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Sohail MU, Batool RM, Aamir J, Saad M, Aisha E, Jain H, Arshad MS, Ahmed R. Trends in Type 2 Diabetes Mellitus and Parkinson's Disease Related Mortality in the United States from 1999 to 2020. Diabetes Res Clin Pract 2025; 224:112239. [PMID: 40345594 DOI: 10.1016/j.diabres.2025.112239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2025] [Revised: 05/01/2025] [Accepted: 05/06/2025] [Indexed: 05/11/2025]
Abstract
BACKGROUND Emerging evidence indicates that individuals with Type 2 Diabetes Mellitus (T2DM) are at an elevated risk of Parkinson's Disease (PD). While mortality trends for each condition have been studied individually, the combined burden of T2DM- and PD-related mortality remains poorly understood. This study aims to evaluate national trends and disparities in T2DM and PD related mortality among older adults in the United States (U.S.). from 1999 to 2020. METHODS Using CDC WONDER database, we analyzed deaths among U.S. residents aged 65 + from 1999 to 2020, identifying T2DM (ICD-10: E11) and PD (ICD-10: G20) related deaths. Crude and age-adjusted mortality rates (AAMR) per 100,000 individuals were calculated, and Joinpoint regression analysis was employed to estimate the annual percent change (APC). RESULTS Between 1999 and 2020, a total of 26,020 deaths occurred among older adults with T2DM and PD. The AAMR increased from 1.65 in 1999 to 5.61 in 2020, with a sharp rise between 2015 and 2020 (APC: +14.42 %; 95 % CI: 11.22 to 20.80). Males experienced higher AAMRs than females (4.51 vs. 1.80). Across racial groups, Hispanic or Latino individuals exhibited the highest AAMR (3.61), while non-Hispanic Black Americans had the lowest (1.96). Non-metropolitan areas experienced higher AAMRs than metropolitan areas (3.64 vs. 2.71). CONCLUSIONS T2DM and PD-related mortality has surged over the past two decades, particularly since 2015, with significant racial, sex-based, and regional disparities. Targeted public health strategies are needed to address these growing health concerns.
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Affiliation(s)
| | | | - Jazza Aamir
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Muhammad Saad
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
| | - Eliza Aisha
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Hritvik Jain
- All India Institute of Medical Sciences, Jodhpur, India
| | | | - Raheel Ahmed
- National Heart and Lung Institute, Imperial College London, London, United Kingdom.
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Hsieh HH, Chu PA, Lin YH, Kao YCJ, Chung YH, Hsu ST, Mo JM, Wu CY, Peng SL. Imaging diabetic cardiomyopathy in a type 1 diabetic rat model using 18F-FEPPA PET. Nucl Med Biol 2024; 128-129:108878. [PMID: 38324923 DOI: 10.1016/j.nucmedbio.2024.108878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/08/2024] [Accepted: 01/22/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Diabetic patients often experience chronic inflammation and fibrosis in their cardiac tissues, highlighting the pressing need for the development of sensitive diagnostic methods for longitudinal assessment of diabetic cardiomyopathy. This study aims to evaluate the significance of an inflammatory marker known as translocator protein (TSPO) in a positron emission tomography (PET) protocol for longitudinally monitoring cardiac dysfunction in a diabetic animal model. Additionally, we compared the commonly used radiotracer, 18F-fluoro-2-deoxy-d-glucose (18F-FDG). METHODS Fourteen 7-week-old female Sprague-Dawley rats were used in this study. Longitudinal PET experiments were conducted using 18F-N-2-(2-fluoroethoxy)benzyl)-N-(4-phenoxypyridin-3-yl)acetamide (18F-FEPPA) (n = 3), the TSPO radiotracer, and 18F-FDG (n = 3), both before and after the onset of diabetes. Histological and immunohistochemical staining assays were also conducted in both the control (n = 4) and diabetes (n = 4) groups. RESULTS Results indicated a significant increase in cardiac tissue uptake of 18F-FEPPA after the onset of diabetes (P < 0.05), aligning with elevated TSPO levels observed in diabetic animals according to histological data. Conversely, the uptake of 18F-FDG in cardiac tissue significantly decreased after the onset of diabetes (P < 0.05). CONCLUSION These findings suggest that 18F-FEPPA can function as a sensitive probe for detecting chronic inflammation and fibrosis in the cardiac tissues of diabetic animals.
