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  • 1
    Online Resource
    Online Resource
    Dietary sodium and potassium intake in people with diabetes: are guidelines being met?
    Springer Science and Business Media LLC ; 2020
    In:  Nutrition & Diabetes Vol. 10, No. 1 ( 2020-06-17)
    Details
    In: Nutrition & Diabetes, Springer Science and Business Media LLC, Vol. 10, No. 1 ( 2020-06-17)
    Abstract: Despite public health bodies advocating for lowering dietary sodium and increasing potassium intake to improve cardiovascular outcomes, people with diabetes are not meeting these targets. We hypothesize that (i) both at an individual level and within the cohort, there will be a low adherence to the guidelines and (ii) sodium and potassium intake will remain stable over time. Methods We conducted this prospective study in a cohort of 904 participants with diabetes who provided 24-h urine collections from 2009 to 2015. Dietary sodium and potassium intake were estimated from 24-h urinary sodium (uNa) and potassium (uK) measurements. Additional data were collected for: 24-h urinary volume (uVol), creatinine (uCr),; serum creatinine, urea, estimated glomerular filtration rate (eGFR), glycated haemoglobin (HbA1c), fasting glucose, lipids); clinical characteristics (age, blood pressure (BP), body mass index (BMI) and duration of diabetes). Adherence to recommended dietary sodium (uNa  〈  2300 mg/24 h (100mmol/24 h)) and potassium (uK  〉  4680 mg/24 h(120 mmol/24)) intake were the main outcome measures. Results Participants ( n  = 904) completed 3689 urine collections (average four collections/participant). The mean ± SD (mmol/24 h) for uNa was 181 ± 73 and uK was 76 ± 25. After correcting uNa for uCr, 7% and 5% of participants met dietary sodium and potassium guidelines respectively. Males were less likely to meet sodium guidelines (OR 0.40, p   〈  0.001) but were more likely to meet potassium guidelines (OR 6.13, p   〈  0.001). Longer duration of diabetes was associated with higher adherence to sodium and potassium guidelines (OR 1.04, p   〈  0.001 and OR 0.96, p  = 0.006 respectively). Increasing age was significantly associated with adherence to potassium guidelines (OR 0.97, p  = 0.007). Conclusions People with diabetes do not follow current dietary sodium and potassium guidelines and are less likely to change their dietary intake of sodium and potassium over time.
    Type of Medium: Online Resource
    ISSN: 2044-4052
    URL: Article
    DOI: 10.1038/s41387-020-0126-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2609314-5
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  • 2
    Online Resource
    Online Resource
    Sodium and Its Role in Cardiovascular Disease – The Debate Continues
    Frontiers Media SA ; 2016
    In:  Frontiers in Endocrinology Vol. 7 ( 2016-12-23)
    Details
    In: Frontiers in Endocrinology, Frontiers Media SA, Vol. 7 ( 2016-12-23)
    Type of Medium: Online Resource
    ISSN: 1664-2392
    URL: Article
    DOI: 10.3389/fendo.2016.00164
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2016
    detail.hit.zdb_id: 2592084-4
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  • 3
    Online Resource
    Online Resource
    Strategies for enumeration of circulating microvesicles on a conventional flow cytometer Counting beads and scatter parameters
    Aboutscience Srl ; 2018
    In:  Journal of Circulating Biomarkers Vol. 7, No. 1 ( 2018-04-04)
    Details
    In: Journal of Circulating Biomarkers, Aboutscience Srl, Vol. 7, No. 1 ( 2018-04-04)
    Abstract: Abstract non disponibile
    Type of Medium: Online Resource
    ISSN: 1849-4544 , 1849-4544
    URL: Article
    DOI: 10.33393/jcb.2018.2087
    Language: Unknown
    Publisher: Aboutscience Srl
    Publication Date: 2018
    detail.hit.zdb_id: 2802655-X
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  • 4
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    Feasibility of using a transition diabetes team to commence injectable therapies postdischarge from a tertiary hospital: a pilot, randomised controlled trial
    BMJ ; 2019
    In:  BMJ Open Vol. 9, No. 9 ( 2019-09), p. e023583-
    Details
    In: BMJ Open, BMJ, Vol. 9, No. 9 ( 2019-09), p. e023583-
