The impact of vegan diet in the prevention and treatment of type 2 diabetes: A systematic review

A protective effect of vegan diets on health outcomes has been observed in previous studies, but its impact on diabetes is still debated. The aim of this review is to assess the relationship between vegan diets and the risk for type 2 diabetes (T2D) along with its effect on glycemic control and diabetes-related complications. In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, Pubmed and Cochrane library databases were systematically searched for all relevant studies. Seven observational and eight randomized controlled (RCTs) studies were included. The methodological quality of studies was assessed using the National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies and the Cochrane Risk of Bias Tool for RCTs. We found that a vegan diet is associated with lower T2D prevalence or incidence and in T2D patients decreases high glucose values and improves glucose homeostasis, as reported from the majority of included studies. This approach seems to be comparable to other recommended healthful eating models, but as it may have potential adverse effects associated with the long-term exclusion of some nutrients, appropriate nutritional planning and surveillance are recommended, particularly in specific groups of diabetic patients such as frail elderly, adolescents, and pregnant or breastfeeding women

Diabetes-Related Autoantibodies in Children With Acute Lymphoblastic Leukemia

[No abstract available

Determinants of weight, psychological status, food contemplation and lifestyle changes in patients with obesity during the COVID-19 lockdown: a nationwide survey using multiple correspondence analysis

Introduction The corona virus disease 2019 (COVID-19) pandemic forced most of the Italian population into lockdown from 11 March to 18 May 2020. A nationwide survey of Italian Clinical Nutrition and Dietetic Services (Obesity Centers or OCs) was carried out to assess the impact of lockdown restrictions on the physical and mental wellbeing of patients with obesity (PWO) who had follow-up appointments postponed due to lockdown restrictions and to compare determinants of weight gain before and after the pandemic. Methods We designed a structured 77-item questionnaire covering employment status, diet, physical activity and psychological aspects, that was disseminated through follow-up calls and online between 2 May and 25 June 2020. Data were analyzed by multiple correspondence analysis (MCA) and multiple linear regression. Results A total of 1,232 PWO from 26 OCs completed the questionnaires (72% female, mean age 50.2 +/- 14.2 years; mean BMI 34.7 +/- 7.6 kg/m(2); 41% obesity class II to III). During the lockdown, 48.8% gained, 27.1% lost, while the remainder (24.1%) maintained their weight. The mean weight change was +2.3 +/- 4.8 kg (in weight gainers: +4.0 +/- 2.4 kg; +4.2% +/- 5.4%). Approximately 37% of participants experienced increased emotional difficulties, mostly fear and dissatisfaction. Sixty-one percent reduced their physical activity (PA) and 55% experienced a change in sleep quality/quantity. The lack of online contact (37.5%) with the OC during lockdown strongly correlated with weight gain (p < 0.001). Using MCA, two main clusters were identified: those with unchanged or even improved lifestyles during lockdown (Cluster 1) and those with worse lifestyles during the same time (Cluster 2). The latter includes unemployed people experiencing depression, boredom, dissatisfaction and increased food contemplation and weight gain. Within Cluster 2, homemakers reported gaining weight and experiencing anger due to home confinement. Conclusions Among Italian PWO, work status, emotional dysregulation, and lack of online communication with OCs were determinants of weight gain during the lockdown period

Quality of life and treatment satisfaction in adults with Type 1 diabetes: A comparison between continuous subcutaneous insulin infusion and multiple daily injections

Aims: The aim of this case-control study was to compare quality of life (QoL) and treatment satisfaction in adults with Type 1 diabetes (T1DM) treated with either continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI). Methods: Consecutive patients aged between 18 and 55 years, and attending diabetes clinics for a routine visit, completed the Diabetes-Specific Quality-of-Life Scale (DSQOLS), the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and the SF-36 Health Survey (SF-36). Case (CSII) and control subjects (MDI) were recruited in a 1 : 2 ratio. Results: Overall, 1341 individuals were enrolled by 62 diabetes clinics; 481 were cases and 860 control subjects. Cases had a longer diabetes duration and were more likely to have eye and renal complications. Age, school education, occupation and HbA1c were similar. Of control subjects, 90% followed glargine-based MDI regimens and 10% used NPH-based MDI regimens. On multivariate analysis, after adjusting for socioeconomic and clinical characteristics, scores in the following areas of the DSQOLS were higher in cases than control subjects: diet restrictions (β = 5.96; P < 0.0001), daily hassles (β = 3.57; P = 0.01) and fears about hypoglycaemia (β = 3.88; P = 0.006). Treatment with CSII was also associated with a markedly higher DTSQ score (β = 4.13; P < 0.0001) compared with MDI. Results were similar when CSII was compared separately with glargine- or NPH-based MDI regimens. Conclusions: This large, non-randomized, case-control study suggests quality of life gains deriving from greater lifestyle flexibility, less fear of hypoglycaemia, and higher treatment satisfaction, when CSII is compared with either glargine-based or NPH-based MDI regimens. © 2008 The Authors

Muscular involvement in long-term type 1 diabetes: Does it represent an underestimated complication?

