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Impact of Dietary and Exercise Interventions on Brain Insulin Action and Brain Function
Published in André Kleinridders, Physiological Consequences of Brain Insulin Action, 2023
Prediabetic dysglycemia and diabetes mellitus are characterized by an impairment of insulin signaling, which is either caused by reduced insulin secretion rate, lower insulin sensitivity or a combination of both. Most patients with dysglycemia in the context of the metabolic syndrome (i.e. associated with obesity, hypertension, dyslipidemia, but also hyperuricemia and NAFLD) and patients with type 2 diabetes (T2DM) show insulin resistance. The major fraction of type 1 diabetes patients (T1DM), but also some T2DM patients can be diagnosed with insulin deficiency, which is related to autoimmune destruction of the beta-cells (T1DM) or – in the case of T2DM – to a mixture of genetic factors, aging, glucolipotoxicity and hyperinsulinemic exhaustion of beta cells. As far as insulin secretion is intact, diabetes mellitus and its impairment of insulin signaling are reversible. Lifestyle interventions, pharmaceutical approaches, and surgical “last resorts” aim for a preservation of beta-cell function by ameliorating insulin resistance and/or reducing the amount of circulating substrates.
Physical Activity and Diabetes, Prediabetes, and the Metabolic Syndrome
Published in James M. Rippe, Increasing Physical Activity, 2020
In addition to the categories of prediabetes and diabetes outlined by the ADA an alternative nomenclature and framework has been suggested by the American Endocrinology Society called adiposity-based chronic disease (ABCD), which refers to the range of chronic disease states resulting from dysglycemia and particularly focused on cardiometabolic risk factors (9). It has been argued that this framework for viewing the spectrum of diseases that result in dysglycemia allows the earliest possible diagnosis of these issues allowing for early preventive strategies including lifestyle interventions such as physical activity, weight loss, and proper nutrition. In addition, it has been argued that the use of ABCD terminology can simplify health messages to patients by combining recommendations for disease prevention with disease treatment.
Impact of Lifestyle Medicine on Dysglycemia-Based Chronic Disease
Published in James M. Rippe, Lifestyle Medicine, 2019
A. Michael, Jeffrey I. Mechanick
The metabolic regulation and internal control of how energy modulates biochemical processes are achieved through complex interactions of substrate-, humoral-, and hormonal-level signals. Dysfunctional activity of this control network confers pathological consequences leading to various clinical syndromes. Many of these syndromes harbor elements of insulin resistance and pancreatic β-cell dysfunction, producing specific states, such as polycystic ovary syndrome (PCOS), metabolic syndrome (MetS), and type 2 diabetes (T2D). In this context, the term dysglycemia describes any pathophysiological state with a primary or secondary disturbance in glucose regulation (Table 28.1). Dysglycemia-based chronic disease (DBCD) refers to the multitude of chronic disease states that result from dysglycemia, especially those with cardiometabolic risks factors. Another way of viewing DBCD is along a spectrum beginning with molecular or genetic risk for T2D, to demonstrable biochemical risk for T2D (“prediabetes”), to early asymptomatic and uncomplicated T2D, to later symptomatic T2D with diabetes-related complications. This new perspective advances the clinical imperative to diagnose DBCD as early as possible so that effective preventive strategies, consisting primarily of lifestyle interventions, can be implemented. In addition, the use of DBCD terminology can simplify health messaging to patients by bundling recommendations about disease prevention with disease treatment.
Medical and gynecological comorbidities in adult women with Turner syndrome: our multidisciplinary clinic experience
Published in Climacteric, 2020
M. Farquhar, M. Jacobson, C. Braun, W. Wolfman, C. Kelly, L. M. Allen, I. C. Lega
Overall, older women had significantly more medical conditions compared to younger women (respective mean number of conditions: 2.9 ± 2.0 vs. 1.6 ± 1.5, p = 0.004) (Table 3). With regards to endocrine conditions, hypothyroidism was the most prevalent endocrine comorbidity with a higher prevalence among older women than younger women (respectively 36.7% vs. 17.7%, p = 0.019) (see Figure 1). Similarly, dysglycemia was present in 16% of our cohort, and was more common among older women than younger women (respectively 24.5% vs. 5.5%; p = 0.023). Among causes of dysglycemia, 56.3% had type 2 diabetes, 37.5% had impaired glucose tolerance, and 6.3% had type 1 diabetes. With regards to bone density, the prevalence of low bone density was 29.5% across the cohort when combining osteoporosis and decreased bone density. Only 1.6% of patients were currently on bone-sparing medications.
Intersections and Clinical Translations of Diabetes Mellitus with Cancer Promotion, Progression and Prognosis
Published in Postgraduate Medicine, 2019
Stanley S. Schwartz, Struan F.A. Grant, Mary E. Herman
The cumulative findings in the area of hyperglycemia are fostering more pragmatic approaches to DM management, and, spawning research into the full scope of derangements of dysmetabolism. Beyond the ‘usual suspects’ impacted by dysglycemia – insulin resistance, hypoglycemia, increased appetite, and weight gain, obesity, dyslipidemia, endothelial dysfunction, atherosclerosis, and hypertension – a large range of medical conditions not traditionally associated with hyperglycemia are impacted by it. More ‘distal’ disease states wrought by dysglycemia include chronic inflammation, Alzheimer’s disease, dementia, depression, sleep disorders, and cancer, among others.
Point of care blood glucose devices in the hospital setting
Published in Critical Reviews in Clinical Laboratory Sciences, 2023
Nam K. Tran, Clayton LaValley, Berit Bagley, John Rodrigo
Glycemic control is essential for reducing inpatient mortality and morbidity [1,2]. Unfortunately, dysglycemia among hospitalized patients is common and results in excess mortality and morbidity. Specifically, hyperglycemia occurs in as many as 46% of hospitalized patients [3]. Among critically ill diabetic patients, its prevalence increases to 80% [4,5] Frequent glucose monitoring is necessary for the safe administration of insulin to reduce hyperglycemia. Point-of-care (POC) blood glucose monitoring at the patient’s bedside is essential for glycemic monitoring in hospital settings [6].