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Affiliation(s)
- Hsin-Hua Hsieh
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei Branch, Taipei, Taiwan
| | - Pei-An Chu
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Yu-Hsin Lin
- Department of Pharmacy, National Yang Ming Chiao Tung University, Taipei Branch, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Yu-Chieh Jill Kao
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei Branch, Taipei, Taiwan
| | - Yi-Hsiu Chung
- Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shih-Ting Hsu
- Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Jia-Min Mo
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Chun-Yi Wu
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei Branch, Taipei, Taiwan.
| | - Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan; Neuroscience and Brain Disease Center, China Medical University, Taichung, Taiwan.
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Wu CY, Lin YH, Hsieh HH, Lin JJ, Peng SL. Sex Differences in the Effect of Diabetes on Cerebral Glucose Metabolism. Biomedicines 2021; 9:1661. [PMID: 34829890 PMCID: PMC8615590 DOI: 10.3390/biomedicines9111661] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 12/25/2022] Open
Abstract
The neuroimaging literature indicates that brain structure and function both deteriorate with diabetes, but information on sexual dimorphism in diabetes-related brain alterations is limited. This study aimed to ascertain whether brain metabolism is influenced by sex in an animal model of diabetes. Eleven rats (male, n = 5; female, n = 6) received a single intraperitoneal injection of 70 mg/kg streptozotocin (STZ) to develop diabetes. Another 11 rats (male, n = 5; female, n = 6) received the same amount of solvent through a single intraperitoneal injection. Longitudinal positron emission tomography scans were used to assess cerebral glucose metabolism before and 4 weeks after STZ or solvent administration. Before STZ or solvent injections, there was no evidence of sexual dimorphism in cerebral metabolism (p > 0.05). Compared with healthy control animals, rats with diabetes had significantly decreased brain metabolism in all brain regions (all p < 0.05). In addition, female diabetic rats exhibited further reduction in cerebral metabolism, relative to male diabetic rats (p < 0.05). The results of this study may provide some biological evidence, supporting the existence of a sexual dimorphism in diabetes-related complications.
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Affiliation(s)
- Chun-Yi Wu
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei Branch, Taipei 112304, Taiwan; (C.-Y.W.); (H.-H.H.)
| | - Yu-Hsin Lin
- Department of Pharmacy, National Yang Ming Chiao Tung University, Taipei Branch, Taipei 112304, Taiwan;
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 404333, Taiwan
| | - Hsin-Hua Hsieh
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei Branch, Taipei 112304, Taiwan; (C.-Y.W.); (H.-H.H.)
| | - Jia-Jia Lin
- Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan 404333, Taiwan;
| | - Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung 404332, Taiwan
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Abstract
Gestational diabetes mellitus and prediabetes are 2 features with research evidence for association with development of diabetes in older women. What matters to older women determines goals of management, lifestyle interventions, and medications. A dearth of palliative guidelines for management of diabetes at the end of life makes management challenging.
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Yu BJ, Li NS, He WH, He C, Wan JH, Zhu Y, Lu NH. Pancreatic necrosis and severity are independent risk factors for pancreatic endocrine insufficiency after acute pancreatitis: A long-term follow-up study. World J Gastroenterol 2020; 26:3260-3270. [PMID: 32684740 PMCID: PMC7336320 DOI: 10.3748/wjg.v26.i23.3260] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/29/2020] [Accepted: 05/15/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pancreatic endocrine insufficiency after acute pancreatitis (AP) has drawn increasing attention in recent years.