Objectives: Structural, metabolic, and functional signs of skeletal muscle damage have been identified in indi-viduals affected by type 1 diabetes (T1D), but, to our knowledge, no guidelines for the diagnosis and treat-ment of muscle impairment exist and studies on T1D and muscle health remain limited. The aim of this study was to evaluate the prevalence of sarcopenia in a long-term T1D population and to assess the effects of some clinical parameters on muscle mass and function.Methods: Thirty-nine patients affected by T1D were enrolled. Body mass index (BMI), body composition (appendicular lean mass index [ALMI] and fat mass [FM]), and muscle strength were measured. Additionally, the relationship between Mediterranean diet adherence and sarcopenia was assessed.Results: In the present sample (mean age 49.32 & PLUSMN; 13.49 y, 41.1% women, mean duration of diabetes 30.13 & PLUSMN; 12.28 y), the prevalence of sarcopenia was 7.7% (12.5 % in women and 4.35% in men). The prevalence of low ALMI was 23.1% (25% in women and 21.74% in men). Significant inverse correlations were found between ALMI and duration of diabetes and ALMI and FM; and significant positive correlations between ALMI and BMI, physical activity level, and muscle strength. At the same time, significant inverse correlations were observed between muscle strength and duration of diabetes and muscle strength and FM.Conclusions: We observed a high prevalence of low muscle mass, similar to those found in the older age groups of the general population (25 years in advance) and our findings suggest a possible pathogenetic role of T1D duration on muscle trophism and function.& COPY; 2023 Elsevier Inc. All rights reserved

Unfermented and fermented rooibos teas (Aspalathus linearis) increase plasma total antioxidant capacity in healthy humans

The aim of the study was to assess the effect of drinking rooibos tea (Aspalathus linearis) on total antioxidant capacity (TAC), lipid triacylglycerols, cholesterol and glycaemia plasma levels in humans. In vitro, unfermented rooibos tea displayed a 28% higher value of TRAP than did the fermented beverage. An acute intervention study, cross-over design, was performed, with 15 healthy volunteers who consumed 500áml of either water, unfermented or fermented rooibos teas. Plasma antioxidant capacity increased significantly with both teas, reaching a peak at 1áh post-consumption (+6.6%, pá<á0.05 fermented tea; +2.9%, pá<á0.01 unfermented tea). No changes in triacylglycerols, cholesterol or uric acid were observed with any of the treatments. A transitory increase in glycaemia at 30ámin was linked to glucose upload. The data show that rooibos teas represent a source of dietary antioxidants in human

Immunological features in children with vernal keratoconjunctivitis

Background: Vernal Keratoconjunctivitis (VKC) is a rare (<1:10 000 in Europe) chronic, bilateral, seasonally exacerbed inflammation of the ocular surface involving tarsal and/or bulbar conjunctiva. VKC especially affects male children and young boys and it tends to regress in puberty. The diagnosis is based on the common conjuncitval symptoms (itching, photophobia and tearing) and on the characteristic signs (giant papillae, conjunctival hyperaemia and Horner-Trantas dots on the limbal conjunctiva). Moreover, photophobia is a constant feature of the VKC. Aim: To define a clinical, anamnestic and immunological profile of patients with VKC evaluating also the presence of biomarker autoantibodies. Methods: The study was performed at the Immunology and Allergology service of the Pediatric Department, Policlinico Umberto I Hospital, Rome. We enrolled 28 children (18:M) aged 4–14 years with diagnosis of VKC made by an ophthalmologist. To each patient, we asked the family history of allergic and immunological diseases. Among the immunological disorders, we evaluated mainly the presence of Hashimoto′ s thyroiditis, type I diabetes, psoriasis, rheumatoid arthritis and Systemic Lupus Erythematosus (SLE). All patients with a diagnosis of VKC underwent to a serological evaluation with the dosage of ANA autoantibodies. Results: 17 patients (60.7%) patients reported a family history of allergic diseases. About the immunological disorders, one patient presented type 1 diabetes and 14 patients (53%) reported a positive family history for autoimmune diseases: 6 (21%) for Hashimoto′s thyroiditis, 4 (14%) for type I diabetes, 3 (10%) for psoriasis and one for Systemic Lupus Erythematosus. 10 (35.7%) patients were ANA positive and they tended to present an higher severity of VKC. The association between ANA positivity and the family history of immune disorders was not demonstrated. Conclusions: These findings encourage us to consider the VKC as a multifactorial disease that can not be explained only by an allergic mechanism. Moreover, among the patients with VKC, it is important to recognise those subgroups with certain anamnestic, clinical and serum characteristics in order to find out an appropriate therapeutic management and a careful follow-up

Effects of polyphenols on cardio-metabolic risk factors and risk of type 2 diabetes. A joint position statement of the Diabetes and Nutrition Study Group of the Italian Society of Diabetology (SID), the Italian Association of Dietetics and Clinical Nutrition (ADI) and the Italian Association of Medical Diabetologists (AMD)

Aim: Accumulating evidence support a role of polyphenols in the prevention of chronic diseases, i.e. type 2 diabetes (DMT2), cardiovascular diseases and some types of cancer. In the present manuscript, the effect of polyphenol/phenolic compounds on the main cardio-metabolic risk factors (body weight, blood pressure, blood glucose concentrations, plasma lipids, inflammation and oxidative stress) in humans will be discussed. Data synthesis: Epidemiological evidence supports the beneficial effects of polyphenol-rich diets in the prevention of T2D risk. However, the available evidence from the randomized controlled clinical trials did not allow to identify specific phenolic compounds or polyphenol-rich foods that effectively improve cardio-metabolic risk factors. The most promising results in term of management of cardio-metabolic risk factors derive from RCTs based on long-term intake of polyphenol-rich foods and beverages. Therefore, future studies should focus on a diet containing different class of polyphenols rather than a specific food or phenolic compound. The hypothesis is that a polyphenol-rich diet may have a pleiotropic effect on cardiometabolic risk factors thanks to the specific action of different polyphenol subclasses. Conclusion: The lack of conclusive evidence on polyphenol effectiveness in the management of cardio-metabolic risk factors does not allow to recommend their use as supplements to reduce T2D and CVD risk. However, the daily consumption of naturally polyphenol-rich foods and beverages might be advised according to the current nutritional dietary recommendation