bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improvement of Vascular Endothelial Function at an Early Stage by the Original Stretching Exercise Designed in Our Study Group in Patients with Type 2 Diabetes Mellitus
Authors: HARA KENJI , SHINOZAKI HIROYUKI , YAMAUCHI MOTOTAKA , NARUSE RIKA , SUETSUGU MARIKO , TSUCHIYA TAKAFUMI , TAKEBAYASHI KOHZO , INUKAI TOSHIHIKO 
Published: June 2018

Background and Aims: Vascular endothelial cells play an important role in protecting and repairing vessels. It is little known that exercise therapy could ameliorate the vascular endothelial function in diabetic patients. In 2015, in collaboration with Tobu Sports Ltd. (Japan), we created the original exercise program including 12 kinds of body-stretching and converted the program to a DVD. The main aim in the present study is whether the exercise therapy using our original DVD would improve the vascular endothelial function in type 2 diabetic patients.
Subjects and Methods: Ten patients with type 2 diabetic mellitus (M/F: 8/2, Age: 58.2±12.7 years) strictly performed the exercise program using the DVD for 12 weeks. Vascular endothelial function was estimated as a reactive hyperemia index (RHI) measured with Endo PAT (Nihon-Koden Ltd. Japan). Body compositions in patients were measured with MC-780 (Tanita Ltd. Japan). We evaluated CAVI or ABI as marker of arteriosclerosis. Various biomedical parameters were assayed in the study.
Results: There was a significant increase in RHI before and after intervention (initiation: 1.63±0.3, after: 2.02±0.5, p&lt;0.01). A marked increase in RHI was shown in 90% of patients (9/10). A single patient who showed a reduction in RHI was observed going up of HbA1c levels on a background of irregularity of diet therapy. Any significant alterations were obtained in neither metabolic markers including HbA1c, FPG and body compositions, nor CAVI and ABI during the study.
Conclusions: The present study suggests that the intervention of exercise composed by various stretching actions could lead to improvement of vascular endothelial function at an early stage, different from alterations of other metabolic markers in diabetic patients. Thereby, we speculate that vascular endothelial function might be relatively sensitive against a stretching-exercise.

Disclosure
K. Hara: None. H. Shinozaki: None. M. Yamauchi: None. R. Naruse: None. M. Suetsugu: None. T. Tsuchiya: None. K. Takebayashi: None. T. Inukai: None.
FGF-21 as a Potential Mediator for the Antidepressant Effects of Physical Exercise
Authors: LIU YAN , YAU SUK YU , WANG YAO , XU AIMIN 
Published: June 2018

Major depressive disorder (MDD), a common psychiatric disease co-morbid with obesity and diabetes, has been one of the most important causes of disability worldwide. Physical exercise by far, is the most effective strategy for the prevention and treatment of MDD. Fibroblast growth factor 21 (FGF-21) is critically involved in energy metabolism and a potential therapeutic agent for treating obesity and its related medical complications. Although the brain is known to be a target of FGF-21 actions, its role in neuropsychological disorders remain unclear. Here, we showed that serum FGF-21 increased progressively with physical exercise and peaked at 3 hours after running, which was 1-2 hours later than that of free fatty acids, suggesting that increased free fatty acids might be the natural agonist of PPARα that induces FGF-21 production during exercise. Real-time PCR analysis further demonstrated that exercise-induced elevation of circulating FGF-21 was predominately from the liver. Furthermore, a series of behavior studies, including tail suspension test, forced swimming test and saccharin preference test uniformly showed that exercise training significantly alleviated depressive symptoms in wild type (WT) mice, which were largely diminished in FGF-21 knockout (KO) mice. Likewise, levels of inflammation markers in the hippocampus were significantly decreased, while synaptic plasticity were notably increased in exercised WT, but not in FGF-21 KO mice, suggesting that inhibition of neuroinflammation and neurogenesis might contribute to the antidepressant effects of FGF-21 during exercise.
In conclusion, FGF-21 is a liver-derived exercise responsive factor mediating the anti-depressant effect of exercise in mice.