    Abstract: This study aimed to investigate if the use of a transition team was feasible for patients with diabetes being discharged from hospital on injectable diabetes therapies. Design Pilot, randomised controlled trial. Setting The trial was conducted between 2014 and 2016 conjointly by a tertiary referral hospital and a community healthcare provider. Participants Hospital inpatients (n=105) on new injectable diabetes therapies were randomised 1:1 to transition team or standard care. The transition team received in-home diabetes education 24–48 hours postdischarge, with endocrinologist review 2–4 weeks and 16 weeks postdischarge. Main outcome measures The primary outcome was feasibility, defined by percentage of patients successfully receiving the intervention. Secondary outcomes included safety, defined by hospital readmission and emergency department presentations within 16 weeks postrandomisation, and treatment satisfaction, measured using Diabetes Treatment Satisfaction Questionnaire (DTSQ). Exploratory outcomes included length of stay (LOS) and change in haemoglobin A1c (HbA1c) throughout the study. Results The intervention was deemed feasible (85% (95% CI 73% to 94%)). No difference in safety between groups was detected. No difference in change in HbA1c between groups was detected (standard care median HbA1c −1.5% (IQR −3.7% to −0.2%) vs transition team median HbA1c −1.9% (IQR −3.8% to −0.2%), p=0.83). There was a trend towards reduced LOS in the transition team group (per protocol, standard care median LOS 8 (IQR 5.5–12); transition team median LOS 6 (IQR 3–12), p=0.06). There was a significant improvement in patient satisfaction in the transition team (standard care median 10.5 (IQR 8.5–16); transition team DTSQ change version median 15 (IQR 10–17.5), p=0.047), although interpretability is limited by missing data. Conclusion This study demonstrated that the use of a novel transition diabetes team is a feasible alternative model of care.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2018-023583
    Language: English
    Publisher: BMJ
    Publication Date: 2019
    detail.hit.zdb_id: 2599832-8
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  • 5
    Online Resource
    Online Resource
    Effect of angiotensin II receptor blocker and salt supplementation on short-term blood pressure variability in type 2 diabetes
    Springer Science and Business Media LLC ; 2020
    In:  Journal of Human Hypertension Vol. 34, No. 2 ( 2020-02), p. 143-150
    Details
    In: Journal of Human Hypertension, Springer Science and Business Media LLC, Vol. 34, No. 2 ( 2020-02), p. 143-150
    Type of Medium: Online Resource
    ISSN: 0950-9240 , 1476-5527
    URL: Article
    DOI: 10.1038/s41371-019-0238-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2006792-6
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  • 6
    Online Resource
    Online Resource
    The relationship between habitual dietary sodium intake and RAAS blockade on circulating microparticle levels in type two diabetes
    Portland Press Ltd. ; 2018
    In:  Clinical Science Vol. 132, No. 20 ( 2018-10-31), p. 2207-2220
    Details
    In: Clinical Science, Portland Press Ltd., Vol. 132, No. 20 ( 2018-10-31), p. 2207-2220
    Abstract: Objective: Low sodium intake is paradoxically associated with adverse cardiovascular outcomes in individuals with type 2 diabetes mellitus (T2D), possibly from renin–angiotensin–aldosterone system (RAAS) activation, leading to endothelial dysfunction. In the present study, we investigated the associations between habitual sodium intake and RAAS blockade on endothelial function by measuring circulating microparticles (MPs) in individuals with T2D. Methods: We conducted a prospective, cross-sectional study in 74 individuals with T2D. Habitual dietary sodium intake was estimated by using the mean of three corrected 24-h urine sodium excretion measurements (24hUNa). MP subtypes in platelet-free plasma were quantitated using flow cytometry. Results: No associations between 24hUNa with levels of endothelial MPs were observed. Instead, a trend toward higher diabetes related CD36+/CD235a+ MP levels was associated with lower 24hUNa (rho = −0.23, P=0.05). When stratified according to tertiles of 24hUNa, platelet-derived CD42b+/CD41+ and CD42+/CD41+/Annexin V+ MPs were higher in the lowest tertile (24hUNa & lt; 157 mmol/24 h) (P=0.02 respectively). Despite RAAS blockade being associated with lower levels of most MP subsets, it was not associated with lower MPs, in the setting of low sodium intake. Conclusion: Lower sodium intake is associated with higher circulating procoagulant MPs, but not with evidence of endothelial dysfunction in individuals with T2D.
    Type of Medium: Online Resource
    ISSN: 0143-5221 , 1470-8736
    URL: Article
    DOI: 10.1042/CS20180472
    Language: English
    Publisher: Portland Press Ltd.
