Endocrinology, Diabetes, and Metabolism Commons^™

Behavioral Predictive Analytics Towards Personalization For Self-Management – A Use Case On Linking Health-Related Social Needs, Bon Sy, Michael Wassil, Helene Connelly, Alisha Hassan

Publications and Research

The objective of this research is to investigate the feasibility of applying behavioral predictive analytics to optimize patient engagement in diabetes self-management, and to gain insights on the potential of infusing a chatbot with NLP technology for discovering health-related social needs. In the U.S., less than 25% of patients actively engage in self-health management even though self-health management has been reported to associate with improved health outcomes and reduced healthcare costs. The proposed behavioral predictive analytics relies on manifold clustering to identify subpopulations segmented by behavior readiness characteristics that exhibit non-linear properties. For each subpopulation, an individualized auto-regression model and …

Dose Adjustment Of Antidiabetic Medications In Chronic Kidney Disease, Matthew Salvatore Snyder, Joshua Fogel, Svetlana Pyatigorskaya, Sofia Rubinstein

Publications and Research

Purpose: The purpose of this study is to identify whether Internal Medicine house-staff (IMHS) have awareness and knowledge about the correct dosage of antidiabetic medications for patients with chronic kidney disease (CKD), as dosing errors result in adverse patient outcomes for those with diabetes mellitus (DM) and CKD.

Methods: There were 353 IMHS surveyed to evaluate incorrect level of awareness of medication dose adjustment in patients with CKD (ILA) and incorrect level of knowledge of glomerular filtration rate level for medication adjustment (ILK-GFR) for Glipizide, Pioglitazone, and Sitagliptin.

Results: Lack of awareness and knowledge was high, with the highest for …

A Body Shape Index Significantly Predicts Mri-Defined Abdominal Adipose Tissue Depots In Non-Obese Asian Indians With Type 2 Diabetes Mellitus, Shajith Anoop, Jesse Krakauer, Nir Krakauer, Anoop Misra

Publications and Research

Introduction: We aimed to determine the correlations of volumes of subcutaneous abdominal adipose tissue (SCAT) (anterior, posterior, superficial and deep), total SCAT, intraperitoneal adipose tissue, retroperitoneal abdominal adipose tissue (RPAT), total intra-abdominal adipose tissue (IAAT), pancreatic volume, liver span, total body fat (TBF) and truncal fat mass (TFM) with anthropometric indices, viz., A Body Shape Index (ABSI), Hip Index, their Z scores and Anthropometric Risk Index in non-obese (body mass index (BMI) /m²) Asian Indians with type 2 diabetes mellitus (T2DM).

Research design and methods: Non-obese patients with T2DM (cases; n, 85) and BMI-matched, healthy subjects …

Prenatal Choline Supplementation During High-Fat Feeding Improves Long-Term Blood Glucose Control In Male Mouse Offspring, Hunter W. Korsmo, Kaydine Edwards, Bhoomi Dave, Chauntelle Jack-Roberts, Huanling Yu, Anjana Saxena, Marie Salvador, Moshe Dembitzer, Jaskomal Phagoora, Xinyin Jiang

Publications and Research

Maternal obesity increases the risk of metabolic dysregulation in rodent offspring, especially when offspring are exposed to a high-fat (HF), obesogenic diet later in life. We previously demonstrated that maternal choline supplementation (MCS) in HF-fed mouse dams during gestation prevents fetal overgrowth and excess adiposity. In this study, we examined the long-term metabolic influence of MCS. C57BL/6J mice were fed a HF diet with or without choline supplementation prior to and during gestation. After weaning, their pups were exposed to either a HF or control diet for 6 weeks before measurements. Prenatal and post-weaning dietary treatments led to sexually dimorphic …

A Mixed-Methods, Randomized Clinical Trial To Examine Feasibility Of A Mindfulness-Based Stress Management And Diabetes Risk Reduction Intervention For African Americans With Prediabetes, Cheryl L. Woods-Giscombe, Susan A. Gaylord, Yin Li, Carrie E. Brintz, Shrikant I. Bangdiwala, John B. Buse, John D. Mann, Chanee Lynch, Pamela Phillips, Sunyata Smith, Karyn Leniek, Laura Young, Saada Al-Barwani, Jeena Yoo, Keturah Faurot

Publications and Research

African Americans have disproportionately high rates of stress-related conditions, including diabetes and diabetes-related morbidity. Psychological stress may negatively influence engagement in risk-reducing lifestyle changes (physical activity and healthy eating) and stress-related physiology that increase diabetes risk. ,is study examined the feasibility of conducting a randomized trial comparing a novel mindfulness-based stress management program combined with diabetes risk-reduction education versus a conventional diabetes risk-reduction education program among African American adults with prediabetes and self-reported life stress. Participants were recruited in collaboration with community partners and randomized to the mindfulness- based diabetes risk-reduction education program for prediabetes (MPD; n = 38) or …