Disclosure
Y. Liu: None. S. Yau: None. Y. Wang: None. A. Xu: None.
Effect of Low-Available Carbohydrate Diet with High Dietary Fiber Using Okara and Konjac on Blood Glucose Levels in Mice
Authors: SURUGA KOHEI , KADOKURA KAZUNARI , MIYATA AYAKA , TOMITA TSUYOSHI , SEKINO YOSHIHIRO , TERADA KAZUO , HATA SACHIYO , ASAKA SHIGERU , KAMATA KAZUHIKO , YAMADA SATORU 
Published: June 2018

Background: Low-carbohydrate diets (LCD) is popular as nutrition therapy since ADA 2013 recommendation. But, for many patients, it may be difficult to obey LCD, especially in noodle lovers. Recently, we have developed low-available carbohydrate noodle with rich-dietary fiber using Okara and Konjac (O-K mix). Thus, in this study, we evaluated the effect of O-K mix on blood glucose levels in mice model.
Methods: Test 1 (single meal test). ICR mice were divided into two groups: (1) administered 3 g of noodle from O-K mix/kg (O-K noodle); (2) administered 3 g of noodle from flour/kg (N noodle). Test 2 (one month test). KK-Ay mice were divided into three groups: group I, fed a standard chow, SC; group II, fed a SC with 30% O-K mix; group III fed a SC with 50% O-K mix, and were allowed free access to each experimental food for 28 days.
Results: Test 1. The increase in the plasma glucose was significantly suppressed at 30 and 60 min after administration in O-K noodle group (Fig. A). Test 2. Even though the sugar volume was lower in diet of the group II and III than those of group I, no significant differences were observed in volume of food intake and body weight among group I, II, and III. On the other hand, in terms of plasma glucose concentration, there were significant difference in group II and III compared with group I (Fig. B).
Conclusions: O-K mix might be useful for patients with diabetes or celiac disease who love noodle.

Disclosure
K. Suruga: None. K. Kadokura: None. A. Miyata: None. T. Tomita: None. Y. Sekino: None. K. Terada: None. S. Hata: None. S. Asaka: None. K. Kamata: None. S. Yamada: None.
Hemochromatosis and Cystic Fibrosis Carriers Identify Risk for GLP-1 Agonist Associated Pancreatitis
Authors: WEST WILLIAM A. , UWAIFO GABRIEL I. 
Published: June 2018

GLP-1 agonists are widely used antidiabetic agents. Among their potential associated side effects is acute pancreatitis (AP). Its exact prevalence is unknown as are known predictors for its incidence. We present two cases that suggest that carrier states for hemochromatosis (HC) and cystic fibrosis (CF) are risk factors for GLP-1 agonist associated AP. Case 1 is a 39 year old Caucasian lady with type 2 diabetes diagnosed 2 years ago. She has morbid obesity, hypothyroidism and NAFLD. She had a history of symptomatic AP to liraglutide (Victoza), exenatide (Byetta), dulaglutide and sitagliptin. She is currently managed with Degludec insulin, repagnilide, metformin and prn Lispro insulin with a current HBA1c of 6.5. Work up for mild transaminitis and prior elevated ferritin revealed she is a heterozygous carrier for the C282Y HC mutation despite currently having normal ferrokinetic profile. Her ongoing glycemic care is now without any further use of GLP-1 analogs nor DPP-4 inhibitors. Case 2 is a 62 year old Caucasian lady with type 2 diabetes diagnosed 8 years ago. She has hypertension, hypercholesterolemia and sleep apnea. She had a history of developing symptomatic AP to exenatide ER (Bydureon), dulaglutide and liraglutide (Victoza). Her current antidiabetic regime consists of Detemir insulin, Aspart insulin prn, metformin, repaglinide, and canagliflozin with a current HBA1c of 7.7. Because of a positive history of CF in several grand children she had genetic testing that showed she is a heterozygous carrier of the Delta F5deletion mutation of the CFTR gene. Her ongoing diabetes care is without any further use of GLP-1 analogs. Our case series present two patients with class associated predilection for GLP-1 analog associated AP. Heterozygous carrier states for CF and HC may represent at risk clinical phenotypes for GLP-1 AP. Consideration should be given to genetic screening for these carrier states prior to commencing diabetic patients on GLP-1 analogs and possibly also DPP-4 inhibitors.

