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Mikael Knip
About 20 years ago an American study suggested that daily subcutaneous injections of a metabolically inactive insulin analogue with a single amino acid substitution (aspartic acid instead of phenylalanine) at position 25 of the B chain was as effective as intact insulin in preventing autoimmune diabetes in NOD mice. In this issue of Diabetologia Grönholm et al (DOI: 10.1007/s00125-017-4276-5 ) report that parenteral administration of the same insulin analogue has no preventive effect whatsoever on the development of diabetes in NOD mice; in fact, high doses of the metabolically inactive insulin accelerated disease development...
June 3, 2017: Diabetologia
Ann V Schwartz
Older adults with diabetes are at higher risk of fracture and of complications resulting from a fracture. Hence, fracture risk reduction is an important goal in diabetes management. This review is one of a pair discussing the relationship between diabetes, bone and glucose-lowering agents; an accompanying review is provided in this issue of Diabetologia by Beata Lecka-Czernik (DOI 10.1007/s00125-017-4269-4 ). Specifically, this review discusses the challenges of accurate fracture risk assessment in diabetes...
July 2017: Diabetologia
Stef J Bloem, Bart O Roep
The role of B lymphocytes in the pathogenesis of type 1 diabetes in humans is not entirely evident. These cells are presumed to be important, but this assumption is largely based on animal models of autoimmune diabetes, where compelling evidence for the contribution of both B lymphocytes and insulin-specific autoantibodies to this disease is in place. For humans, this is much less the case; the exact way in which B lymphocytes and/or autoantibodies may contribute to type 1 diabetes is not yet known but the possibilities include a pathogenic function ('fire'), or they may represent a surrogate of loss of immune tolerance to beta cells ('smoke') or, indeed, they could be a marker of an attempt at immune regulation ('ice water')...
April 24, 2017: Diabetologia
Beata Lecka-Czernik
Skeletal fragility often accompanies diabetes and does not appear to correlate with low bone mass or trauma severity in individuals with diabetes. Instead (and in contrast to those with osteoporotic bone disease), bone remodelling and bone turnover are compromised in both type 1 and type 2 diabetes, contributing to defective bone material quality. This review is one of a pair discussing the relationship between diabetes, bone and glucose-lowering agents; an accompanying review is provided in this issue of Diabetologia by Ann Schwartz (DOI: 10...
July 2017: Diabetologia
Beverley Shields, Kevin Colclough
MODY is an early-onset monogenic form of diabetes. Correctly identifying MODY is of considerable importance as diagnosing the specific genetic subtype can inform the optimal treatment, with many patients being able to discontinue unnecessary insulin treatment. Diagnostic molecular genetic testing to confirm MODY is expensive, so screening strategies are required to identify the most appropriate patients for testing. In this issue of Diabetologia, Johansson and colleagues (DOI 10.1007/s00125-016-4167-1 ) describe a nationwide systematic screening approach to identify individuals with MODY in the paediatric age range...
January 29, 2017: Diabetologia
Paddy C Dempsey, Megan S Grace, David W Dunstan
While regular structured exercise is a well-established (though arguably under-utilised) cornerstone in the prevention and management of type 2 diabetes, population adherence to recommended exercise guidelines remains stubbornly low. Indeed, most adults are exposed to environmental settings (at work, in automobile travel and in the domestic environment) that may not only limit their physical activity, but also promote sitting for prolonged periods of time. However, recent experimental evidence indicates that reducing and breaking up sitting time may also be a useful strategy to improve glycaemic control...
March 2017: Diabetologia
Aidan McElduff
Gross iron overload has long been known to result in diabetes mellitus. However, it is now thought that milder levels of iron overload, possibly within the normal range, also increase the risk of diabetes mellitus. The article by Rawal et al in this issue (Diabetologia doi: 10.1007/s00125-016-4149-3 ) provides further support for the relationship between mild degrees of iron overload and the risk of gestational diabetes. The purpose of this commentary is to briefly discuss the background of this relationship and the implications it may have for routine pregnancy care...
February 2017: Diabetologia
Mikael Knip, Jenni Selvenius, Heli Siljander, Riitta Veijola
Type 1 diabetes is an immune-mediated disease leading to almost total beta cell destruction and permanent exogenous insulin dependency. The appearance of clinical symptoms is preceded by an asymptomatic preclinical period, the duration of which is highly individual. The emergence of diabetes-associated autoantibodies into the peripheral circulation is the first detectable sign of beta cell autoimmunity. If type 1 diabetes is diagnosed in childhood the preclinical period lasts for an average of 2.5-3 years, but clinical symptoms may in some cases appear within a few months or be delayed for more than 20 years...
January 2017: Diabetologia
Kai Sun, Jiyoung Park, Min Kim, Philipp E Scherer
Endotrophin is a cleavage product derived from the collagen VI(α3) chain. Collagen VI is expressed in a number of different tissues, but adipose tissue is a particularly prominent source for this extracellular matrix constituent. Mice lacking collagen VI are metabolically healthier due to reduced fibrosis in adipose tissue. Endotrophin seems to be one of the key players of collagen VI-mediated signalling effects, including its pro-fibrotic nature and chemoattractant properties for macrophages, while also playing an important role in cancer progression and the chemoresistance of tumour cells...
