Cardiovascular disease (CVD) is the most significant prognostic factor in individuals with type 2 diabetes (T2D). However, a significant number of individuals may develop CVD that does not present with the classic angina-related or heart failure symptoms. In these cases, CVD may seem to be ‘silent’ or ‘asymptomatic’, but may be more accurately characterised as unrecognised diabetic cardiac impairment. An initial step to raise awareness of unrecognised CVD in individuals with T2D would be to reach a consensus regarding the terminology used to describe this phenomenon. By standardising the terminologies, and agreeing on the implementation of an efficient screening program, it is anticipated that patients will receive an earlier diagnosis and appropriate and timely treatment. Given the availability of anti-diabetic medications that have been shown to concomitantly reduce CV risk and mortality, it is imperative to improve early identification and initiate treatment as soon as possible in order to enable as many patients with T2D as possible to benefit.
1 July 2020 in Applied Physiology, Nutrition, and Metabolism
We applied the Framingham risk equation in healthy, metabolic syndrome, and diabetes populations, following treatment with viscous fibre from konjac-based blend (KBB). KBB yielded reduction in estimated risk score by 16% (1.04 ± 0.03 vs. 0.87 ± 0.04, p < 0.01) in type 2 diabetes, 24% (1.08 ± 0.01 vs. 0.82 ± 0.02, p < 0.01) in metabolic syndrome, and 25% (1.09 ± 0.05 vs. 0.82 ± 0.06, p < 0.01) in healthy individuals. Drivers for decreased risk were improvements in blood cholesterol and systolic blood pressure. The composite coronary heart disease risk across populations was reduced 22% (p < 0.01). Novelty Viscous fibre from konjac-xanthan reduced 10-year relative coronary heart disease using Framingham Risk Score across the glycemic status spectrum.
Background/Objectives: Post-translationally modified peptide fragments of fetuin-A (FetA) were identified as a potential biomarker of diabetic kidney disease (DKD). An independent association between urinary FetA-derived peptide levels (uPTM3-FetA) and DKD progression in patients with type 2 diabetes (T2D) was evidenced. This study aimed to explore uPTM3-FetA excretion and its associations with insulin resistance, inflammatory and metabolic biomarkers in patients with type 1 diabetes (T1D), and the normal albuminuria and estimated glomerular filtration rate (eGFR) > 60 mL/min/1.73 m2. Methods: uPTM3-FetA levels in aliquots of 24 h urine specimens, routine laboratory renal, metabolic and inflammatory tests, adipokines (leptin, adiponectin, resistin), and insulin resistance, assessed as the estimated glucose disposal rate (eGDR), were measured in a cohort of 169 adult T1D patients. To evaluate the changes in early renal dysfunction, the cohort was divided according to the median eGFR. Above- and below-median-eGFR groups were considered as having normal and declining kidney function, respectively. Results: The median (IQR) uPTM3-FetA level was 11.7 (8.43–16.65 µg/24 h), with no significant difference between males and females, as well as normal and declining kidney function patients. However, a sex-specific analysis revealed a significantly higher uPTM3-FetA excretion in male T1D patients with lower eGFRs, when compared to those with higher eGFRs, whereas no such difference was observed in female patients. BMI, hs-CRP, resistin and HDL-cholesterol were identified as independent predictors of uPTM3-FetA excretion. Conclusions: Our results implicate the potential role of uPTM3-FetA in the detection of an early renal dysfunction in male patients with T1DM and pinpoint the importance of a sex-specific approach in diabetes diagnostics and research.