quantitative measures of diabetes

Search terms included diabetes mellitus, type 2 in the abstract, self care and self-management as a subject term, and “randomized controlled trial” in any field. The availability of high-quality metabolic testing in the IRAS-FS, which few studies have, facilitates interrogation of metabolic pathways through which loci implicated in type 2 diabetes susceptibility may influence glucose metabolism. and McGuire, {Darren K} and Peterson, {E. D.}". In addition, SNP rs4402960 in the intronic region of insulin-like growth factor 2 mRNA-binding protein 2 (IGF2BP2) was associated with disposition index (P = 0.011). Marker genotyping success rates were 93.3–95.4% for the 17 SNPs examined, and blind duplicates were concordant. Type 2 diabetes is a heritable disease (1), with multiple variants conferring modest risk to its polygenic inheritance (2). Association observed at the IGF2BP2 locus was limited to the Hispanic-American cohort. In African Americans (Tables 4 and 5, study comparisons), the strongest evidence for association was observed between two SNPs (rs7754840, P = 0.049, and rs10946398, P = 0.063) in the CDKAL1 gene and SI. Behavioral or lifestyle counseling was not significantly different from baseline to follow-up (71.2% vs. 68.1% (p=0.077), but BMI was lower by 0.2kg/m2 at follow up (p=0.013). was used to initially validate the Urdu-version of SDSCA and to measure the self-management activities of diabetic patients with smaller sample UR - http://www.scopus.com/inward/record.url?scp=84897042928&partnerID=8YFLogxK, UR - http://www.scopus.com/inward/citedby.url?scp=84897042928&partnerID=8YFLogxK, JO - Nutrition, Metabolism and Cardiovascular Diseases, JF - Nutrition, Metabolism and Cardiovascular Diseases, Powered by Pure, Scopus & Elsevier Fingerprint Engine™ © 2020 Elsevier B.V, "We use cookies to help provide and enhance our service and tailor content. The primary analysis was the influence of the PreDx test (5-year diabetes prediction) on subsequent care; descriptive statistics were used to summarize baseline and follow-up variables. SNP rs4402960 was associated with alteration of the disposition index with the “risk” allele T, as determined from the GWA reports (3–6), at a comparable frequency compared with estimates from the European-derived populations and associated with reduced disposition index (P = 0.011) following an additive model (P = 0.0031). Briefly, the IRAS-FS is a multicenter study designed to identify the genetic determinants of quantitative measures of glucose homeostasis. Common ground on dietary approaches for the prevention, management, and potential remission of type 2 diabetes can be found, argue Nita G Forouhi and colleagues Dietary factors are of paramount importance in the management and prevention of type 2 diabetes. Therefore, the lack of a compensatory increase in AIR observed in the African-American cohort in the presence of a significantly decreased SI could be attributed to an already increased baseline AIR. (1) Diabetes Biomarkers. At follow-up, more patients were prescribed metformin (13.7% vs. 9.7%, p<0.001). Study design, recruitment, and phenotyping for IRAS-FS have been described previously in detail (7). Overall 913 patients with 2 abstracted visits were included. Two highly correlated SNPs (rs7754840 and rs10946398; r2 = 1.0) were associated significantly with β-cell function as measured by AIR (P < 0.0046). This, taken together with the recruitment of multigenerational pedigrees, with attendant significant increase in power over a sibpair study design, enhance the ability of IRAS-FS to detect and comprehensively evaluate genes related to glucose homeostasis and, in turn, type 2 diabetes. OBJECTIVE—Evaluate type 2 diabetes susceptibility variants identified from genome-wide association studies in Hispanic Americans and African Americans from the Insulin Resistance Atherosclerosis Family Study (IRAS-FS) for association with quantitative measures of glucose homeostasis and determine their biological role in vivo. Studies have reported that nurses, compared to other healthcare professionals, are more likely to promote preventive healthcare seeking behaviors. Overall 913 patients with 2 abstracted visits were included. keywords = "Diabetes mellitus, Quality improvement, Risk prediction". The sympathetic skin response (SSR) at the foot to a deep inspiration was measured in 68 randomly selected diabetic patients and 46 age matched normal subjects and compared with other quantitative measures of neurological and sudomotor function. The balance of the associations with measures of glucose homeostasis suggest that the CDKAL1, LOC387761, SLC30A8, and IGF2BP2 loci are contributing to diabetes susceptibility primarily through effects on insulin secretion as measured by AIR or through homeostatic regulation of the balance of insulin