AIM To assess the impact of risk factors on the development of pancreatic endocrine insufficiency after AP.
METHODS This retrospective observational long-term follow-up study was conducted in a tertiary hospital. Endocrine function was evaluated by the oral glucose tolerance test. The data, including age, sex, body mass index, APACHE II score, history of smoking and drinking, organ failure, pancreatic necrosis, debridement of necrosis (minimally invasive and/or open surgery), and time interval, were collected from the record database.
RESULTS A total of 361 patients were included in the study from January 1, 2012 to December 30, 2018. A total of 150 (41.6%) patients were diagnosed with dysglycemia (including diabetes mellitus and impaired glucose tolerance), while 211 (58.4%) patients had normal endocrine function. The time intervals (mo) of the above two groups were 18.73 ± 19.10 mo and 31.53 ± 27.27 mo, respectively (P = 0.001). The morbidity rates of pancreatic endocrine insufficiency were 46.7%, 28.0%, and 25.3%, respectively, in the groups with different follow-up times. The risk factors for pancreatic endocrine insufficiency after AP were severity (odds ratio [OR] = 3.489; 95% confidence interval [CI]: 1.501-8.111; P = 0.004) and pancreatic necrosis (OR = 4.152; 95%CI: 2.580-6.684; P = 0.001).
CONCLUSION Pancreatic necrosis and severity are independent risk factors for pancreatic endocrine insufficiency after AP. The area of pancreatic necrosis can affect pancreatic endocrine function.
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Affiliation(s)
- Bing-Jun Yu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Nian-Shuang Li
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Wen-Hua He
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Cong He
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Jian-Hua Wan
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Yin Zhu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Nong-Hua Lu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
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Ding G, Chopp M, Li L, Zhang L, Davoodi-Bojd E, Li Q, Wei M, Zhang Z, Jiang Q. Differences between normal and diabetic brains in middle-aged rats by MRI. Brain Res 2019; 1724:146407. [PMID: 31465773 PMCID: PMC8063608 DOI: 10.1016/j.brainres.2019.146407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/23/2019] [Accepted: 08/24/2019] [Indexed: 01/01/2023]
Abstract
Normal aging is a risk factor for metabolic disorders such as diabetes, and diabetes is also a recognized cause of accelerated aging. Being able to distinguish changes caused by normal aging from those caused by diabetes, would provide insight into how the aging brain interacts with diabetes. Eight types of MRI metric maps (magnetization relaxation time constants of T1 and T2, cerebral blood flow, cerebrovascular permeability, mean diffusivity, diffusion fractional anisotropy, mean diffusion kurtosis and diffusion directional entropy) were generated for all rats from the three groups of normal young, healthy and 1.5-month diabetic middle-aged rats under investigation. Measurements of multiple MRI indices of cerebral white and gray matter from animals of the three groups provide complementary results and insight into differences between healthy and diabetic white / gray matter in the mid-aged rats. Our data indicate that MRI may distinguish between the normal and diabetes in mid-aged rat brains by measuring either T1 and T2 of gray matter, or fractional anisotropy of white matter and gray matter. Therefore, MRI can distinguish changes of cerebral tissue due to the normal aging from diabetic aging, which may lead to be able to better understand how diabetes accelerates aging in normal brain.
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Affiliation(s)
- Guangliang Ding
- Department of Neurology, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA
| | - Michael Chopp
- Department of Neurology, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA; Department of Physics, Oakland University, Rochester, MI 48309, USA
| | - Lian Li
- Department of Neurology, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA
| | - Li Zhang
- Department of Neurology, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA
| | - Esmaeil Davoodi-Bojd
- Department of Neurology, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA
| | - Qingjiang Li
- Department of Neurology, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA
| | - Min Wei
- Department of Neurology, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA
| | - Zhenggang Zhang
- Department of Neurology, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA
| | - Quan Jiang
- Department of Neurology, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA; Department of Physics, Oakland University, Rochester, MI 48309, USA.