Disclosure
W.A. West: None. G.I. Uwaifo: None.
Effect of Lupin Flour on Corn Oil–Induced Insulin Resistance in C57BL/6 Mice
Authors: TERRUZZI ILEANA , VACANTE FERNANDA , SENESI PAMELA , MONTESANO ANNA , CODELLA ROBERTO , LUZI LIVIO 
Published: June 2018

As the rate of obesity and type-2 diabetes is constantly increasing, there is a need to develop new therapeutic approaches with better effects and lower side effects at lower prices. The use of traditional foods with beneficial health properties could be a solution. Lupin, a legume rich in proteins, exerts a hypoglycemic effects and positively modifies proteins involved in glucose homeostasis, in both animals and humans. The aim of this study was to investigate the beneficial effects of lupin flour supplementation on glucose homeostasis using an in vivo model. The condition of insulin resistance (IR) was induced by diet containing corn oil (4%). Ten-week-old male C57BL/6 mice were given ad libitum access to a corn bean meal diet for 9 weeks (CD) or a cornbean meal diet enriched with 2% lupine flour (LC). Food intake was evaluated daily and body weight was measured weekly. Intra-peritoneal glucose tolerance test (IPGTT) was performed to assess the body’s ability to metabolize glucose. Food was removed 15 h before the start of IPGTT, and mice body weights after food deprivation were used to calculate glucose doses. Blood glucose and plasma insulin concentrations were measured. The quantity of food ingested was similar between groups. At the 9th week of treatment, the time-course of glucose clearance in both groups remained elevated for 120 min after glucose administration, indicating a glucose intolerance state. However, HOMA-IR was significantly lower (p=0.02) in LC than in CD group: the LC group showed significantly lower plasma insulin (2.09 ± 0.53 ng/mL) (p = 0.002) than the CD group (3.34 ± 0.56 ng/mL) while plasma glucose did not differ between groups (140 ± 24.9 mg/dL vs. 138 ± 35.5 mg/dL). These biological effects of lupine flour strengthen its promising potential as a new therapeutic agent of treatment for human insulin resistance conditions.

Disclosure
I. Terruzzi: None. F. Vacante: None. P. Senesi: None. A. Montesano: None. R. Codella: None. L. Luzi: Speaker's Bureau; Self; A. Menarini Diagnostics, AstraZeneca, Eli Lilly and Company. Research Support; Self; Gelesis. Consultant; Self; McKinsey & Company. Speaker's Bureau; Self; Menarini Group, Merck Sharp & Dohme Corp.. Research Support; Self; Novartis AG. Speaker's Bureau; Self; Novo Nordisk A/S. Research Support; Self; Sunstar Foundation. Speaker's Bureau; Self; Smith & Nephew.
Diabetes Patients’ Perception of Diet—Facts and Fads
Authors: ERUKULAPATI RAVI S. , YALAMANCHILI SANDHYA , RANI SUDHA 
Published: June 2018

