Associations Between Depressive Symptoms and Indices of Obesity in Adults With Prediabetes and Normal Blood Glucose Levels: Results From the Emotional Health and Wellbeing Study

Pros and cons of live kidney donation in prediabetics: A critical review and way forward

There is shortage of organs, including kidneys, worldwide. Along with deceased kidney transplantation, there is a significant rise in live kidney donation. The prevalence of prediabetes (PD), including impaired fasting glucose and impaired glucose tolerance, is on the rise across the globe. Transplant teams frequently come across prediabetic kidney donors for evaluation. Prediabetics are at risk of diabetes, chronic kidney disease, cardiovascular events, stroke, neuropathy, retinopathy, dementia, depression and nonalcoholic liver disease along with increased risk of all-cause mortality. Unfortunately, most of the studies done in prediabetic kidney donors are retrospective in nature and have a short follow up period. There is lack of prospective long-term studies to know about the real risk of complications after donation. Furthermore, there are variations in recommendations from various guidelines across the globe for donations in prediabetics, leading to more confusion among clinicians. This increases the responsibility of transplant teams to take appropriate decisions in the best interest of both donors and recipients. This review focuses on pathophysiological changes of PD in kidneys, potential complications of PD, other risk factors for development of type 2 diabetes, a review of guidelines for kidney donation, the potential role of diabetes risk score and calculator in kidney donors and the way forward for the evaluation and selection of prediabetic kidney donors.

Nutrition and Emotional Health Education: The Use of Emotional Intelligence and a Plant-Based Diet to Reduce Cardiometabolic Risk

Background

For individuals living with chronic conditions like diabetes mellitus and obesity, there is a need for sustainable behavioral strategies and physiologic tools. These tools support identifying and addressing barriers to healthy eating, reducing body mass index (BMI), and building increased physical resilience in real time.

Objective

To evaluate whether a 12-week learning management system designed to combine nutritional intervention with education and coaching on improving emotional intelligence (EI) could alter cardiometabolic outcomes.

Methods

This pre-post prospective study enrolled 37 adult volunteers with BMI greater than 25 to participate in a 12-week learning management system. Primary (BMI, systolic blood pressure, diastolic blood pressure, low-density lipoprotein [LDL], high-density lipoprotein, and fasting glucose levels) and secondary self-reported outcomes were assessed at baseline, 12 weeks, and 6 months after enrollment using Short Form-36, Emotional Quotient Inventory (EQi), and Whole Health Index (WHI). Linear mixed-effects regression models with random effect were used to estimate changes in primary and secondary outcomes. We adjusted for multiple testing using Holm step-down method.

Results

BMI and LDL were the only primary endpoints lower at program completion and 6-month follow-up compared to baseline levels (-1.63 and -17.77 mg/dL, respectively; P < .001). Secondary outcomes showing statistically significant improvement from baseline to 6-month follow-up included energy/fatigue (Short Form-36), self-regard (EQi), decision-making (EQi), impulse control (EQi), stress management (EQi), Whole Brain - Form A (WHI), Whole Food - Form C (WHI), and Whole Body - Form D (WHI).

Conclusion

This study provides preliminary evidence that lifestyle programs combining nutritional interventions and EI can have a significant impact on BMI and LDL. Our study highlights the potential importance of both nutrition and EI in programs targeting diet and lifestyle modification.

Effects of self-care programs on the incidence of diabetes among adults with prediabetes: A systematic review and meta-analysis of randomised controlled trials

OBJECTIVES

To verify the effects of self-care programs among adults with prediabetes, to identify the preferable structure components and to summarise the core content components of self-care programs.

DESIGN

A systematic review and meta-analysis of randomised controlled trials.

METHODS

PubMed, Embase, Cochrane, CINAHL, PsycINFO, Wanfang, CNKI, Chinese Biomedical Database and Open Grey were searched for studies published from January 2002 to December, 2021. Meta-analysis was conducted to verify the effects of self-care programs on diabetes incidence. Subgroup analyses based on structure components were performed to contrast the effects. We made a critical analysis to generalise the core elements of content components. The study was reported according to PRISMA statement.