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Squires E, Duber H, Campbell M, Cao J, Chapin A, Horst C, Li Z, Matyasz T, Reynolds A, Hirsch IB, Dieleman JL. Health Care Spending on Diabetes in the U.S., 1996-2013. Diabetes Care 2018; 41:1423-1431. [PMID: 29748431 PMCID: PMC6014544 DOI: 10.2337/dc17-1376] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 04/07/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Health care spending on diabetes in the U.S. has increased dramatically over the past several decades. This research describes health care spending on diabetes to quantify how that spending has changed from 1996 to 2013 and to determine what drivers are increasing spending. RESEARCH DESIGN AND METHODS Spending estimates were extracted from the Institute for Health Metrics and Evaluation's Disease Expenditure 2013 database. Estimates were produced for each year from 1996 to 2013 for each of 38 age and sex groups and six types of care. Data on disease burden were extracted from the Global Burden of Disease 2016 study. We analyzed the drivers of spending by measuring the impact of population growth and aging and changes in diabetes prevalence, service utilization, and spending per encounter. RESULTS Spending on diabetes in the U.S. increased from $37 billion (95% uncertainty interval $32-$42 billion) in 1996 to $101 billion ($97-$107 billion) in 2013. The greatest amount of health care spending on diabetes in 2013 occurred in prescribed retail pharmaceuticals (57.6% [53.8-62.1%] of spending growth) followed by ambulatory care (23.5% [21.7-25.7%]). Between 1996 and 2013, pharmaceutical spending increased by 327.0% (222.9-456.6%). This increase can be attributed to changes in demography, increased disease prevalence, increased service utilization, and, especially, increases in spending per encounter, which increased pharmaceutical spending by 144.0% (87.3-197.3%) between 1996 and 2013. CONCLUSIONS Health care spending on diabetes in the U.S. has increased, and spending per encounter has been the biggest driver. This information can help policy makers who are attempting to control future spending on diabetes.
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Affiliation(s)
- Ellen Squires
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
| | - Herbert Duber
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA.,Department of Emergency Medicine, University of Washington, Seattle, WA
| | - Madeline Campbell
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
| | - Jackie Cao
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
| | - Abigail Chapin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
| | - Cody Horst
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
| | - Zhiyin Li
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
| | - Taylor Matyasz
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
| | - Alex Reynolds
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
| | - Irl B Hirsch
- Division of Metabolism, Endocrinology and Nutrition, University of Washington, Seattle, WA
| | - Joseph L Dieleman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
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Tu J, Zhang J, Ke L, Yang Y, Yang Q, Lu G, Li B, Tong Z, Li W, Li J. Endocrine and exocrine pancreatic insufficiency after acute pancreatitis: long-term follow-up study. BMC Gastroenterol 2017; 17:114. [PMID: 29078749 PMCID: PMC5658961 DOI: 10.1186/s12876-017-0663-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/02/2017] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Patients could develop endocrine and exocrine pancreatic insufficiency after acute pancreatitis (AP), but the morbidity, risk factors and outcome remain unclear. The aim of the present study was to evaluate the incidence of endocrine and exocrine pancreatic insufficiency after AP and the risk factors of endocrine pancreatic insufficiency through a long-term follow-up investigation. METHODS Follow-up assessment of the endocrine and exocrine function was conducted for the discharged patients with AP episodes. Oral Glucose Tolerance Test (OGTT) and faecal elastase-1(FE-1) test were used as primary parameters. Fasting blood-glucose (FBG), fasting insulin (FINS), glycosylated hemoglobin HBA1c, 2-h postprandial blood glucose (2hPG), Homa beta cell function index (HOMA-β), homeostasis model assessment of insulin resistance (HOMA-IR) and FE-1 were collected. Abdominal contrast-enhanced computed tomography (CECT) was performed to investigate the pancreatic morphology and the other related data during hospitalization was also collected. RESULTS One hundred thirteen patients were included in this study and 34 of whom (30.1%) developed diabetes mellitus (DM), 33 (29.2%) suffered impaired glucose tolerance (IGT). Moreover, 33 patients (29.2%) developed mild to moderate exocrine pancreatic insufficiency with 100μg/g CONCLUSION The integrated morbidity of DM and IGT after AP was 59.25%, which was higher than exocrine pancreatic insufficiency. 6.2% and 29.2% of patients developed severe and mild to moderate exocrine pancreatic insufficiency, respectively. The extent of pancreatic necrosis>50%, WON and insulin resistance were the independent risk factors of new onset diabetes after AP.
