<i>Diabetes Care</i>: “Taking It to the Limit One More Time”

Cefalu, William T.; Boulton, Andrew J.M.; Tamborlane, William V.; Moses, Robert G.; LeRoith, Derek; Greene, Eddie L.; Hu, Frank B.; Bakris, George L.; Wylie‐Rosett, Judith; Rosenstock, Julio; Kahn, Steven E.; Weinger, Katie; Blonde, Lawrence; Groot, Mary de; Rich, Stephen S.; D’Alessio, David A.; Reynolds, L. Raymond; Riddle, Matthew C.

doi:10.2337/dc16-2326

Diabetes Care

2017

DOI: 10.2337/dc16-2326

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Diabetes Care: “Taking It to the Limit One More Time”

William T. Cefalu

Andrew J.M. Boulton

William V. Tamborlane

et al.

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Cited by 6 publications

(1 citation statement)

References 39 publications

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“…between the two groups with respect to age, sex, or body mass index (BMI). Most people in Thailand who are diagnosed with T2DM are prescribed metformin 29 . Consistent with this strategy, approximately 75% of T2DM patients in the present study were also prescribed metformin (Table 1).…”

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confidence: 99%

Metformin-induced suppression of IFN-α via mTORC1 signalling following seasonal vaccination is associated with impaired antibody responses in type 2 diabetes

Saenwongsa

Nithichanon

Chittaganpitch

et al. 2020

Sci Rep

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Diabetes mellitus (DM) patients are at an increased risk of complications following influenza-virus infection, seasonal vaccination (SV) is recommended. However, SV with trivalent influenza vaccine (TIV) can induce antibody and type-I interferon (IFN) responses, and the effect of anti-DM treatment on these responses is incompletely understood. We evaluated the antibody response and IFN-α expression in individuals with and without type 2 DM (T2DM) following SV, and examined the effects on anti-DM treatment. TIV elicited sero-protection in all groups, but antibody persistency was <8 months, except for the antibody response to B-antigens in non-DM. T2DM impaired the IgG avidity index, and T2DM showed a significantly decreased response against H1N1 and H3N2, in addition to delaying and reducing haemagglutination-inhibition persistency against influenza B-antigens in DM groups treated with metformin (Met-DM) or glibenclamide (GB-DM). Following TIV, the Met-DM and GB-DM groups exhibited reduced IFN-α expression upon stimulation with whole-and split-virion influenza vaccines. Suppression of IFN-α expression in the Met-DM group was associated with a reduction in the mechanistic target of rapamycin complex-1 pathway and impaired IgG avidity index. Thus, single-dose TIV each year might not be suitable for T2DM. Our data could aid the development of an efficacious influenza vaccine for T2DM. The prevalence of type-2 diabetes mellitus (T2DM) is increasing worldwide, particularly in developing countries. In 2017, it was estimated that 451 million people worldwide were living with DM, and this number is expected to increase to 693 million by 2045 1. Due to multiple impairments of the immune system, patients with DM are more susceptible to infections such as influenza virus infection 2,3. Annual influenza vaccination is recommended by the World Health Organization (WHO) and the Advisory Committee on Immunization Practices in the USA to prevent influenza infection 4. The efficacy of vaccination should be evaluated in patients with T2DM, who are classified as a high-risk group for influenza infection 2,5,6. Interestingly, it has been reported that anti-DM medications further impair immune responses 7-10. Metforminthe first-line anti-hyperglycaemic drug for T2DM in Thailand-has been reported to impair the immune response by upregulating the expression of 5′ adenosine monophosphate-activated protein kinases (AMPKs) and inhibiting the mechanistic target of rapamycin (mTOR)-mediated pathway 11,12. Glibenclamide is another anti-hyperglycaemic agent that has been reported to impair immune responses by decreasing the production of interleukin (IL)-1β and IL-8 and decreasing glutathione levels in polymorphonuclear cells 13. Furthermore,

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confidence: 99%

Metformin-induced suppression of IFN-α via mTORC1 signalling following seasonal vaccination is associated with impaired antibody responses in type 2 diabetes

Saenwongsa

Nithichanon

Chittaganpitch

et al. 2020

Sci Rep

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Modeling Health Disparities and Outcomes in Disenfranchised Populations

Hauenstein

Clark

Merwin

2018

Community Ment Health J

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The Health Disparities and Outcomes (HDO) model originally created to explain the complexity of obtaining healthcare in rural settings has been revised and updated using emerging theoretical models of adversity and inequity and two decades of empirical work by the authors. With a strong orientation to explaining population-based health inequities, the HDO is applied to individuals with Serious Mental Illness (SMI), to explain their high rates of morbidity and mortality compared to the general population. Individual-, community-, and system-level factors that reflect an understanding of life-long risk, accrued hazards associated with multiple and intersecting disadvantages, and difficulty obtaining healthcare that meets accepted standards are described. The revised HDO can be applied to populations with disproportionate health challenges to identify multi-level factors that affect illness trajectory and overall health outcomes.

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Neighborhood Food Environment Associated with Cardiometabolic Health among Predominately Low-income, Urban, Black Women

et al. 2021

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Objectives: This study sought to: 1) understand how the perceived food environment (availability, accessibility, and affordability) is associated with cardiometabolic health outcomes in predominately low-income Black residents in urban neighborhoods with limited healthy food access; and 2) examine the association of shopping at specific store types with cardiometabolic health outcomes.Methods: We report on cross-sectional data from 459 individuals participating in the Pittsburgh, PA Hill/Homewood Research on Neighborhoods and Health (PHRESH) study. Mean participant age was 60.7 (SD=13.9); 81.7% were female. We used logistic regression to examine associations between three factors (perceived fruit and vegetable availability, quality, and price; primary food shopping store characteristics; and frequency of shopping at stores with low or high access to healthy foods) and cardiometabolic and self-rated health.Results: Adjusting for sociodemographic characteristics, participants with higher perceived fruit and vegetable accessibility (AOR:.47, 95%CI: .28-.79, P=.004) and affordability (AOR:.59, 95%CI: .36-.96, P=.034) had lower odds of high blood pressure. Shopping often (vs rarely) at stores with low access to healthy foods was associated with higher odds of high total cholesterol (AOR:3.52, 95%CI: 1.09-11.40, P=.035). Finally, primary food shopping at a discount grocery (vs full-service supermarket) was associated with lower odds of overweight/obesity (AOR:.51, 95%CI: .26-.99, P=.049).Conclusions: These results suggest that both perceived accessibility and affordability of healthy foods are associated with reduced cardiometabolic risk factors in this urban, low-income predominantly Black population. Additionally, discount grocery stores may be particularly valuable by providing access and affordability of healthy foods in this population. Ethn Dis. 2021;31(4):537-546; doi:10.18865/ed.31.4.537

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Diabetes Care: “Taking It to the Limit One More Time”

Cited by 6 publications

References 39 publications

Metformin-induced suppression of IFN-α via mTORC1 signalling following seasonal vaccination is associated with impaired antibody responses in type 2 diabetes

Metformin-induced suppression of IFN-α via mTORC1 signalling following seasonal vaccination is associated with impaired antibody responses in type 2 diabetes

Modeling Health Disparities and Outcomes in Disenfranchised Populations

Neighborhood Food Environment Associated with Cardiometabolic Health among Predominately Low-income, Urban, Black Women

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