RESULTS

Totally, 15 studies were included in systematic review, of which 14 studies were eligible for meta-analysis. The results of meta-analysis showed the incidence of diabetes for prediabetic adults receiving self-care programs was significantly lower than those who received usual care (OR 0.58; 95% CI 0.46 to 0.73). The results of subgroup analyses based on delivery mode, intervention implementer, health education brochures provided, and follow-up duration showed statistically significant reduction in incidence compared with control group (p < .05). However, the differences of these pair-wise comparisons (face-to-face or remote, individual or interdisciplinary team, with or without brochures provided, ≤1 year or >1 year) were not statistically significant (p > .05). Three core content elements were generalised: cognitive education, behaviour guidance and psychological support.

CONCLUSIONS

Self-care programs can effectively delay the progression of prediabetes to diabetes. Regardless of the diversified structure components, self-care programs can achieve better effects on the diabetes incidence than usual care, while the optimal structure components still remain unknown. Cognitive education, behaviour guidance and psychological support are core elements for these programs.

RELEVANCE TO CLINICAL PRACTICE

More clinical trials with rigorous study design are needed to provide further evidence.

Fatigue, anxiety and depression in patients with prediabetes: a controlled cross-sectional study

Objective

We aimed to determine fatigue, depression, anxiety levels, and quality of life (QoL) in patients with prediabetes (PD) and to compare them with healthy subjects.

Materials and methods

A controlled, cross-sectional study was conducted. The patients, aged 18-65, were recruited from a tertiary care hospital. A total of 105 patients with newly diagnosed untreated PD and 48 normoglycemic subjects were included in the study. Participants did not know the diagnosis of PD and did not give psychological distress to the newly diagnosed. All participants were evaluated for body mass index (BMI), oral glucose tolerance test (OGTT), glycated hemoglobin (HbA1c), Fatigue Severity Scale (FSS), Hospital Anxiety and Depression Scale (HADS), Short Form-36 (SF-36).

Results

Age, gender, BMI were similar between groups. The scores of psychological measures were significantly worse in patients with PD compared with normoglycemic subjects (FSS median score: 4.33 vs. 2.22, HADS-anxiety mean score: 7.53 vs. 2.64, HADS-depression mean score: 6.33 vs. 2.79, SF-36 total median score: 52.81 vs. 79.89). The FSS, HADS and SF-36 scores showed a weak but statistically significant relationship with BMI. OGTT, HbA1c and HOMA-IR did not show any relationship with these scores.

Conclusion

Psychosocial problems may present in the prediabetic stage before the onset of diabetes.

The Potential Role of Serum IGF-1 and Leptin as Biomarkers: Towards Screening for and Diagnosing Postmenopausal Osteoporosis

Purpose

To investigate the differences of several serum markers among population with different bone mass and to explore the utility of new potential biomarker for the diagnosing and screening for postmenopausal osteoporosis (PMOP).

Materials and Methods

A total of 1055 postmenopausal women were screened and gathered data on BMD screening, biological samples, and questionnaire information. A liquid chip assay was used to measure serum IL-6, IGF-1, BMP-2, VEGF, leptin and FGF23. The predictive value of the indicator panels was assessed using the area under the receiver-operator characteristic curve (AUC). Statistical analyses were conducted by using SAS 9.4 and R software 4.1.1. Figures were created in GraphPad Prism 8.0.

Results

When compared against the normal group, in addition to the vitamin D, the PMOP group showed a significant increase in median values for other indicators (P < 0.05), especially in P1NP and β-CTX. Among the six cytokines representing different osteoporosis mechanisms, currently, we found that only IGF-1 and leptin showed significant differences between the groups. Also, the liquid chip assay results showed that IGF-1 and leptin, as newer cytokines in osteoporosis, not only have significant differences between groups, but also have a strong correlation with each other (P < 0.05). Then, we reported the accuracy of different indicator combinations by using AUC and, moreover, we demonstrated that IGF-1 with leptin did significantly provide incremental value to the AUC of conventional indexes, it markedly improved diagnostic efficacy, displaying an IDI of 9.45% (P = 0.000).

Conclusion

IFG-1 and leptin seem to be key biomarker associated with PMOP. The high prevalence of PMOP makes these cytokines might bear the potential of becoming a very useful screening test also for clinical follow-up of patients.