    Publication Date: 2018
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  • 7
    Online Resource
    Online Resource
    Short-term dietary salt supplementation blunts telmisartan induced increases in plasma renin activity in hypertensive patients with type 2 diabetes mellitus
    Portland Press Ltd. ; 2015
    In:  Clinical Science Vol. 129, No. 5 ( 2015-09-01), p. 415-422
    Details
    In: Clinical Science, Portland Press Ltd., Vol. 129, No. 5 ( 2015-09-01), p. 415-422
    Abstract: Current guidelines recommend low dietary salt intake (LDS) in patients with diabetes to reduce blood pressure (BP). However, low salt intake has been associated with higher mortality rates in people with diabetes. Our aim is to examine the effect of angiotensin II receptor blocker (ARB), telmisartan, with and without dietary sodium chloride (NaCl) supplementation, on BP [mean arterial pressure (MAP)], plasma renin activity (PRA), serum aldosterone level and estimated glomerular filtration rate (eGFR) in hypertensive patients with type 2 diabetes. In a randomized, double-blind, placebo-controlled study (RCT), 28 patients with type 2 diabetes, treated with telmisartan (40 mg daily), received 2 weeks of placebo or NaCl capsules (100 mmol/24 h). Following a 6-week washout, the protocol was repeated in reverse. Twenty-four-hour urinary sodium excretion (24hUNa), ambulatory BP (ABP) monitoring and blood tests were performed before and after each study phase. The telmisartan-associated increase in PRA was blunted by approximately 50% during salt supplementation compared with placebo; median PRA was 2.3 μg/l/h with placebo compared with 1.7 μg/l/h with salt (P & lt;0.001). A trend towards blunting of ARB induced increases in serum aldosterone was also demonstrated. Salt supplementation significantly reduced the MAP lowering effects of telmisartan (P & lt;0.05). The present study demonstrates that salt supplementation blunts the telmisartan induced increase in PRA in patients with type 2 diabetes.
    Type of Medium: Online Resource
    ISSN: 0143-5221 , 1470-8736
    URL: Article
    DOI: 10.1042/CS20140536
    Language: English
    Publisher: Portland Press Ltd.
    Publication Date: 2015
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  • 8
    Online Resource
    Online Resource
    Relationship between urinary sodium excretion and serum aldosterone in patients with diabetes in the presence and absence of modifiers of the renin–angiotensin–aldosterone system
    Portland Press Ltd. ; 2014
    In:  Clinical Science Vol. 126, No. 2 ( 2014-01-01), p. 147-154
    Details
    In: Clinical Science, Portland Press Ltd., Vol. 126, No. 2 ( 2014-01-01), p. 147-154
    Abstract: Although low dietary salt intake has beneficial effects on BP (blood pressure), low 24hUNa (24 h urinary sodium excretion), the most accurate estimate of dietary salt intake, is associated with increased mortality in people with diabetes. In the non-diabetic population, low salt intake is associated with increased RAAS (renin–angiotensin–aldosterone system) activity. In this cross-sectional study, we examined the relationship between 24hUNa, PRA (plasma renin activity), serum aldosterone and BNP (brain natriuretic peptide) in patients with diabetes. Clinical characteristics, 24hUNa, PRA, serum aldosterone and BNP were recorded in 222 consecutive patients (77% with Type 2 diabetes) attending a diabetes clinic at a tertiary hospital. The relationship between 24hUNa, serum aldosterone, PRA, BNP, urinary potassium excretion, serum potassium, serum sodium, eGFR (estimated glomerular filtration rate), urinary albumin excretion and HbA1c (glycated haemoglobin) was examined by a multivariable regression model. Levels of 24hUNa significantly predicted serum aldosterone in a linear fashion (R2=0.20, P=0.002). In the subgroup of patients (n=46) not taking RAAS-modifying agents, this relationship was also observed (R2=0.10, P=0.03), and the effect of 24hUNa on serum aldosterone was found to be more pronounced than in the whole cohort (coefficient=−0.0014, compared with −0.0008). There was no demonstrable relationship between 24hUNa and PRA or BNP. Low 24hUNa is associated with increased serum aldosterone in people with diabetes, in the presence and absence of RAAS-modifying agents. This raises the possibility that stimulation of the RAAS may be a mechanism that contributes to adverse outcomes observed in patients with low 24hUNa.