Can An Exercise-Based Educational And Motivational Intervention Be Durably Effective In Changing Compliance To Physical Activity And Anthropometric Risk In People With Type 2 Diabetes? A Follow-Up Study, Francesca Gallè, Jesse C. Krakauer, Nir Krakauer, Giuliana Valerio, Giorgio Liguori

Publications and Research

Aims. A nine-month motivational exercise-based intervention was previously offered to subjects with type 2 diabetes (T2D). A year after the end of the intervention, compliance to physical activity (PA) and anthropometric indices of participants were analyzed to evaluate the durability of its effects. Methods. PA levels, expressed as total energy expenditure per week, were assessed with the International Physical Activity Questionnaire (IPAQ). Changes in Body Mass Index (BMI), A Body Shape Index (ABSI), Hip Index (HI) z-scores, the relative mortality risk related to each of these measures, and a combined Anthropometric Risk Index (ARI) were also evaluated. Results. Of a …

Associations Of Hemoglobin A1c With Cognition Reduced For Long Diabetes Duration, Jeremy M. Silverman, James Schmeidler, Pearl G. Lee, Neil B. Alexander, Michal Schnaider Beeri, Elizabeth Guerrero-Berroa, Rebecca K. West, Mary Sano, Martina Nabozny, Carolina Rodriguez Alvarez

Publications and Research

Introduction: Associations of some risk factors with poor cognition, identified prior to age 75, are reduced or reversed in very old age. The Protected Survivor Model predicts this interaction due to enhanced survival of those with extended risk factor duration. In a younger sample, this study examines the association of cognition with the mean hemoglobin A1c risk factor over the time at risk, according to its duration.

Methods: The interaction of mean hemoglobin A1c (average = 9.8%), evaluated over duration (average = 116.8 months), was examined for overall cognition and three cognitive domains in a sample of 150 “young-old” veterans …

Prefronto-Cerebellar Neuromodulation Affects Appetite In Obesity, Elena M. Marron, Raquel Viejo-Sobera, Guillem Cuatrecasas, Diego Redolar-Ripoll, Pilar García Lorda, Abhishek Datta, Marom Bikson, Greta Magerowksi, Miguel Alonso-Alonso

Publications and Research

Human neuroimaging studies have consistently reported changes in cerebellar function and integrity in association with obesity. To date, however, the nature of this link has not been studied directly. Emerging evidence suggests a role for the cerebellum in higher cognitive functions through reciprocal connections with the prefrontal cortex. The purpose of this exploratory study was to examine appetite changes associated with noninvasive prefronto-cerebellar neuromodulation in obesity. 12 subjects with class I obesity (mean BMI 32.9 kg/m2) underwent a randomized, single-blinded, sham-controlled, crossover study, during which they received transcranial direct current stimulation (tDCS; active/sham) aimed at simultaneously enhancing the activity of …

Anthropometrics, Metabolic Syndrome, And Mortality Hazard, Nir Krakauer, Jesse C. Krakauer

Publications and Research

Independent indices (height, body mass index, a body shape index, and hip index) derived from basic anthropometrics have been found to be powerful predictors of mortality hazard, especially when the attributable risks are summed over these indices to give an anthropometric risk index (ARI). The metabolic syndrome (MS) is defined based on the co-occurrence of anthropometric, clinical, and laboratory criteria and is also widely employed for evaluating disease risk. Here, we investigate correlations between ARI and MS in a general population sample, the United States Third National Health and Nutrition Examination Survey. Baseline values of ARI and MS were also …

Maternal Betaine Supplementation Affects Fetal Growth And Lipid Metabolism Of Highfat Fed Mice In A Temporal-Specific Manner, Yaelle Joselit, Khatia Nanobashvili, Chauntelle Jack-Roberts, Esther Greenwald, Olga V. Malysheva, Marie A. Caudill, Anjana Saxena, Xinyin Jang

Publications and Research

Background/objectives: Maternal obesity increases the risk of gestational diabetes mellitus (GDM), which results in fetal overgrowth and long-lasting metabolic dysfunctioning in the offspring. Previous studies show that maternal choline supplementation normalizes fetal growth and adiposity of progeny from obese mice. This study examines whether supplementation of betaine, a choline derivative, has positive effects on fetal metabolic outcomes in mouse progeny exposed to maternal obesity and GDM.