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Affiliation(s)
- Jianfeng Tu
- Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002 China
- Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Shangtang road 158#, Hangzhou, 310014 China
| | - Jingzhu Zhang
- Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002 China
| | - Lu Ke
- Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002 China
| | - Yue Yang
- Hangzhou Medical College, Binwen road 481#, Hangzhou, 310053 China
| | - Qi Yang
- Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002 China
| | - Guotao Lu
- Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002 China
| | - Baiqiang Li
- Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002 China
| | - Zhihui Tong
- Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002 China
| | - Weiqin Li
- Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002 China
| | - Jieshou Li
- Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002 China
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Mortality and Cardiovascular Complications in Older Complex Chronic Patients with Type 2 Diabetes. BIOMED RESEARCH INTERNATIONAL 2017; 2017:6078498. [PMID: 28856160 PMCID: PMC5569628 DOI: 10.1155/2017/6078498] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 07/10/2017] [Indexed: 01/06/2023]
Abstract
AIMS/INTRODUCTION Determining the prevalence of diabetes and its cardiovascular complications and all-cause mortality in older chronic complex patients. MATERIALS AND METHODS We carried out a multicenter retrospective study and included a randomized sample of 932 CCP people. We assessed the prevalence of diabetes according to World Health Organization criteria. Data included demographics and functional, comorbidity, cognitive, and social assessment. RESULTS The prevalence of diabetes was 53% and average age 81.16 ± 8.93 years. There were no significant differences in the survival of CCP patients with or without DM, with or without ischaemic cardiopathy, and with or without peripheral vascular disease. The prognostic factors of all-cause mortality in patients with DM were age ≥ 80 years [HR 1.47, 95% CI 1.02-2.13, p 0.038], presence of heart failure [HR 1.73, 95% CI 1.25-2.38, p 0.001], Charlson score [HR 1.20, 95% CI 1.06-1.36, p 0.003], presence of cognitive impairment [HR 1.73, 95% CI 1.24-2.40, p 0.001], and no treatment with statins [HR 1.49, 95% CI 1.08-2.04, p 0.038]. CONCLUSIONS We found high prevalence of DM among CCP patients and the relative importance of traditional risk factors seemed to wane with advancing age. Recommendations may include relaxing treatment goals, providing family/patient education, and enhanced communication strategies.