    Type of Medium: Online Resource
    ISSN: 0143-5221 , 1470-8736
    URL: Article
    DOI: 10.1042/CS20130128
    Language: English
    Publisher: Portland Press Ltd.
    Publication Date: 2014
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  • 9
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    Online Resource
    Relationship between urinary sodium‐to‐potassium ratio and ambulatory blood pressure in patients with diabetes mellitus
    Wiley ; 2018
    In:  Clinical and Experimental Pharmacology and Physiology Vol. 45, No. 1 ( 2018-01), p. 94-97
    Details
    In: Clinical and Experimental Pharmacology and Physiology, Wiley, Vol. 45, No. 1 ( 2018-01), p. 94-97
    Abstract: Previous studies investigating the relationship between sodium intake and blood pressure have mostly relied on dietary recall and clinic blood pressure measurement. In this cross‐sectional study, we aimed to investigate the relationship between 24 hour urinary sodium and potassium excretion, and their ratio, with 24 hour ambulatory blood pressure parameters including nocturnal blood pressure dipping in patients with type 1 and 2 diabetes. We report that in 116 patients with diabetes, systolic blood pressure was significantly predicted by the time of day, age, the interaction between dipping status with time, and 24 hour urinary sodium‐to‐potassium ratio ( R 2  = 0.83) with a relative contribution of 53%, 21%, 20% and 6%, respectively. However, there was no interaction between urinary sodium‐to‐potassium ratio and dipping status.
    Type of Medium: Online Resource
    ISSN: 0305-1870 , 1440-1681
    URL: Issue
    URL: Article
    DOI: 10.1111/cep.2018.45.issue-1
    DOI: 10.1111/1440-1681.12852
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2020033-X
    SSG: 15,3
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  • 10
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    Online Resource
    Effect of Salt Supplementation on Sympathetic Activity and Endothelial Function in Salt-Sensitive Type 2 Diabetes
    The Endocrine Society ; 2020
    In:  The Journal of Clinical Endocrinology & Metabolism Vol. 105, No. 4 ( 2020-04-01), p. e1187-e1200
    Details
    In: The Journal of Clinical Endocrinology & Metabolism, The Endocrine Society, Vol. 105, No. 4 ( 2020-04-01), p. e1187-e1200
    Abstract: Lower sodium intake is paradoxically associated with higher mortality in type 2 diabetes (T2D). Objective To determine whether sympathetic nervous system (SNS) activation and endothelial dysfunction contribute to these observations, we examined the effect of salt supplementation on these systems in people with T2D with habitual low sodium. We hypothesized that salt supplementation would lower SNS activity and improve endothelial function compared to placebo. Design We conducted a randomized, double-blinded, placebo-controlled crossover trial. Setting The study took place in a tertiary referral diabetes outpatient clinic. Participants Twenty-two people with T2D with habitual low sodium intake (24-hour urine sodium & lt;150 mmol/24h) were included. Intervention Salt supplementation (100 mmol NaCl/24h) or placebo for 3 weeks was administered. Main outcome measures The primary outcome of SNS activity and endothelial function was assessed as follows: Microneurography assessed muscle sympathetic nerve activity (MSNA), pulse amplitude tonometry assessed endothelial function via reactive hyperemic index (RHI), and arterial stiffness was assessed via augmentation index (AI). Secondary outcomes included cardiac baroreflex, serum aldosterone, ambulatory blood pressure monitoring (ABPM), heart rate variability (HRV), and salt sensitivity. Results Compared to placebo, salt supplementation increased MSNA (burst frequency P = .047, burst incidence P = .016); however, RHI (P = .24), AI (P = .201), ABPM (systolic P = .09, diastolic P = .14), and HRV were unaffected. Salt supplementation improved baroreflex (slope P = .026) and lowered aldosterone (P = .004), and in salt-resistant individuals there was a trend toward improved RHI (P = .07). Conclusions In people with T2D and low habitual sodium intake, salt supplementation increased SNS activity without altering endothelial function or blood pressure but improved baroreflex function, a predictor of cardiac mortality. Salt-resistant individuals trended toward improved endothelial function with salt supplementation.
    Type of Medium: Online Resource
    ISSN: 0021-972X , 1945-7197
    URL: Article
    DOI: 10.1210/clinem/dgz219
    RVK:
    XA 10000
    Language: English
    Publisher: The Endocrine Society
    Publication Date: 2020
    detail.hit.zdb_id: 2026217-6
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