Methods: C57BL/6J mice were fed either a high-fat (HF) diet or a control (normal-fat, NF) diet and received either 1% betaine (BS) or control untreated (BC) drinking water 4–6 weeks before timed-mating and throughout …

Effects Of Cetp Inhibition With Anacetrapib On Metabolism Of Vldl-Tg And Plasma Apolipoproteins C-Ii, C-Iii, And E, John S. Millar, Michael E. Lassman, Tiffany Thomas, Rajasekhar Ramakrishnan, Patricia Jumes, Richard L. Dunbar, Emil M. Degoma, Amanda L. Baer, Wahida Karmally, Daniel S. Donovan, Hashmi Rafeek, John A. Wagner, Stephen Holleran, Joseph Obunike, Yang Liu, Soumia Aoujil, Taylor Standiford, David E. Gutstein, Henry N. Ginsberg, Daniel J. Rader, Gissette Reyes-Soffer

Publications and Research

Cholesteryl ester transfer protein (CETP) mediates the transfer of HDL cholesteryl esters for triglyceride (TG) in VLDL/LDL. CETP inhibition, with anacetrapib, increases HDL-cholesterol, reduces LDL-cholesterol, and lowers TG levels. This study describes the mechanisms responsible for TG lowering by examining the kinetics of VLDL-TG, apoC-II, apoC-III, and apoE. Mildly hypercholesterolemic subjects were randomized to either placebo (N = 10) or atorvastatin 20 mg/qd (N = 29) for 4 weeks (period 1) followed by 8 weeks of anacetrapib, 100 mg/qd (period 2). Following each period, subjects underwent stable isotope metabolic studies to determine the fractional catabolic rates (FCRs) and production rates …

Supporting Practices To Adopt Registry-Based Care (Sparc): Protocol For A Randomized Controlled Trial, Rebeccar S. Etz, Rosalind E. Keith, Anna M. Matemick, Karen L. Stein, Roy T. Sabo, Melissa S. Hayes, Purvi Sevak, John Holland, Jesse C. Crosson

Publications and Research

Background: Diabetes is predicted to increase in incidence by 42% from 1995 to 2025. Although most adults with diabetes seek care from primary care practices, adherence to treatment guidelines in these settings is not optimal. Many practices lack the infrastructure to monitor patient adherence to recommended treatment and are slow to implement changes critical for effective management of patients with chronic conditions. Supporting Practices to Adopt Registry-Based Care (SPARC) will evaluate effectiveness and sustainability of a low-cost intervention designed to support work process change in primary care practices and enhance focus on population-based care through implementation of a diabetes …

Estimation Of Total Body Skeletal Muscle Mass In Chinese Adults: Prediction Model By Dual-Energy X-Ray Absorptiometry, Xinyu Zhao, Zimian Wang, Junyi Zhang, Jianming Hua, Wei He, Shankuan Zhu

Publications and Research

Background: There are few reports on total body skeletal muscle mass (SM) in Chinese. The objective of this study is to establish a prediction model of SM for Chinese adults.

Methodology: Appendicular lean soft tissue (ALST) was measured by dual energy X-ray absorptiometry (DXA) and SM by magnetic resonance image (MRI) in 66 Chinese adults (52 men and 14 women). Images of MRI were segmented into compartments including intermuscular adipose tissue (IMAT) and IMAT-free SM. Regression was used to fit the prediction model SM~czk|ALST. Age and gender were adjusted in the fitted model. The piece-wise linear function was performed to …

‘What’S In The Niddk Cdr?’—Public Query Tools For The Niddk Central Data Repository, Huaqin Pan, Mary-Anne Ardini, Vesselina Bakalov, Michael Delatte, Paul Eggers, Laxminarayana Ganapathi, Craig R. Hollingsworth, Joshua Levy, Sheping Li, Joseph Pratt, Norma Pugh, Ying Qin, Rebekah Rasooly, Helen Ray, Jean E. Richardson, Amanda Flynn Riley, Susan M. Rogers, Sylvia Tan, Charles F. Turner, Stacie White, Philip C. Cooley

Publications and Research

The National Institute of Diabetes and Digestive Disease (NIDDK) Central Data Repository (CDR) is a web-enabled resource available to researchers and the general public. The CDR warehouses clinical data and study documentation from NIDDK funded research, including such landmark studies as The Diabetes Control and Complications Trial (DCCT, 1983–93) and the Epidemiology of Diabetes Interventions and Complications (EDIC, 1994–present) follow-up study which has been ongoing for more than 20 years. The CDR also houses data from over 7 million biospecimens representing 2 million subjects. To help users explore the vast amount of data stored in the NIDDK CDR, we developed …

Cationic Amino Acid Transport Across The Blood-Brain Barrier Is Mediated Exclusively By System Y+, Robyn L. O'Kane, Juan R. Viña, Ian Simpson, Rosa Zaragozá, Ashwini Mokashi, Richard A. Hawkins

Publications and Research

Cationic amino acid (CAA) transport is brought about by two families of proteins that are found in various tissues: Cat (CAA transporter), referred to as system y+, and Bat [broad-scope amino acid (AA) transporter], which comprises systems b0,+, B0,+, and y+L. CAA traverse the blood-brain barrier (BBB), but experiments done in vivo have only been able to examine the BBB from the luminal (blood-facing) side. In the present study, plasma membranes isolated from bovine brain microvessels were used to identify and characterize the CAA transporter(s) on both sides of the BBB. From these studies, it was concluded that system y+ …