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Risk Factors of Hyperglycemia in Patients After a First Episode of Acute Pancreatitis: A Retrospective Cohort. Pancreas 2017; 46:209-218. [PMID: 27846145 DOI: 10.1097/mpa.0000000000000738] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the risk factors for hyperglycemia development after a first episode of acute pancreatitis (AP). METHODS Three hundred and ten patients treated for AP were retrospectively evaluated. Hyperglycemia was determined by fasting blood glucose. All data were collected from the medical records room database and a follow-up telephone call. RESULTS The incidence rate of hyperglycemia was obviously increased 5 years after the event. Hazard ratios (HRs) of developing hyperglycemia in patients with hyperlipidemia, fatty liver, and hypertension were 2.52 (P < 0.001), 1.87 (P = 0.01), and 1.78 (P = 0.017), respectively. Patients of biliary origin that underwent endoscopic retrograde cholangiopancreatography presented a 4.62-fold greater risk than those managed conservatively. Other risk factors were random blood glucose greater than 8.33 mmol/L (HR, 4.19; P < 0.001), lactate dehydrogenase greater than 350 U/L (HR, 1.99; P = 0.017), calcium less than 1.75 mmol/L (HR, 3.86; P = 0.004), and elevated creatine kinase (HR, 2.74; P = 0.001). Patients with AB blood type showed 2.92-fold greater risk compared with those with O blood type. Among them, hyperlipidemia and hyperglycemia on admission were the only independent risk factors (both P < 0.05). CONCLUSIONS Hyperlipidemia, fatty liver, hypertension, endoscopic retrograde cholangiopancreatography treatment, acute hyperglycemia, elevated lactate dehydrogenase and creatine kinase, decreased calcium, and AB blood type were risk factors for hyperglycemia development after AP.
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12
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Affiliation(s)
- Elsa S Strotmeyer
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 North Bellefield Avenue, Room 515, Pittsburgh, PA 15213, USA.
| | - Janice C Zgibor
- Center for Aging and Population HealthPrevention Research Center, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 North Bellefield Avenue, Room 307, Pittsburgh, PA 15213, USA.
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Cheng C, Lin CH, Tsai YW, Tsai CJ, Chou PH, Lan TH. Type 2 diabetes and antidiabetic medications in relation to dementia diagnosis. J Gerontol A Biol Sci Med Sci 2014; 69:1299-305. [PMID: 24899525 DOI: 10.1093/gerona/glu073] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Type 2 diabetes (T2D) has been shown to increase dementia risk, but few studies evaluated the relationship between antidiabetic treatment and dementia. METHODS We followed up 67,731 participants who were nondemented, nondiabetic, aged 65 or over at baseline from January 2004 to December 2009, to observe the onset of T2D (median follow-up 2.4 years), and to compare the risk of the development of dementia associated with particular types of antidiabetic medication among participants with T2D who had solely one type of antidiabetic agents throughout the follow-up period (median follow-up for participants with T2D 3.1 years). RESULTS The hazard ratio for dementia diagnosis in the new-onset T2D participants compared with the non-T2D participants was 1.56 (95%CI: 1.39-2.18). The relative rate of dementia was 5.31 (95% CI: 1.89-14.96) for participants taking thiazolidinediones (n = 28) and 1.22 (95% CI: 0.78-1.91) for those taking sulfonylureas (n = 796) compared to those taking metformin (n = 1,033). The risk of dementia was higher in ever (n = 841) versus never users (n = 4,579) of thiazolidinediones: 1.44 (95% CI: 1.12-1.86). CONCLUSIONS Diabetes is associated with an increased risk of dementia. The risk effect becomes weaker provided that participants take sulfonylureas or metformin rather than thiazolidinediones for a longer period.
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Affiliation(s)
- Chin Cheng
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. Department of Psychiatry and
| | - Ching-Heng Lin
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yi-Wen Tsai
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan. Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
| | - Chia-Jui Tsai
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
| | - Po-Han Chou
- Department of Psychiatry and Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Tsuo-Hung Lan
- Department of Psychiatry and Department of Psychiatry, National Yang-Ming University, Taipei, Taiwan. Center for Neuropsychiatric research, National Health Research Institutes, Miaoli, Taiwan.
