Prevention of type 2 diabetes in a primary healthcare setting: Three-year results of lifestyle intervention in Japanese subjects with impaired glucose tolerance

<p>Abstract</p> <p>Background</p> <p>A randomized control trial was performed to test whether a lifestyle intervention program, carried out in a primary healthcare setting using existing resources, can reduce the incidence of type 2 diabetes in Japanese with impaired glucose tolerance (IGT). The results of 3 years' intervention are summarized.</p> <p>Methods</p> <p>Through health checkups in communities and workplaces, 304 middle-aged IGT subjects with a mean body mass index (BMI) of 24.5 kg/m²were recruited and randomized to the intervention group or control group. The lifestyle intervention was carried out for 3 years by public health nurses using the curriculum and educational materials provided by the study group.</p> <p>Results</p> <p>After 1 year, the intervention had significantly improved body weight (-1.5 ± 0.7 vs. -0.7 ± 2.5 kg in the control; p = 0.023) and daily non-exercise leisure time energy expenditure (25 ± 113 vs. -3 ± 98 kcal; p = 0.045). Insulin sensitivity assessed by the Matsuda index was improved by the intervention during the 3 years. The 3-year cumulative incidence tended to be lower in the intervention group (14.8% vs.8.2%, log-rank test: p = 0.097). In a sub-analysis for the subjects with a BMI > 22.5 kg/m², a significant reduction in the cumulative incidence was found (p = 0.027).</p> <p>Conclusions</p> <p>The present lifestyle intervention program using existing healthcare resources is beneficial in preventing diabetes in Japanese with IGT. This has important implications for primary healthcare-based diabetes prevention.</p> <p>Trial registration number</p> <p><b>UMIN000003136</b></p

Significance of intracellular K+ in the pancreatic memory for glucose

info:eu-repo/semantics/publishe

The stimulus-secretion coupling of glucose-induced insulin release: Fuel metabolism in islets deprived of exogenous nutrient

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Metabolism and insulinotropic effect of pyruvate in isolated islets

info:eu-repo/semantics/publishe

Effect of tolbutamide upon metabolic and cationic events in rat pancreatic islets

Comm. Japanese Biochem. Soc. - Kyoto (Japan), 27.11.1978info:eu-repo/semantics/publishe

The stimulus secretion coupling of glucose-induced insulin release. Effect of lactate upon islet function

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

The stimulus–secretion coupling of glucose-induced insulin release. Metabolism of glucose in K(+)-deprived islets

1. When pancreatic islets were exposed to a K(+)-free medium, the intracellular concentration of K(+) was decreased and that of Na(+) increased. 2. In the K(+)-deprived islets, the utilization of [5-(3)H]glucose, output of lactic acid and oxidation of [U-(14)C]-glucose were decreased by about 30–40% below the control values found at normal extracellular K(+) concentration (5.0mm). However, the oxidation of [U-(14)C]pyruvate was unaffected. 3. The omission of extracellular K(+) little affected the production of (14)CO(2) from islets prelabelled with [U-(14)C]palmitate and incubated in the absence of glucose, despite the fact that K(+) deprivation significantly increased the ATP concentration and ATP/ADP concentration ratio in the glucose-deprived islets. 4. At normal K(+) concentration, glucose increased the concentrations of phosphoenolpyruvate, NAD(P)H and ATP in the islets. In the glucose-stimulated islets, the concentration of phosphoenolpyruvate, but not that of either NAD(P)H or ATP, was higher in the absence than in the presence of extracellular K(+). In islet homogenates, the activity of pyruvate kinase (EC 2.7.1.40) was stimulated by K(+) (optimal activity at 100–150mm-K(+)) and inhibited by Na(+) (except at very low K(+) concentrations). 5. K(+) could be replaced by NH(4)(+), Rb(+), Cs(+) or Na(+) to maintain, at least to some extent, pyruvate kinase activity in islet homogenates. Addition of Rb(+) or Cs(+), but not NH(4)(+), to K(+)-deprived media also increased [U-(14)C]glucose oxidation by intact islets. 6. The omission of K(+) did not cause any obvious anomaly in the apparent dependency of (45)Ca(2+) net uptake on NAD(P)H concentration in the islets. 7. These data suggest that the coupling between metabolic and ionic events in the islet cells involves feedback mechanisms through which glucose oxidation may be modulated by cationic factors

Pool size, fractional turn-over rate and flux of monovalent cations in pancreatic islets

info:eu-repo/semantics/publishedComm. 13th Annual Meeting European Association for the Study of Diabetes - Geneva, 28.9.1977

Effect of glucose upon Na+ fluxes in islet cells

info:eu-repo/semantics/publishe