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47 (95% confidence interval 2.77-4.37). The prevalence of combined nonvalvular/valvular AF and nonvalvular AF increased with age. Other relevant factors associated with AF and nonvalvular AF were male sex, presence of hypertension, and decreased platelet count.
Higher prevalence of AF was observed in Japanese patients with type 2 diabetes than the general population. Advanced age, male sex, and hypertension were independent predictive factors for AF.
Higher prevalence of AF was observed in Japanese patients with type 2 diabetes than the general population. Advanced age, male sex, and hypertension were independent predictive factors for AF.
The efficacy of dulaglutide was assessed according to the pretreatments administered before the initiation of dulaglutide in patients with type 2 diabetes.
In total, 89 patients treated using dulaglutide (0.75mg, once a weekly) were investigated. The subjects were divided into the three groups based on the form in which therapy was started additional therapy (
= 35), switched from dipeptidyl peptidase-4 (DPP-4) inhibitors (
= 32) and switched from daily glucagon-like peptide-1 receptor agonists (GLP-1 RAs,
= 30). The changes in medication adherence were determined in the daily GLP-1 RAs group using questionnaire surveys.
The HbA1c values significantly decreased after the initiation of dulaglutide in all groups (additional therapy group, -1.4 ± 1.6%; DPP-4 inhibitors group, -1.2 ± 1.3%; and daily GLP-1 RAs group, -0.5 ± 0.7%). Forty-six percent of the subjects in the daily GLP-1 RAs group reported that the incidence of forgetting injections of GLP-1 RA was decreased. The reduction of HbA1c was significantly greater in the subjects who reported a decrease in the incidence of forgetting injections (0.9 ± 0.9%) in comparison to those in which there was no change (0.1 ± 0.4%).
Dulaglutide is considered effective in patients with type 2 diabetes and inadequate glycemic control, regardless of whether their pretreatment includes daily GLP-1 RA treatment.
Dulaglutide is considered effective in patients with type 2 diabetes and inadequate glycemic control, regardless of whether their pretreatment includes daily GLP-1 RA treatment.
We assessed the effect of supervised, combined aerobic and resistance exercise on diabetic parameters in Japanese patients with type 2 diabetes mellitus (T2DM).
This 12-week, multicenter (17 medical institutions), open-label, parallel-group study (clinicaltrials.jp; JapicCTI-184002), randomized (11) Japanese patients aged 20-75years with T2DM and hemoglobin A1c (HbA1c) of 7.0-10.0% to supervised exercise (
= 113) or standard therapy (
= 115). The supervised exercise group undertook supervised aerobic (30min) and resistance exercise 3 times/week (20 designated gyms). Primary endpoint was change in HbA1c from baseline at week 13. Secondary endpoints were change in fasting blood glucose (FBG), glycoalbumin, fasting insulin, homeostatic model assessment of insulin resistance (HOMA-IR), and HOMA-β at week 13.
Of 228 randomized patients, 97 (85.8%) in the supervised exercise group and 108 (93.9%) in the standard therapy group completed the study. Supervised exercise significantly lowered HbA1c at week 13 versus standard therapy (estimated difference in change from baseline [95% confidence interval]- 0.44% [-0.61,-0.28],
< 0.001). Supervised exercise also significantly decreased FBG (estimated difference-13.0 [-19.2,-6.7] mg/dL) and glycoalbumin (estimated difference -1.52% [-2.10,-0.93]) compared with standard therapy. Fasting insulin (-0.5 µIU/mL) and HOMA-IR (-0.3) decreased with supervised exercise, but group differences were not significant. Treatment-emergent adverse events were more frequent in the supervised exercise group (42.5%) than in the standard therapy group (29.6%); however, no major safety concerns were identified.
A structured, supervised, aerobic and resistance exercise program improved HbA1c and was well accepted among patients with T2DM.
The online version contains supplementary material available at 10.1007/s13340-021-00506-5.
The online version contains supplementary material available at 10.1007/s13340-021-00506-5.Type 2 diabetes mellitus (T2DM) is a chronic disease prevalent in the world, and it is also one of the overall factors leading to overall morbidity and mortality. Throughout Asia, the proportion of people with T2DM and obesity has increased and this growth rate shows no signs of slowing down. Thiazolidinediones (TZDs) can specifically treat insulin resistance and improve metabolic syndrome, including rosiglitazone, troglitazone and pioglitazone, which are peroxisome proliferator-activated receptor (PPAR) agonists. These drugs have been shown to have better therapeutic effect and glycemic control, but also accompanied by a series of adverse reactions. Cardiovascular events are currently the most serious adverse events of rosiglitazone, which cardiovascular toxicity is higher than pioglitazone. Rosiglitazone has been restricted or even withdrawal from the market in most countries owing to concerns about its cardiovascular safety, while its beneficial effect on insulin resistance has been demonstrated. New data on rosiglitazone-mediated heart failure, myocardial infarction and fractures provide clinicians with prescriptions with fewer side effects to treat patients. Studies have shown that rosiglitazone is the most effective treatment in TZDs (in vivo study), not only hypoglycemic effect but with some additional effects, such as anti-inflammatory and anti-cancer capabilities, retinopathy (animal models) and ischemia-reperfusion injury protection effects, lipid regulation and blood pressure reduction, etc. Although rosiglitazone shows the highest risk of arrhythmia in diabetes management while has the capacity to reduce the risk of atrial fibrillation.