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Arum O, Saleh JK, Boparai RK, Kopchick JJ, Khardori RK, Bartke A. Preservation of blood glucose homeostasis in slow-senescing somatotrophism-deficient mice subjected to intermittent fasting begun at middle or old age. AGE (DORDRECHT, NETHERLANDS) 2014; 36:9651. [PMID: 24789008 PMCID: PMC4082609 DOI: 10.1007/s11357-014-9651-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 03/26/2014] [Indexed: 05/19/2023]
Abstract
Poor blood glucose homeostatic regulation is common, consequential, and costly for older and elderly populations, resulting in pleiotrophically adverse clinical outcomes. Somatotrophic signaling deficiency and dietary restriction have each been shown to delay the rate of senescence, resulting in salubrious phenotypes such as increased survivorship. Using two growth hormone (GH) signaling-related, slow-aging mouse mutants we tested, via longitudinal analyses, whether genetic perturbations that increase survivorship also improve blood glucose homeostatic regulation in senescing mammals. Furthermore, we institute a dietary restriction paradigm that also decelerates aging, an intermittent fasting (IF) feeding schedule, as either a short-term or a sustained intervention beginning at either middle or old age, and assess its effects on blood glucose control. We find that either of the two genetic alterations in GH signaling ameliorates fasting hyperglycemia; additionally, both longevity-inducing somatotrophic mutations improve insulin sensitivity into old age. Strikingly, we observe major and broad improvements in blood glucose homeostatic control by IF: IF improves ad libitum-fed hyperglycemia, glucose tolerance, and insulin sensitivity, and reduces hepatic gluconeogenesis, in aging mutant and normal mice. These results on correction of aging-resultant blood glucose dysregulation have potentially important clinical and public health implications for our ever-graying global population, and are consistent with the Longevity Dividend concept.
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Affiliation(s)
- Oge Arum
- Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL, 62794, USA,
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15
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Das SLM, Singh PP, Phillips ARJ, Murphy R, Windsor JA, Petrov MS. Newly diagnosed diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis. Gut 2014; 63:818-31. [PMID: 23929695 DOI: 10.1136/gutjnl-2013-305062] [Citation(s) in RCA: 272] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Diabetes mellitus (DM) is common in the general population and it poses a heavy burden to society in the form of long-term disability, healthcare use and costs. The pancreas is a key player in glucose homeostasis, but the occurrence of newly diagnosed DM after acute pancreatitis (AP), the most frequent disease of the pancreas, has never been assessed systematically. The aim of this study was to conduct a systematic literature review to determine the prevalence and time course of DM and related conditions after the first attack of AP as well as the impact of covariates. METHODS Relevant literature cited in three electronic databases (Scopus, EMBASE and MEDLINE) was reviewed independently by two authors. The main outcome measures studied were newly diagnosed prediabetes, DM, or DM treated with insulin. Pooled prevalence and 95% CIs were calculated for all outcomes. RESULTS A total of 24 prospective clinical studies, involving 1102 patients with first episode of AP, met all the eligibility criteria. Prediabetes and/or DM was observed in 37% (95% CI 30% to 45%) individuals after AP. The pooled prevalence of prediabetes, DM and treatment with insulin after AP was 16% (95% CI 9% to 24%), 23% (95% CI 16% to 31%), and 15% (95% CI 9% to 21%), respectively. Newly diagnosed DM developed in 15% of individuals within 12 months after first episode of AP and the risk increased significantly at 5 years (relative risk 2.7 (95% CI 1.9 to 3.8)). A similar trend was observed with regard to treatment with insulin. The severity of AP, its aetiology, individuals' age and gender had minimal effect on the studied outcomes. CONCLUSIONS Patients with AP often develop prediabetes and/or DM after discharge from hospital, and have a greater than twofold increased risk of DM over 5 years. Further studies are warranted to determine the optimal strategy for its detection and whether the risk of developing DM after AP can be reduced.