Aim: Diet and knowledge of it plays a crucial role in the management of diabetes. The purpose of the study was to survey diabetes patients’ awareness of the basic ingredients of diet and their insights into the facts and fads of their daily dietary constituents.
Methods: An objective qualitative questionnaire-based assessment was performed among outpatient diabetes patients who visited Apollo Sugar diabetes care center in a metropolitan city, India. The questionnaire was answered by patients in a simple ’Yes’ or ’No’ format relevant to their awareness of various foods. The questions were about the protein, carbohydrate, fat constitution, quantity that could be consumed, and myths surrounding various food products they come across in their daily routine. Patients’ perception of diet was categorized into ’correct’ and ’incorrect’ depending on their response to each question mentioned in a 10-point questionnaire. A score of ’1’ was given for each ’correct’ answer and ’0’ for an ’incorrect’ answer. Total maximum score each diabetic patient can score is 10/10 and a minimum of 0/10. Appropriate statistics were applied to test the results at significance p ≤0.05.
Results: Total 581 patients with diabetes were assessed in this study. Patients included were in age range 16 to 85 years with median age of 56 years. Males and females were 60% and 40%, respectively. Among these patients a mean score of 4.5 and median score of 4 was achieved in the questionnaire. 35 (6%) patients achieved the maximum score of 10/10 and 74 (12.7%) patients had a minimum score of 0/10. There was no significant difference in the mean score achieved between males (4.1) and females (3.9). Though it was not statistically significant there was a negative correlation between age and the score (-0.06; p = 0.2).
Conclusion: The survey gave us useful insights into the lack of awareness about daily food products in diabetic patients. Majority of them didn’t have adequate knowledge, which recommends for a thorough diet counseling to improve their dietary patterns for better clinical outcomes.

Disclosure
R.S. Erukulapati: None. S. Yalamanchili: None. S. Rani: None.
eGFR Changes in Overweight/Obese Mexican-American Children
Authors: QUINTANA FERNANDO G. , WANG HONGWEI , CERVANTES-GONZALEZ FRANCISCO J. , PEREZ MAYRA A. 
Published: June 2018

Researchers have reported that there is an association between BMI and eGFR. AS BMI increases chronic kidney disease prevalence increases in adults.
Purpose: the aim of this study is to analyze the relationship between eGFR vs. BMI and age for overweight and obese boys and girls visiting a pediatric clinic in South Texas.
Methods: to calculate eGFR the “Bedside Schwartz” formula: eGFR = 0.413 x (height/SCr) height expressed in centimeters was used to estimate kidney function for 583 girls and 650 boys visiting a pediatric clinic from 2001 to 2017. The children were classified as overweight and obese according with CDC BMI percentiles. Age in years were classified as follows. 1-4.9; 5-7.9; 8-10.9; 11-12.9; 13-15.9 and 16+ years. A general linear model: GFR = BMI + Age + Age*Age was used to analyze the data. IRB approval #2016-01-31 was obtained from the TAMIU IRB.
Results: girls: BMI levels were not significantly different. Age was significantly different (df=5, F=11.64, p&lt;0.05), the interaction was not significant. The eGFR means by age were as follows: overweight: 128.19; 138.83; 136.73; 133.69; 120.11; 107.21. Age groups 5 and 6 were different from groups 1, 2, 3 and 4 (p&lt;0.05). Obese: 127.41; 131.71; 130.58; 135.55; 121.00; 112.35. Age groups 5 and 6 were different from groups 1, 2, 3 and 4 (p&lt;0.05), Graph 1. Boys: BMI levels were not significantly different. Age levels were significantly different (df=5, F=20.96; p&lt;0.05), the interaction was not significant. The eGFR means by age were as follows: overweight: 133.84; 134.61; 136.91; 127.91; 120.51; 98.52. Age groups 5 and 6 were different from groups 1, 2, 3, and 4 (p&lt;0.05). Obese: 126.74; 135.12; 140.23; 137.44; 117.64; 96.58 (p&lt;0.05), Graph 2.
Conclusion: The results support that eGFR decreases as age increases for overweight and obese children from age 1 to age 16+. Therefore we can hypothesize that there is a relationship between kidney function and children overweight and obesity as age increases for the population of boys and girls studied.