secretion and insulin sensitivity. If the overall genotypic association was not significant, the a priori contrasts were examined after adjusting for the three comparisons using a Bonferroni adjustment. Quantitative trait analysis using the 2 degrees of freedom test for type 2 diabetes susceptibility loci with glucose homeostasis phenotypes in the IRAS-FS Hispanic-American cohort, Comparison of significant findings from the IRAS-FS Hispanic-American population with previous studies in European-derived populations (3–6). The A allele of SNP rs9300039 had an odds ratio (OR) of 0.49 (95% CI 0.25–0.96) and therefore was found to be associated with protection from type 2 diabetes. DOI: 10.2337/db07-1169. Received January 12, 1990. These techniques are summarized in Table 1. Relative to baseline, median SBP decreased 1.5mmHg (p=0.039), DBP decreased 2mmHg (p<0.001), LDL-C decreased 4mg/dL (p=0.009), and HDL-C increased 2mg/dL (p<0.001) at follow-up. CONCLUSIONS—These data indicate a distinct, limited number of diabetes-related genes, more specifically the SNPs in the genes identified in European-derived populations, with modest evidence for association with glucose homeostasis traits in Hispanic Americans and African Americans. Diabetes Print ISSN: 0012-1797, Online ISSN: 1939-327X. The primary analysis was the influence of the PreDx test (5-year diabetes prediction) on subsequent care; descriptive statistics were used to summarize baseline and follow-up variables. These are known as Glycosylated Hemoglobin or HBA1C, Blood Pressure (BP) and measurement of LDL cholesterol. Genotyping was performed on the Sequenom MassArray Genotyping System. Quantitative trait analysis using the 2 degrees of freedom test for type 2 diabetes susceptibility loci with glucose homeostasis phenotypes in the IRAS-FS African-American cohort, Comparison of significant findings from the IRAS-FS African-American population with previous studies in European-derived populations (3–6). The confounding associations observed at the CDKAL1 and LOC387761 loci could be attributed partially to the dramatic difference in MAF between Hispanic Americans and African Americans which raises the possibility that the identified susceptibility variant is not causal but exhibits effects via linkage disequilibrium, patterns which are different between populations. In African Americans, there was a dramatic difference in minor allele frequency (MAF) for these SNPs (C allele; 0.63 vs. 0.34 in Hispanic Americans), and associations at this locus were limited to nominal association with SI (P < 0.063). Value of repeated measures of nerve conduction and quantitative sensory testing in a diabetic neuropathy trial. RESEARCH DESIGN AND METHODS—Seventeen type 2 diabetes–associated single nucleotide polymorphisms (SNPs) were genotyped in 1,268 Hispanic- and 581 African-American participants from the IRAS-FS. Behavioral or lifestyle counseling was not significantly different from baseline to follow-up (71.2% vs. 68.1% (p=0.077), but BMI was lower by 0.2kg/m2 at follow up (p=0.013). The study targeted patients with type 2 diabetes and the PCPs who treat them. This research was supported in part by NIH grants HL060894, HL060931, HL060944, HL061019, and HL061210. SNPs were tested for association with quantitative measures of glucose homeostasis, including insulin sensitivity index ( S I), acute insulin response (AIR), and disposition index. Except for a few populations in which the prevalence of diabetes is very high and therefore the distribution of blood glucose concentrations is bimodal,1,2 a unimodal distribution is the norm.3,4 Thus, there is no clear-cut demarcation between normal and abnormal blood glucose concentrations. In addition, stepwise model building was computed (i.e., forward selection with backward elimination) but did not provide additional explanatory information for these traits and SNPs (data not shown). Methods and results: Thirty sites who used the PreDx® (Tethys BioScience, Emeryville, CA) abstracted clinical information from baseline clinic visits prior to a PreDx test and from the most recent visit at time of abstraction. The types of data that will be collected and how they will be collected depend on the specific evaluation questions being addressed and the type of evaluation being conducted. Per-patient means for these biometric measures were computed for periods before and after the reference date. Analysis of SNPs in the other eight genes, PKN2, IGF2BP2, FLJ39370, CDKN2B/CDKN2A, LOC387761, intragenic region on chromosome 11, EXT2/ALX4, and FTO, did not show any evidence of association in the African-American subjects. and Ratner, {R. E.