vs. 21.3% and 69.2% vs. 14.9%; p<0.0001 and p<0.0001 respectively). Of the 48 patients who did not gain weight, 30 were under aGLP1 treatment (61.7%). The worsening of abnormal eating patterns was lower among patients treated with aGLP-1.
A lockdown is a vulnerable period to gain weight, especially in those patients with a psychopathological history. aGLP1 manage to control emotional eating, making them a valuable therapeutic option.
Endostatin, a naturally cleaved fragment of type XVIII collagen with antiangiogenic activity, has been involved in the regulation of neovascularization during diabetic retinopathy. Here, the ...intracellular distribution of endostatin in healthy mouse and human neuroretinas has been analyzed. In addition, to study the effect of experimental hyperglycemia on retinal endostatin, the db/db mouse model has been used. Endostatin protein expression in mouse and human retinas was studied by immunofluorescence and Western blot, and compared with db/db mice. Eye fundus angiography, histology, and immunofluorescence were used to visualize mouse retinal and intravitreal vessels.
For the first time, our results revealed the presence of endostatin in neurons of mouse and human retinas. Endostatin was mainly expressed in bipolar cells and photoreceptors, in contrast to the optic disc, where endostatin expression was undetectable. Diabetic mice showed a reduction of endostatin in their retinas associated with the appearance of intravitreal vessels at the optic disc in 50% of db/db mice. Intravitreal vessels showed GFAP positive neuroglia sheath, basement membrane thickening by collagen IV deposition, and presence of MMP-2 and MMP-9 in the vascular wall. All together, these results point that decreased retinal endostatin during experimental diabetes is associated with optic disc intravitreal vascularization. Based on their phenotype, these intravitreal vessels could be neovessels. However, it cannot be ruled out the possibility that they may also represent persistent hyaloid vessels.
•Endostatin is found intracellularly in mouse and human retinal neurons.•Diabetic db/db mice showed decreased retinal endostatin.•Endostatin is observed throughout the retina except for the optic disc, an area prone to neovascularization.•Diabetic mice showed intravitreal vessels protruding from the optic disc.
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