Disclosure
F.G. Quintana: None. H. Wang: None. F.J. Cervantes-Gonzalez: None. M.A. Perez: None.
Fast Insulin Secretion Blunted by Impaired Insulin Storage of Islet ß Cells in Mice
Authors: ZHAO YINAN , ZHAO TIAN , ZONG AILUN , ZHOU YINGSHENG 
Published: June 2018

Purpose: To clarify the effects of cellular insulin content and restoration on fast insulin secretion after acute hyperglycemia challenges.
Methods: To analyze the impairment and recovery mechanisms of acute hyperglycemia on the first phase insulin secretion, we evaluated the function of insulin secretion by glucose tolerance test. To explore the ramification of insulin secretion and storage in pancreatic islets after acute hyperglycemia challenges, we isolated the islet for GSIS and measured insulin content in vitro. HE for pancreas tissues were performed to study morphologic changes of the islets and to assess the impact of acute hyperglycemia on islet histology. EM for β cells were used to study morphologic changes of insulin granules.
Results: The mice with acute hyperglycemia showed, (1) blunted early insulin secretion in impaired glucose tolerance test; (2) disrupted insulin secretion using static islet incubation at low (2.8 mmol/l), high (16.7 mmol/l) glucose, 30 or 40mmol/l Potassium Chloride stimulus; (3) lack of intracellular insulin content. Five days after termination of hyperglycemic treatment, blunted early insulin secretion and glucose levels were completely reversed in the glucose tolerance test, but insulin contents in islet study did not return to the values of the control groups. In morphological study, irregular islets in HE and decreased insulin granules in EM caused by hyperglycemia did not alleviate.
Conclusions: Blunted fast insulin secretion and impaired glucose tolerance caused by acute intravenous hyperglycemia can be reversed, but poor insulin storage remained.

Disclosure
Y. Zhao: None. T. Zhao: None. A. Zong: None. Y. Zhou: None.
Predicting Future Glycemic Trajectories with a Mathematical Model
Authors: HA JOON , CHEN PHIL H. , SHERMAN ARTHUR 
Published: June 2018

Diverse pathogenesis pathways to type 2 diabetes make optimal care and prevention challenging. Identifying heterogeneous metabolic parameters of patients would be beneficial for developing personalized therapies and prediction of future glycemia. As such, we developed a mathematical model based on Ha et al. Endo 2016,) to extract metabolic parameters of patients and predict their future glycemic trajectories. We fitted longitudinal Oral Glucose Tolerance Test data from a cohort of Pima Indians to predict future glycemic trajectories. First, we estimated three major metabolic parameters from a single OGTT: peripheral insulin sensitivity, hepatic insulin sensitivity, and beta-cell function. Insulin sensitivity estimated by the fitting algorithm correlated well with insulin sensitivity measured by insulin clamp and MINMOD, R2 =0.5 in both cases. Second, we used the fits to two OGTTs separated in time by several years to estimate capacity of beta-cell function to compensate for insulin resistance. Third, we found a strong correlation between an individual’s BMI and insulin sensitivity, R2 =0.75. Using a range of projected BMIs, the model predicts future glycemia. When measured BMIs from later time points were used, the future glycemic trajectory was accurately predicted. The mathematical model has great potential for clinical application in guiding therapy.

Disclosure
J. Ha: None. P.H. Chen: None. A. Sherman: Other Relationship; Self; Eli Lilly and Company.
CoMac Communication System—A Feasibility Implementation of Language-Centered Intervention for T2DM
Authors: CONNOR ULLA M. , SANDY ROBERT , GROOT MARY DE , MACNEILL ROBERT S. 
Published: June 2018

