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  • 1
    In: Diabetes Care, American Diabetes Association, Vol. 42, No. 5 ( 2019-05-01), p. 777-788
    Abstract: The long-term impact of intentional weight loss on cardiovascular events remains unknown. We describe 12-month changes in body weight and cardiovascular risk factors in PREvención con DIeta MEDiterránea (PREDIMED)-Plus, a trial designed to evaluate the long-term effectiveness of an intensive weight loss lifestyle intervention on primary cardiovascular prevention. RESEARCH DESIGN AND METHODS Overweight/obese adults with metabolic syndrome aged 55–75 years (n = 626) were randomized to an intensive weight loss lifestyle intervention based on an energy-restricted Mediterranean diet, physical activity promotion, and behavioral support (IG) or a control group (CG). The primary and secondary outcomes were changes in weight and cardiovascular risk markers, respectively. RESULTS Diet and physical activity changes were in the expected direction, with significant improvements in IG versus CG. After 12 months, IG participants lost an average of 3.2 kg vs. 0.7 kg in the CG (P & lt; 0.001), a mean difference of −2.5 kg (95% CI −3.1 to −1.9). Weight loss ≥5% occurred in 33.7% of IG participants compared with 11.9% in the CG (P & lt; 0.001). Compared with the CG, cardiovascular risk factors, including waist circumference, fasting glucose, triglycerides, and HDL cholesterol, significantly improved in IG participants (P & lt; 0.002). Reductions in insulin resistance, HbA1c, and circulating levels of leptin, interleukin-18, and MCP-1 were greater in IG than CG participants (P & lt; 0.05). IG participants with prediabetes/diabetes significantly improved glycemic control and insulin sensitivity, along with triglycerides and HDL cholesterol levels compared with their CG counterparts. CONCLUSIONS PREDIMED-Plus intensive lifestyle intervention for 12 months was effective in decreasing adiposity and improving cardiovascular risk factors in overweight/obese older adults with metabolic syndrome, as well as in individuals with or at risk for diabetes.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2019
    detail.hit.zdb_id: 1490520-6
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  • 2
    In: Diabetes, American Diabetes Association, Vol. 73, No. Supplement_1 ( 2024-06-14)
    Abstract: Introduction and Objectives: Individuals with type 1 diabetes (T1D) are faced with a growing prevalence of obesity, a recognized determinant of cardiovascular (CV) risk. This study aims to evaluate the metabolic profile, CV risk, and diabetes-related complications across body mass index (BMI) classes in individuals with T1D. Methods: Using data from SFDT1, a multicentric French cohort, individuals with T1D were stratified into four BMI classes: underweight ( & lt;18.5 kg/m²), normal weight (18.5-24.9 kg/m²), overweight (OW) (25-29.9 kg/m²), and obesity (OB) (BMI ≥30 kg/m²). Baseline statistical analyses were performed with mean ± SD or frequency (%), with group comparisons through Kruskall-Wallis, variance analysis, and Chi-squared tests. Spearman correlation and logistic regression were applied. CV risk was evaluated using the Steno T1 Risk Engine score (STRS) in people in primary prevention. Results: Among 1,724 participants (age 38 years, diabetes duration 22 years, BMI 24.9kg/m2, Male 53%), 8% had a CV history and 31% were classified as OW or OB. Age and duration of diabetes (ranging from 17.5 to 25.0 years) increased with BMI class. The mean HbA1c remained comparable (7.5% overall, p=0.5975) but the proportion of participants with HbA1c≥6.9%, as well as those with high blood pressure and dyslipidemia increased with BMI class. BMI was associated with CV history (OR=1.044, CI95% 1.004-1.084), even after adjustments for age, sex, and diabetes duration. In the primary prevention population, compared to normal weight, those with OW and OB had an increase of STRS at 5 years (57% and 74%) and 10 years (50 and 60%) (p & lt;0.001). BMI correlated with 5 and 10-year STRS (p & lt;0.001) and Waist/Height ratio with 10-year risk (p & lt;0.001). OW and OB were associated with retinopathy but not nephropathy. Conclusion: T1D individuals with OW and OB had more CV history, higher STRS at 5 and 10 years, and more retinopathy. Visceral adiposity was associated with increased STRS. Disclosure L. Salle: Advisory Panel; Sanofi, Amarin Corporation. J. Julla: Board Member; Sanofi. Speaker's Bureau; Lilly Diabetes, Novo Nordisk. G.A. Aguayo: None. S. Tatulashvili: None. L. Sablone: None. M. Joubert: Consultant; Abbott, Medtronic, Dexcom, Inc. E. Renard: None. S. Lablanche: None. E. Cosson: Advisory Panel; Abbott, AstraZeneca, Lilly Diabetes, Novo Nordisk, Sanofi, Roche Diagnostics, Novartis AG, Amgen Inc. G. Fagherazzi: Speaker's Bureau; Sanofi. Advisory Panel; Timkl, SAB Biotherapeutics, Inc., Vitalaire, Roche Diabetes Care. J. Riveline: Board Member; Abbott, Novo Nordisk A/S, Sanofi, Eli Lilly and Company, Medtronic, Dexcom, Inc., Insulet Corporation, Air Liquide, AstraZeneca.