Among chronic diseases, diabetes is a frequent focus of performance measurement. Disease-specific indicators based on evidence-based clinical guidelines have been used to evaluate the quality of care. There are worldwide efforts to improve the quality of diabetes care. Measuring the gap is an essential first step toward improving the quality of care.
In order to better understand the status of quality of diabetes care in Japan, a country with a universal healthcare system, we performed a literature search looking for all studies reporting on quality indicators. In this review, we summarized the studies that have looked at the status of the quality of diabetes care over the last decade.
There were a total of 6 studies that reported on process including HbA1c, blood pressure, lipid screening, retinopathy and nephropathy screening and intermediate clinical measures which included percentages of patients reaching targets for HbA1c, blood pressure and LDL-C. Overall, the process measures continue to improve, however the clinical intermediate outcome measures remain suboptimal.
Despite the improvement in diabetes related process measures, there is limited data on clinical measures. It is necessary to shed more light on the assessment of the quality of diabetes care.
Despite the improvement in diabetes related process measures, there is limited data on clinical measures. It is necessary to shed more light on the assessment of the quality of diabetes care.Suppression of hepatic gluconeogenesis is thought to largely underlie the antidiabetes action of metformin. However, this drug also exerts various effects on the gut, one of which is the enhancement of the uptake of 18F-labeled fluorodeoxyglucose (FDG), a nonmetabolizable glucose derivative, during [18F]FDG positron emission tomography (PET)-computed tomography (CT). Whereas the relevance of this effect to the glucose-lowering action of metformin remains unclear, it is of special interest because it was discovered in humans. Cessation of metformin treatment for several days is required to normalize [18F]FDG uptake in the intestine, suggesting that the enhanced uptake is not a direct effect of the drug in the circulation but rather a prolonged secondary effect. A recent study with state-of-the-art PET-magnetic resonance imaging (MRI), which provides better tissue registration and soft-tissue contrast compared with PET-CT, revealed that metformin-induced accumulation of [18F]FDG occurs primarily in the lumen of the intestine, indicating that the drug promotes excretion of glucose from the circulation into this space. This phenomenon does not necessarily imply that metformin stimulates the removal of glucose from the body in the stool. Instead, it might be related to changes in the abundance and metabolism of the gut microbiota induced by metformin. Further studies of this effect of metformin might shed light on the unanswered questions that still remain concerning the clinical action of this old drug.[This corrects the article DOI 10.1007/s13340-021-00551-0.].[This corrects the article DOI 10.1007/s13340-021-00551-0.].Polyhydroxyalkanoates (PHAs) are versatile biodegradable polymers produced by bacteria and are suitable for many downstream applications. They can be produced inexpensively from mixed microbial cultures under feast and famine conditions in the presence of biobased volatile fatty acids (VFAs). Here, we investigated the effect of changing the sludge retention time (SRT) and the addition of fermented cellulosic primary sludge (CPS) as a carbon source on the selection of PHA-storing biomass when applying the feast and famine strategy under aerobic and anoxic conditions, respectively. Increasing the SRT from 5 to 7-10 days enhanced PHA yields under feast conditions from 0.18 gCODPHA/gCODVFA (period 1) to 0.40 gCODPHA/gCODVFA (period 2). The use of fermented CPS as a carbon source (period 3) increased PHA yields to 0.62 gCODPHA/gCODVFA despite the presence of biodegradable non-VFA fractions. Microbial characterization by denaturing gradient gel electrophoresis and fluorescence in situ hybridization revealed high microbial speciation during the three experimental periods. In period 3, the dominant genera were Thauera, Paracoccus, and Azoarcus, which accounted for ∼95% of the total microbial biomass.This study aimed to evaluate the virucidal effect and potential use as a disinfectant of undiluted and diluted slightly acidic electrolyzed water (SAEW) on human noroviruses (HuNoVs) using the in vitro suspension test and in food test. The oxidization reduction potential of SAEW gradually decreased with the increase in distilled water volume. Moreover, as the volume of distilled water and the dilution ratio increased, the available chlorine concentration of the samples significantly decreased from 31.2 ± 0.63 (SAEW) to 1.3 ± 0.21 (110 dilution of SAEW solution) (p
The online version contains supplementary material available at 10.1007/s10068-021-01011-w.
The online version contains supplementary material available at 10.1007/s10068-021-01011-w.Rosa rugosa root is traditionally known to be effective in the treatment of diabetes in Korea. R. rugosa root-specific compounds also show antioxidant effects, and could reduce lipid and fat accumulation, however, the underlying mechanism has not been clarified. In present study, the antioxidant and lipid-reducing effects of a 50% ethanol extract of R. rugosa (REE) were investigated differentiated mouse preadipocytes (3T3-L1 cells). REE showed strong radical scavenging activities and inhibitory effect of total lipid accumulation and triglyceride levels in differentiated 3T3-L1 cells. SB239063 solubility dmso In addition, REE treatment reduced the mRNA and protein levels of adipogenesis and lipogenesis markers. This REE-promoted lipid reduction was caused by downregulation of peroxisome proliferator activated receptor gamma (PPARγ), CCAAT/enhancer binding protein alpha (C/EBPα), and sterol regulatory element binding protein1 (SREBP1c) and down regulation of ERK expression. Overall, these results demonstrate the potential of REE for development of a drug in the medical treatment of lipid-associated disorders.