The CoMac Communication System is a scientifically tested set of tools to individualize Diabetes Self-Management Education and Support (DSMES), by speaking to persons with type 2 diabetes (T2DM) using their own language and worldviews.
In this quasi experimental study, conducted in a Midwestern diabetes care clinic with an accredited DSMES, a tablet was provided for patients to complete the CoMac segmentation survey. Altogether 72 patients took the survey and received the tailored communication. An unplanned control group of 48 patients emerged, due to occasional unavailability of the tablet/survey. These patients received the clinic’s standard DSMES, without the use of the CoMac tools. A1C levels from the first visit to the follow-up visit for each group were compared.
Interviews with the healthcare providers (HCPs), conducted during the six-month study, provided evidence about the success of the implementation. Individual psychosocial profiles and language recommendations helped HCPs better align their language. “Words matter” led to more efficient and effective behavioral goal settings with the patients.
The A1Cs of the intervention group decreased from 8.9 to 7.3, the control group’s from 8.3 to 7.6. A multiple regression analysis with the A1C level change as the dependent variable showed that the independent variables of age, gender, and starting weight were not significant predictors of A1C reduction. Statistically significant were the starting value of A1C and the CoMac intervention. Patients with higher initial A1Cs showed a greater decline in A1Cs. The key variable of interest, treated with the CoMac intervention, had a t-value of -1.81, with a prob value of 0.037. Although a cause-and-effect relationship cannot be proven without random assignment, the significantly improved A1Cs of the intervention group are highly encouraging.
As diabetes care teams and delivery models expand, person-centered language tools are an innovation in effective management of DSMES.

Disclosure
U.M. Connor: Other Relationship; Self; CoMac Analytics, Inc..R. Sandy: None. M. de Groot: Consultant; Self; Johnson & Johnson Diabetes Institute, LLC., Eli Lilly and Company. R.S. MacNeill: Other Relationship; Self; comAc analytics inc.
Subcutaneous Transplantation of MIN6 Beta Cells Embedded in mPEG-Ala Hydrogel
Authors: JUANG JYUHN-HUARNG , LIN HSIU-CHAO , CHEN CHEN-YI , KAO CHEN-WEI , WU SHU-TING , LIN SUNG-HAN , SHEN CHIA-RUI , WANG JIUN-JIE , CHU I-MING 
Published: June 2018

The liver is the current site of choice for clinical islet transplantation, but many intraportal grafts were lost in the early stage of transplantation. Other disadvantages include the difficulty of monitoring the islets and procedure-associated complications. In contrast, the subcutaneous space offers the advantages of a large space, a less invasive procedure and easy graft monitoring and removal. However, islet transplantation into an unmodified subcutaneous site has poor efficacy; possibly due to poor oxygenation and inadequate vascularization of the transplanted tissue. In this study, we tested the feasibility of subcutaneous transplantation of MIN6 beta cells embedded in temperature-sensitive poly(ethylene glycol) methyl ether (mPEG)-Ala hydrogels as scaffolds. After culturing for 14 days, the viability of MIN6 beta cells in mPEG-Ala hydrogel was comparable with those in medium, either assayed by MTT or LIVE/DEAD. Static incubation showed that both had comparable insulin secretion. For in vivo experiments, we infected MIN6 beta cells with luciferase by AAV and then transplanted 5*106 cells embedded in mPEG-Ala hydrogel into the subcutaneous space of each nude mouse’s upper back. Positive In Vivo Imaging System (IVIS) images and positive insulin staining of tissue histology were observed up to 41 days after transplantation. Meanwhile, we incubated MIN6 beta cells with chitosan-coated superparamagnetic iron oxide (CSPIO) overnight and then transplanted 5*106 MIN6 beta cells into the subcutaneous tissue of each nude mouse’s left flank. The graft of CSPIO-labeled MIN6 beta cells was visualized on Magnetic Resonance (MR) scans as distinct hypointense spots on T2-weighted images located at the transplantation site at day 6 and 20. These results indicate that subcutaneous transplantation of MIN6 beta cells embedded in temperature-sensitive mPEG-Ala hydrogels is feasible. Moreover, the IVIS and MR imaging are useful tools for detecting and monitoring beta cells at the subcutaneous site.

Disclosure
J. Juang: None.H. Lin: None.C. Chen: None.C. Kao: None.S. Wu: None.S. Lin: None.C. Shen: None.J. Wang: None.I. Chu: None.