Background: Insulin stimulates glucose uptake by triggering TUG proteolysis, which liberates intracellular storage vesicles containing GLUT4. Results: TUG acetylation modulates its interaction with Golgi matrix proteins and enhances its function to trap GLUT4 storage vesicles within unstimulated cells. SIRT2 modulates TUG acetylation and controls insulin sensitivity in vivo. Conclusion: TUG acetylation promotes GLUT4 accumulation in insulin-responsive vesicles. Significance: Nutritional status modulates insulin-stimulated glucose uptake.

BackgroundLifestyle interventions targeting weight loss, such as those delivered through the Diabetes Prevention Program, reduce the risk of developing type 2 diabetes. Technology-mediated interventions may be an option to help overcome barriers to program delivery, and to disseminate diabetes prevention programs on a larger scale.ObjectiveWe conducted a meta-analysis to evaluate the effect of such technology-mediated interventions on weight loss.MethodsIn this meta-analysis, six databases were searched to identify studies reporting weight change that used technology to mediate diet and exercise interventions, and targeted individuals at high risk for developing type 2 diabetes. Studies published between January 1, 2002 and August 4, 2016 were included.ResultsThe search identified 1196 citations. Of those, 15 studies met the inclusion criteria and evaluated 18 technology-mediated intervention arms delivered to a total of 2774 participants. Study duration ranged from 12 weeks to 2 years. A random-effects meta-analysis showed a pooled weight loss effect of 3.76 kilograms (95% CI 2.8-4.7; P<.001) for the interventions. Several studies also reported improved glycemic control following the intervention. The small sample sizes and heterogeneity of the trials precluded an evaluation of which technology-mediated intervention method was most efficacious.ConclusionsTechnology-mediated diabetes prevention programs can result in clinically significant amounts of weight loss, as well as improvements in glycaemia in patients with prediabetes. Due to their potential for large-scale implementation, these interventions will play an important role in the dissemination of diabetes prevention programs.

IntroductionF or this year's article on information technology, we selected articles that will give the reader a sense of the current state of the art of the field and a hint of where it is going. To help organize thinking about how technology can improve outcomes for people with or at risk for diabetes, it is helpful to frame technology's roles in the range of approaches that are being used to improve outcomes.A new equilibrium is being forged among independent, but overlapping, health-promoting paradigms for which information technology often is at the core of any approach. There are four tried and true approaches that complement each other but also compete for resources as well as attention.Personal health approaches: Those services and supports that are provided by an organized healthcare system primarily for the benefit of the individual receiving the service.Public health approaches: Activities aiming to provide conditions in which people can be healthy that focus on entire populations rather than on individual patients or diseases. Public health is concerned with the total system and not only the eradication of a particular disease.Direct-to-consumer approaches: Goods and services marketed and sold directly to end users and that are usually paid for by the consumer.Population health approaches: Improving health outcomes of one or more subpopulations out of the entire population is the area of focus. It is understood that such population health outcomes are the product of multiple determinants of health. The outcomes are influenced by social, economic, and physical environments; personal health and lifestyle practices; individual capacity and coping skills; human biology; prenatal and early childhood development; and healthcare services.These subpopulations can be geographic regions, such as nations or communities, but they can also be other groups, such as employees, ethnic groups, disabled persons, members of a health plan, patients being served by a healthcare system, or individuals with specific clinical conditions or life circumstances. Often groups are segmented by risk or health status (e.g., stable and well, moderate risk, high risk/high cost). Most of the articles chosen for this chapter would fall into population health approaches that are linked to, or integrated with, personal health approaches.As we think about ways to improve outcomes, there are six key questions that must be answered in order for the chosen approach to have a chance of being successful. How is the target population defined and segmentedfrom the larger population? 2. What are the characteristics of the target population? 3. What are the key modifiable determinants of the health status and healthcare utilization patterns of the target population? 4. What are the evidence-based approaches that have been shown to modify the identified determinants in the target population? 5. Can these approaches be cost-effectively and efficiently provided at a large enough scale to improve the entire population's outcomes? 6. Is there capacity...

No abstract

No abstract