    Type of Medium: Online Resource
    ISSN: 0012-1797
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2024
    detail.hit.zdb_id: 1501252-9
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  • 3
    In: Diabetes Care, American Diabetes Association, Vol. 42, No. 10 ( 2019-10-01), p. 1903-1911
    Abstract: Frailty is a dynamic state of vulnerability in the elderly. We examined whether individuals with overt diabetes or higher levels of HbA1c or fasting plasma glucose (FG) experience different frailty trajectories with aging. RESEARCH DESIGN AND METHODS Diabetes, HbA1c, and FG were assessed at baseline, and frailty status was evaluated with a 36-item frailty index every 2 years during a 10-year follow-up among participants from the English Longitudinal Study of Ageing (ELSA). Mixed-effects models with age as time scale were used to assess whether age trajectories of frailty differed as a function of diabetes, HbA1c, and FG. RESULTS Among 5,377 participants (median age [interquartile range] 70 [65, 77] years, 45% men), 35% were frail at baseline. In a model adjusted for sex, participants with baseline diabetes had an increased frailty index over aging compared with those without diabetes. Similar findings were observed with higher levels of HbA1c, while FG was not associated with frailty. In a model additionally adjusted for income, social class, smoking, alcohol, and hemoglobin, only diabetes was associated with an increased frailty index. Among nonfrail participants at baseline, both diabetes and HbA1c level were associated with a higher increased frailty index over time. CONCLUSIONS People with diabetes or higher HbA1c levels at baseline had a higher frailty level throughout later life. Nonfrail participants with diabetes or higher HbA1c also experienced more rapid deterioration of frailty level with aging. This observation could reflect a role of diabetes complications in frailty trajectories or earlier shared determinants that contribute to diabetes and frailty risk in later life.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2019
    detail.hit.zdb_id: 1490520-6
    Location Call Number Limitation Availability
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  • 4
    In: Diabetes, American Diabetes Association, Vol. 72, No. Supplement_1 ( 2023-06-20)
    Abstract: CGM-derived data are usually analyzed in silos, metric by metric, for diabetes care or therapeutic strategy. Simultaneous analysis of the various dimensions of glycemic control would allow a more comprehensive overview. We analyzed data of people with type 1 diabetes (PWT1D) in the SFDT1 cohort study. A K-means clustering model was developed with HbA1c, coefficient of variation (CV), time in range (TIR), time below 70 mg/dl (TBR), Gold score and Glycemic Risk Index (GRI). We included 618 participants (53% men, age 41±14 years) from 20 centres in France. The optimal model had 3 clusters. The “Euglycemia” cluster (n=280, 45%) was characterized by a high TIR (mean 69.3%); low TBR ​​(4.2%), TAR (time above 180 mg/dl: 26.5%), CV (35.7%), HbA1c (7.0%) and GRI (36.4) values. The “Hyperglycaemia" cluster (n=197, 32%) was characterized by high TAR (56.5%), GRI (71.8) and HbA1c (8.5%) and low TIR (40.3%), TBR (3.2%) and Gold score (2.3). The “Hypoglycemia” cluster (n=141, 23%) was characterized by high TBR (15.8%), CV (46.1%), GRI (69.2) and Gold score (3.0). Participants in the “Hyperglycemia” cluster were younger, socially vulnerable, and had more frequent hypertension than those in the “Euglycemia” cluster. To conclude, we identified three distinct, clinically relevant glycemic control profiles, enabling better characterization of PWT1D and, thus, more personalised management. Disclosure E.Cosson: Board Member; Abbott, Medtronic. G.A.Aguayo: None. L.Sablone: None. M.Huet: None. J.Riveline: Board Member; Abbott Diabetes, Medtronic, Dexcom, Inc., Novo Nordisk, Eli Lilly and Company, Sanofi. G.Fagherazzi: Advisory Panel; Roche Diabetes Care, Consultant; AbbVie Inc., Lilly. Sfdt1 study team: n/a.