January 2017: Diabetologia
Joel T Haas, Bart Staels
Oxidative stress has long been considered a key driving factor of many obesity-related health problems. However, recent work by Merry, Tran et al (Diabetologia DOI 10.1007/s00125-016-4084-3 ) challenges this idea with an interesting study using a hepatocyte-specific Gpx1-knockout (HGKO) mouse. GPX1 is an important detoxification enzyme that converts H2O2 to water. The authors found that high-fat diet-fed HGKO mice were more insulin sensitive than wildtype controls, despite elevated hepatic levels of H2O2 and evidence of increased systemic oxidative stress...
October 1, 2016: Diabetologia
N Wah Cheung
Steroid-induced hyperglycaemia is a common problem faced by endocrinologists in hospital wards. In this issue of Diabetologia, Popovic and colleagues (DOI 10.1007/s00125-016-4091-4 ) have conducted a subanalysis within a randomised controlled trial of prednisone therapy for community-acquired pneumonia. The authors found that the presence of diabetes or hyperglycaemia related to steroid therapy did not attenuate the clinical benefits of steroid therapy. The relevance and possible implications of these findings are discussed...
December 2016: Diabetologia
Charlotte Ling, Tina Rönn
Epigenetic variation in human adipose tissue has been linked to type 2 diabetes and its related risk factors including age and obesity. Insulin resistance, a key risk factor for type 2 diabetes, may also be associated with altered DNA methylation in visceral and subcutaneous adipose tissue. Furthermore, linking epigenetic variation in target tissues to similar changes in blood cells may identify new blood-based biomarkers. In this issue of Diabetologia, Arner et al studied the transcriptome and methylome in subcutaneous and visceral adipose tissue of 80 obese women who were either insulin-sensitive or -resistant (DOI 10...
November 2016: Diabetologia
Rachel M Freathy
Lower birthweight is consistently associated with a higher risk of type 2 diabetes in observational studies, but the mechanisms underlying this association are not fully understood. Animal models and studies of famine-exposed populations have provided support for the developmental origins hypothesis, under which exposure to poor intrauterine nutrition results in reduced fetal growth and also contributes to the developmental programming of later type 2 diabetes risk. However, testing this hypothesis is difficult in human studies and studies aiming to do so are mostly observational and have limited scope for causal inference due to the presence of confounding factors...
September 2016: Diabetologia
Patrick Gilon
Type 2 diabetes is characterised by chronic hyperglycaemia and its incidence is highly increased by exaggerated food consumption. It results from a lack of insulin action/production, but growing evidence suggests that it might also involve hyperglucagonaemia and impaired control of glucose homeostasis by the brain. In recent years, the cocaine and amphetamine-regulated transcript (CART) peptides have generated a lot of interest in the battle against obesity because, via the brain, they exert anorexic effects and they increase energy expenditure...
September 2016: Diabetologia
Nadine Taleb, Rémi Rabasa-Lhoret
The prevention and management of exercise-induced hypoglycaemia remains a challenge for patients with type 1 diabetes. Strategies involving changes to insulin dosing and/or carbohydrate consumption in anticipation of or during different types of exercise have proved to be helpful but not sufficient to fully prevent the hypoglycaemic risk. Meanwhile, the defect in glucagon secretion in response to hypoglycaemia in diabetes and the contributory role of somatostatin to this dysregulation constitute an important therapeutic target...
August 2016: Diabetologia
Lars C Stene
Two papers in this issue of Diabetologia present recent trends in life expectancy for people with type 1 diabetes, one using data from an Australian registry (Huo et al, DOI: 10.1007/s00125-015-3857-4 ), the other, a Swedish registry (Petrie et al, DOI: 10.1007/s00125-016-3914-7 ). This commentary provides a brief review of the concept of the period life expectancy and complexities regarding applicability to patients, before summarising and discussing the main results of the two papers. In addition, some remaining relevant knowledge gaps are discussed...
June 2016: Diabetologia
Rebecca Wyatt, Alistair J K Williams
Type 1 diabetes (T1D) is a chronic inflammatory disease, caused by the immune mediated destruction of insulin-producing β-cells in the islets of the pancreas (Ziegler and Nepom, Immunity 32(4):468-478, 2010). Semiquantitative assays with high specificity and sensitivity for T1D are now available to detect antibodies to the four major islet autoantigens: glutamate decarboxylase (GADA) (Baekkeskov et al., Nature 347(6289):151-156, 1990), the protein tyrosine phosphatase-like proteins IA-2 (IA-2A) and IA-2β (Notkins et al...
2016: Methods in Molecular Biology
Martin K Rutter
This commentary discusses and reviews the implications of two studies published in this issue of Diabetologia by Hermida et al (DOIs: 10.1007/s00125-015-3748-8 and 10.1007/s00125-015-3749-7 ) suggesting that high nocturnal blood pressure could have a role in the prediction of diabetes and act as a therapeutic target to prevent diabetes. This overview addresses the clinical implications of this work and new research that is likely to advance this field. It also provides a framework for interpreting claims of causality from observational studies and clinical trials...
February 2016: Diabetologia
Petter S Alm, Anna Krook, Thais de Castro Barbosa
No abstract text is available yet for this article.
January 2016: Diabetologia
Julie Robitaille
Gestational diabetes mellitus (GDM) is associated with many adverse neonatal and maternal outcomes and prevention of this condition is considered a key strategy for breaking the intergenerational cycle of obesity and diabetes. Whether prevention of excessive gestational weight gain in the first weeks of pregnancy is associated with a reduced risk for GDM is currently unclear. In this issue of Diabetologia, Brunner et al (DOI: 10.1007/s00125-015-3686-5) address this possible association by conducting a systematic review and a meta-analysis...
October 2015: Diabetologia
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