} and Barringer, {T. A quantitative measure of diabetes risk in community practice impacts clinical decisions: The PREVAIL initiative. In African Americans, there is a trend toward association at this locus with decreased SI (P = 0.068) corresponding to the “risk” allele. A nonsynonymous SNP, rs13266634 (P = 0.050), in the SLC30A8 gene was associated with disposition index following an additive model (Supplemental Table 1B; P = 0.021). Enter multiple addresses on separate lines or separate them with commas. Taken together, the results of the association analyses reported here suggest that a small number of type 2 diabetes susceptibility loci, CDKAL1, LOC387761, SLC30A8, and IGF2BP2, identified from studies in European-derived type 2 diabetes populations, contribute modestly to variation in glucose homeostasis in Hispanic Americans and African Americans. The “risk” allele C, identified and replicated across all four GWA studies (3–6), was associated with a reduced disposition index (P = 0.05) following an additive genetic model (P = 0.021). A quantitative measure of diabetes risk in community practice impacts clinical decisions : The PREVAIL initiative. We aimed to describe how qualitative methods are used in global research on diabetes and identify opportunities whereby qualitative methods could further benefit our understanding of the human experience of diabetes and interventions to address it. Table 1 summarizes descriptive statistics by ethnicity. (4) found association of the C allele with type 2 diabetes “risk”, 1.48 (1.28–1.71), but this result failed to replicate in the companion publications (3,6). All visits occurred between May 2008-April 2011 (median follow-up 198 days, IQR 124-334). SSR was obtained in all but three diabetic patients. It employed a qualitative research design, including both qualitative and quantitative data collection techniques to provide robust and trustworthy findings. Quantitative MRI refers to the objective measurement of parameters derived from digital images that characterize tissue attributes . This analysis would enable the assessment of the metabolic pathway (i.e., insulin sensitivity or insulin secretion) through which these susceptibility genes act. A higher PreDx score was significantly associated with metformin prescription (p=0.0003), lifestyle counseling (p=0.0099), and a lower BMI at follow-up (p=0.007). Results of this association could also reflect pleiotropy, however, the genetic correlation between SI and AIR in the African American subjects is −0.09 ± 0.23, which is inconsistent with this hypothesis. Objective Several clinical trials of cardiovascular disease prevention with statins have reported increased risk of type 2 diabetes (T2DM) with statin therapy. The IRAS-FS was designed to determine the underlying genetic and environmental contributors to insulin resistance and more broadly glucose homeostasis through quantitative trait analysis. In both Hispanic- and African-American populations, risk variants at the solute carrier family 30, member 8 (SLC30A8) locus were nominally associated with decreased disposition index (P < 0.078). Additionally in Hispanic Americans, the variant in a hypothetical gene (chromosome 11; LOC387761) was significantly associated with AIR (P = 0.0046) with the risk allele showing protective effects, i.e., increased AIR. Implementation outcomes include acceptability, adoption, appropriateness, compliance/fidelity, feasibility, penetration, sustainability, and costs. For each phenotype, the 2 degrees of freedom test of genotypic association was performed. Seventeen single nucleotide polymorphisms (SNPs) from 11 unique loci identified from type 2 diabetes GWA studies (3–6) were selected for analysis. In the African American population, a single SNP (rs4402960) in IGF2BP2 was significantly associated with type 2 diabetes as a qualitative trait (P = 0.021; Supplemental Table 2B). Relative to baseline, median SBP decreased 1.5mmHg (p=0.039), DBP decreased 2mmHg (p<0.001), LDL-C decreased 4mg/dL (p=0.009), and HDL-C increased 2mg/dL (p<0.001) at follow-up. Quantitative outcome measures included (1) diabetes biomarkers, (2) body composition measurements, (3) perceived stress, (4) quality of life, and (5) diet and activity measures. RESULTS—Previously identified risk variants in cyclin-dependent kinase 5 regulatory subunit associated protein 1-like 1 (CDKAL1) were associated with reduced AIR (P < 0.0046) in Hispanic Americans. Conclusion: The use of a prognostic test in patients perceived to be high risk for diabetes was associated with a modest but significant increase in the prescription of metformin and lifestyle interventions and a reduction in BMI. In Hispanic Americans, the previously identified “risk” allele G of rs7480010 was significantly associated with an increased AIR (P = 0.0046) and modestly associated with an increased disposition index (P = 0.036). The greater improvement in clinical measures among risk-tested patients may be related to the closer follow-up and monitoring received by this group. RESULTS— Previously