    Type of Medium: Online Resource
    ISSN: 0012-1797
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2023
    detail.hit.zdb_id: 1501252-9
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  • 5
    In: Diabetes, American Diabetes Association, Vol. 73, No. Supplement_1 ( 2024-06-14)
    Abstract: Introduction & Objectives: To evaluate whether medical care for and level of cardiovascular risk factors differ in primary prevention between adult men and women with type 1 diabetes (T1D) in two European countries in 2020-2022. Methods: We included 2657 participants from the DPV registry (Germany, mean age 40±15, diabetes duration 23±14 years; 50.9% men) and 1172 from the SFDT1 study (France, age 39±14, diabetes duration 22±13 years; 53.2% men). Results: HbA1c levels and body mass indexes were similar in women and men with similar proportions of HbA1c & lt;7% (DPV: 36.6 vs. 33.0%, respectively; SFDT1: 22.8 vs. 24.9%; both n.s.). Women had less overweight in DPV (55.4 vs. 61.0%, p & lt;0.05) but not in SFDT1 (48.0 vs. 44.9%, n.s.) and were less prone to smoke (DPV: 19.7 vs. 25.8%, p & lt;0.05; SFDT1: 21.0 vs. 26.0%, n.s.). Systolic blood pressure was lower in women than men (DPV: 124±15 vs. 129±15; SFDT1: 121±16 vs. 126±14mmHg, both p & lt;0.05) with similar rates of antihypertensive therapy in case of systolic/diastolic blood pressure ≥140/90mmHg (DPV: 70.5 vs. 63.6%; SFDT1: 73.3 vs. 68.6%, both n.s.). In case of microalbuminuria, ACEi-ARB were less prescribed in women than men in DPV (21.4 vs 37.6%, p & lt;0.05) but not SFDT1 (70.6 vs 62.0%, n.s.). In women compared to men, HDL-cholesterol levels were higher; triglycerides lower and LDL-cholesterol similar in DPV and SFDT1. In those with LDL-cholesterol & gt;130 mg/dL (DPV: 19.9 vs. 23.9%; SFDT1 17.0 vs. 19.2%, both n.s.), statin therapy was less prescribed in women than men in DPV (7.9 vs. 17.0%, p & lt;0.05), SFDT1 (18.2 vs. 21.0%, n.s.). Conclusion: Women in primary prevention have a better cardiovascular risk profile than men in both studies. We observed a high rate of therapeutic inertia, which might be higher in women for statin and nephroprotection with ACEi-ARB especially in Germany. Disclosure E. Cosson: Advisory Panel; Abbott, AstraZeneca, Lilly Diabetes, Novo Nordisk, Sanofi, Roche Diagnostics, Novartis AG, Amgen Inc. M. Auzanneau: Other Relationship; Insulet Corporation. G.A. Aguayo: None. W. Karges: None. J. Riveline: Board Member; Abbott, Novo Nordisk A/S, Sanofi, Eli Lilly and Company, Medtronic, Dexcom, Inc., Insulet Corporation, Air Liquide, AstraZeneca. P. Augstein: None. L. Sablone: None. P.M. Jehle: None. G. Fagherazzi: Speaker's Bureau; Sanofi. Advisory Panel; Timkl, SAB Biotherapeutics, Inc., Vitalaire, Roche Diabetes Care. R.W. Holl: None.
    Type of Medium: Online Resource
    ISSN: 0012-1797
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2024
    detail.hit.zdb_id: 1501252-9
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