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Affiliation(s)
- Stephanie L M Das
- Department of Surgery, The University of Auckland, , Auckland, New Zealand
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16
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Roche E, Ramírez-Tortosa CL, Arribas MI, Ochoa JJ, Sirvent-Belando JE, Battino M, Ramírez-Tortosa MC, González-Alonso A, Pérez-López MP, Quiles JL. Comparative analysis of pancreatic changes in aged rats fed life long with sunflower, fish, or olive oils. J Gerontol A Biol Sci Med Sci 2013; 69:934-44. [PMID: 24136874 DOI: 10.1093/gerona/glt157] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
An adequate pancreatic structure is necessary for optimal organ function. Structural changes are critical in the development of age-related pancreatic disorders. We aimed to study the effect of oil consumption on pancreas histology in order to find aging-related signs. To this end, three groups of rats were fed an isocaloric diet for 2 years, where virgin olive, sunflower, or fish oil was included. Pancreatic samples for microscopy and blood samples were collected at the moment of sacrifice. As a result, the sunflower oil-fed rats presented higher β-cell numbers and twice the insulin content than virgin olive oil-fed animals. In addition, rats fed with fish oil developed acinar fibrosis and macrophage infiltrates in peri-insular regions, compared with counterparts fed with virgin olive oil. Inflammation signs were less prominent in the sunflower group. The obtained data emphasize the importance of dietary fatty acids in determining pancreatic structure.
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Affiliation(s)
- Enrique Roche
- Bioengineering Institute, University Miguel Hernandez, Elche (Alicante), Spain
| | | | - María I Arribas
- Bioengineering Institute, University Miguel Hernandez, Elche (Alicante), Spain
| | - Julio J Ochoa
- Institute of Nutrition and Food Technology "José Mataix Verdú" and Department of Physiology, University of Granada, Spain
| | - José E Sirvent-Belando
- Department of Analytical Chemistry, Nutrition and Bromatology, University of Alicante, Spain
| | - Maurizio Battino
- Dipartimento di Scienze Biomediche e Sanità Pubblica, Università Politecnica delle Marche, Ancona, Italy
| | - M Carmen Ramírez-Tortosa
- Institute of Nutrition and Food Technology "José Mataix Verdú" and Department of Biochemistry and Molecular Biology II, University of Granada, Spain
| | - Adrián González-Alonso
- Institute of Nutrition and Food Technology "José Mataix Verdú" and Department of Physiology, University of Granada, Spain
| | - M Patricia Pérez-López
- Institute of Nutrition and Food Technology "José Mataix Verdú" and Department of Physiology, University of Granada, Spain
| | - José L Quiles
- Institute of Nutrition and Food Technology "José Mataix Verdú" and Department of Physiology, University of Granada, Spain.
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Rogers SC, Zhang X, Azhar G, Luo S, Wei JY. Exposure to high or low glucose levels accelerates the appearance of markers of endothelial cell senescence and induces dysregulation of nitric oxide synthase. J Gerontol A Biol Sci Med Sci 2013; 68:1469-81. [PMID: 23585419 DOI: 10.1093/gerona/glt033] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
To test the hypothesis that aging impairs endothelial cell response to glucose stress, we utilized a human umbilical vein endothelial cell in vitro model in which clinically relevant concentrations of normal (5.5 mM), high (25 mM), and low (1.5mM) glucose were tested. With advancing population doubling, exposure to normal glucose gradually decreased endothelial nitric oxide synthase expression and activity, resulting in slow, progressive development of markers of cell senescence (by population doubling level [PDL] 44). High or low glucose treatment accelerated the appearance of markers of senescence (by ~PDL 35) along with declines in endothelial nitric oxide synthase expression and activity. Human umbilical vein endothelial cells exposed to alternating low and high glucose gave even more rapid acceleration in the appearance of markers of senescence (by ~PDL 18) and reduction in endothelial nitric oxide synthase levels. Thus, exposure to low and high glucose induces earlier appearance of markers of endothelial cell senescence and dysregulation of the nitric oxide synthase gene and protein expression and function. These findings will help to elucidate endothelial dysfunction associated with glucose intolerance and improve future therapy for diabetic seniors.
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Affiliation(s)
- Steven C Rogers
- Reynolds Institute on Aging, University of Arkansas for Medical Sciences, 629 Jack Stephens Drive, Little Rock, AR 72205.
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