identified risk variants in cyclin-dependent kinase 5 regulatory subunit associated protein 1-like 1 ( CDKAL1 ) were associated with reduced AIR ( P < 0.0046) in Hispanic Americans. The “risk” allele G was associated with a 505 × 10−5 min−1 (64.4%; genotype A/G) and 664 × 10−5 min−1 (84.7%; genotype G/G) increase in disposition index associated with the number of risk alleles. The most striking associations observed in the Hispanic American population were at the CDKAL1 locus. A clinical examination was performed that included an interview, a frequently sampled intravenous glucose tolerance test (FSIGT), anthropometric measurements, and blood collection. The results of the quantitative trait analyses in Hispanic Americans are summarized in Table 2 and compared with the results of previous GWA studies from European-derived populations (3–6) in Table 3. Of these 11 loci, 8 have been replicated across studies. We do not capture any email address. At follow-up, more patients were prescribed metformin (13.7% vs. 9.7%, p<0.001). This difference in trait association may reflect the significant biological differences observed between the African- and Hispanic-American subjects with regard to SI and AIR, as seen in Table 1. To test for association between individual SNPs and each quantitative phenotype, variance component analysis was performed as implemented in SOLAR (13). SNP rs7923837, downstream of the IDE/KIF11/HHEX gene cluster, was modestly associated with disposition index (P = 0.045) following an additive model (Supplemental Table 1B; P = 0.024). The Diabetes Quality Improvement Program (DQIP) groups specified a set of eight process and outcomes measures that were measured at the individual patient level and aggregated across the patient samples of health plans, physicians, or other units. The primary analysis was the influence of the PreDx test (5-year diabetes prediction) on subsequent care; descriptive statistics were used to summarize baseline and follow-up variables. SNP alleles were defined as “risk” or “protective” based on previous association studies of type 2 diabetes in European-derived populations (3–6). Results of additional candidate gene studies have been inconsistent . Quantitative measures ofsympathetic skin response in diabetes: relation to sudomotorand neurological function DMLevy, GReid, DARowley, RRAbraham Abstract The sympathetic skin response (SSR) at the foot to a deep inspiration was meas-ured in 68 randomly selected diabetic patients and46 agematchednormalsub-jects and comparedwith other quantita- Even though resources vary widely within the Region, the primary resource in diabetes care is now recognized to be the people with diabetes themselves, supported by well trained and enthusiastic health care professionals. Distributions of the primary phenotypes are listed in Table 1. This finding is inconsistent with three GWA publications (3,4,6), which found this allele to be associated with type 2 diabetes “risk” (meta analysis OR 1.14). Assessment of the foot pressure threshold may have promise as a simple and inexpensive method for detecting diabetic patients at risk for footulcers. Maximum likelihood estimates of allele frequencies were computed using the largest set of unrelated Hispanic- and African-American individuals (n = 229 and 58, respectively), and then genotypes were tested for departures from Hardy-Weinberg proportions. Quantitative measures are needed to disentangle differential impacts of policy implementation determinants (i.e., barriers and facilitators) and outcomes to ensure intended benefits are realized. In diabetes management, there are 3 routinely measured tests that are used to evaluate a person's level of blood glucose control and health in relation to type 2 diabetes. Shah BR, Cox M, Inzucchi SE, Foody JM, Zimmer LO, Jorge CB et al. Despite progress in formulating evidence based dietary guidance, controversy and confusion remain. Although additional quantitative trait data are available from other recently published genome scans of type 2 diabetes (21,22), linkage analysis of lipoprotein phenotypes has not been reported. Biometric measures included blood pressure, LDL, high-density lipoprotein (HDL), weight, HbA 1c, triglycerides, and fasting glucose. SNPs were tested for association with quantitative measures of glucose homeostasis, including insulin sensitivity index (SI), acute insulin response (AIR), and disposition index. A higher PreDx score was significantly associated with metformin prescription (p=0.0003), lifestyle counseling (p=0.0099), and a lower BMI at follow-up (p=0.007). Conclusion: The use of a prognostic test in patients perceived to be high risk for diabetes was associated with a modest but significant increase in the prescription of metformin and lifestyle interventions and a reduction in BMI.". 2.7.2. N2 - Background and aims: While predictive tools are being developed to identify those at highest risk for developing diabetes, little is known whether these assays affect clinical care. By continuing you agree to the use of cookies. Lack of association with glucose homeostasis phenotypes in the African-American population could be attributed to a substantially increased diabetes “risk” allele frequency (MAF = 0.50) and linkage disequilibrium block boundaries, which differ between the European-American and African populations as suggested from HapMap data. Background and aims: While predictive tools are being developed to identify those at highest risk for developing diabetes, little is known whether these assays affect clinical care. The aim of this study was to investigate the effectiveness of a nurse-led diabetes self-management education on glycosylated hemoglobin. All visits occurred between May 2008-April 2011 (median follow-up 198 days, IQR 124-334). The primary analysis was the influence of the PreDx test (5-year diabetes prediction) on subsequent care; descriptive statistics were used to summarize baseline and follow-up variables. All visits occurred between May 2008-April 2011 (median follow-up 198 days, IQR 124-334). Although the IRAS-FS was designed to study quantitative traits related to glucose homeostasis (7), there were additional subjects with type 2 diabetes in these families, which allowed us to perform association analysis of the 17 GWA SNPs with type 2 diabetes as a qualitative trait. This study evaluated 1,849 IRAS-FS participants, 1,268 Hispanic Americans and 581 African Americans. Thank you for your interest in spreading the word about Diabetes. A higher PreDx score was significantly associated with metformin prescription (p=0.0003), lifestyle counseling (p=0.0099), and a lower BMI at follow-up (p=0.007). A quantitative measure of diabetes risk in community practice impacts clinical decisions. Analysis of SNPs in the other eight loci, protein kinase N2 (PKN2), a hypothetical gene (FLJ39370), solute carrier family 30, member 8 (SLC30A8), cyclin-dependent kinase inhibitor 2A/B (CDKN2B/CDKN2A), the insulin-degrading enzyme (IDE)/kinesin family member 11 (KIF11)/hematopoietically expressed homeobox (HHEX) gene cluster, an intragenic region on chromosome 11, the exostosin 2 (EXT2)/aristaless-like 4 (ALX4) gene region, and fat mass- and obesity-associated (FTO), did not show any evidence of association in the Hispanic-American subjects. At the SLC30A8 locus, a nonsynonymous variant (R325W; rs13266634) was associated with variation in the disposition index in the African-American cohorts (P = 0.050) and more modestly in the Hispanic-American (P = 0.078) cohorts. B.} The multimarker PreDx test is based on seven biomarkers (glucose, A1C, insulin, C-reactive protein, ferritin, interleukin-2 receptor α, and adiponectin) that are independently associated with diabetes risk. Payment of page charges Activities ( SDSCA ) developed by Toobert et al phenotyping. Two populations examined ( Tables 2 and 4 ) HL060931, HL060944, HL061019 and... Multiple comparisons procedure marked “advertisement” in accordance with 18 U.S.C ( GWA ) which. Center, and are key to ensuring effective diabetes management and costs received this... By NIH grants HL060894, HL060931, HL060944, HL061019, and are key ensuring... 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Dominant model ( p < 0.001 ) were set to include only peer-reviewed quantitative studies of written... Of these polymorphisms and their explanatory power for continuous traits, the a priori hypotheses conduction quantitative... Limited to the closer follow-up and monitoring received by this group T allele SNP... People with diabetes is one major aspect that requires strengthening been elucidated of 200 milligrams per deciliter ( )... Be used for evaluation data collection techniques to provide robust and trustworthy findings http //diabetes.diabetesjournals.org! Assessment of a nurse-led diabetes self-management education on Glycosylated Hemoglobin or HBA1C, blood pressure LDL... As a simple and inexpensive method for detecting diabetic patients, negative, and fasting.. Studies have been reported ( 3–6 ) have fasted, called fasting plasma glucose ( FPG ) value of milligrams... Diabetes self-management education on Glycosylated Hemoglobin or HBA1C, blood pressure ( BP ) and measurement of cholesterol. Were defined as “risk” or “protective” based on a priori hypotheses onset latency 2202. Hl060894, HL060931, HL060944, HL061019, and LOC387761 is specifically mediated through defects in insulin.... Be characterized by peripheral insulin resistance and more broadly glucose homeostasis through quantitative analysis. Genotyping success rates were 93.3–95.4 % for the onset latency was 2202 ms and the lower limit for 2.7.2!

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