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Nutrition and Lipid Metabolism in Type 2 Diabetes

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Lipids".

Deadline for manuscript submissions: closed (30 April 2021) | Viewed by 63888

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Special Issue Editor

Dr. Ahmad Al-Mrabeh

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Guest Editor

Newcastle Magnetic Resonance Centre, Translational and Clinical Research Institute, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne NE4 5PL, UK
Interests: Mechanisms of type 2 diabetes development and reversal; Lipoprotein metabolism; Fatty acids metabolism and beta cell dysfunction; Pancreas morphology and function in diabetes; Biology of adipose tissue dysfunction; Lipids and cardiovascular disease in women; Mass spectrometry and magnetic resonance

Special Issue Information

Dear Colleagues,

I am pleased to invite contributions of original research or reviews concerning nutrition, lipid metabolism, and type 2 diabetes (T2DM).

This is a field of pivotal importance. Subcutaneous adipose tissue allows metabolically well-tolerated fat storage. If an individual has the capacity to safely store excess calories, T2DM will not develop. However, fat spillover will cause ectopic accumulation, including in the liver and pancreas. In susceptible people, fat-induced stress of β-cells causes loss of function.

Inflammation in adipose tissue becomes likely with excess fat accumulation. The role of inflammatory cytokines on adipose tissue biology remains unclear. Whether or not these entities contribute to cellular dysfunction in T2DM and cardiovascular disease is currently unproven, and requires further investigation.
Abnormalities in lipid metabolism can be corrected through dietary-induced weight loss, leading to durable remission of T2DM with restoration of β-cell capacity. This is enormously important considering the prevalence and economic importance of this disease.

This Special Issue will bring together the latest research on the role of lipid metabolism in the pathogenesis of T2DM. We invite you to submit your research covering these important topics. Submission of original research in human and mechanistic work in animal models are particularly welcome.

Yours sincerely,

Dr. Ahmad Al-Mrabeh
Guest Editor

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Keywords

type 2 diabetes
lipid metabolism
nutrition
dietary (calorie) restriction
lipoproteins
fatty acids
lipotoxicity
beta cell dysfunction
lipids and CVD risk in diabetes
pancreas

Published Papers (12 papers)

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Research

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10 pages, 240 KiB

Open AccessArticle

Effects of a Self-Prepared Carbohydrate-Reduced High-Protein Diet on Cardiovascular Disease Risk Markers in Patients with Type 2 Diabetes

by Ahmad H. Alzahrani, Mads J. Skytte, Amirsalar Samkani, Mads N. Thomsen, Arne Astrup, Christian Ritz, Jan Frystyk, Jens J. Holst, Sten Madsbad, Steen B. Haugaard, Thure Krarup, Thomas M. Larsen and Faidon Magkos

Nutrients 2021, 13(5), 1694; https://doi.org/10.3390/nu13051694 - 17 May 2021

Cited by 6 | Viewed by 4094

Abstract

We previously observed beneficial effects of a carbohydrate-reduced, high-protein (CRHP) diet on cardiovascular risk markers in patients with type 2 diabetes mellitus (T2DM) in a crossover 2 × 6-week trial, when all food was provided to subjects as ready-to-eat meals. Here, we report the results from a 6-month open label extension: 28 patients with T2DM were instructed to self-prepare the CRHP diet with dietetic guidance. At weeks 0, 6, 12, and 36, fasting and postprandial (4-h meal test) blood samples were collected for measurements of total, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triacylglycerol (TG), apolipoproteins A1 and B, non-esterified fatty acids (NEFA), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6. Diurnal blood pressure and heart rate were also assessed. At the end of the study (week 36), concentrations of fasting total and LDL-cholesterol, fasting and postprandial NEFA and TG, and fasting apolipoprotein-B, CRP and TNF-α concentrations were significantly lower compared with week 0 (p < 0.05). A significant decrease in diurnal heart rate was also observed. From week 12 to 36, an increase in HDL-cholesterol and apolipoprotein-A1 concentrations and a further reduction in fasting and postprandial NEFA (p < 0.05) were found. These changes were independent of minor fluctuations in body weight. We conclude that the substitution of dietary carbohydrate for protein and fat has beneficial effects on several cardiovascular risk markers in patients with T2DM, which are maintained or augmented over the next 6 months when patients select and prepare the CRHP diet on their own in a dietitian-supported setting. Full article

(This article belongs to the Special Issue Nutrition and Lipid Metabolism in Type 2 Diabetes)

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14 pages, 976 KiB

Open AccessArticle

Effect of Weight Loss by Low-Calorie Diet on Cardiovascular Health in Type 2 Diabetes: An Interventional Cohort Study

by Shaden Melhem, Sarah Steven, Roy Taylor and Ahmad Al-Mrabeh

Nutrients 2021, 13(5), 1465; https://doi.org/10.3390/nu13051465 - 26 Apr 2021

Cited by 12 | Viewed by 4030

Abstract

Cardiovascular disease (CVD) remains a major problem for people with type 2 diabetes (T2DM), and the leading cause of death worldwide. We aimed to determine cardiovascular benefits of weight loss with or without remission of diabetes, and to assess utility of plasma biomarkers. 29 people with T2DM were studied at baseline and after dietary weight loss. Change in plasma adipokines and lipid related markers was examined in relation to weight loss, diabetes remission, 10-year cardiovascular risk (QRISK), and duration of diabetes. QRISK decreased markedly after weight loss (18.9 ± 2.2 to 11.2 ± 1.6%, p < 0.0001) in both responders and non-responders, but non-responders remained at higher risk (15.0 ± 2.0 vs. 5.8 ± 1.6%, p < 0.0001). At baseline, plasma GDF-15 was higher in longer diabetes duration (1.19 ± 0.14 vs. 0.82 ± 0.09 ng/mL, p = 0.034), as was the QRISK (22.8 ± 2.6 vs. 15.3 ± 3.4%, p = 0.031). Leptin, GDF-15 and FGF-21 decreased whereases adiponectin increased after weight loss in responders and non-responders. However, the level of FGF-21 remained higher in non-responders (0.58 [0.28–0.71] vs. 0.25 [0.15–0.42] ng/mL, p = 0.007). QRISK change correlated with change in plasma VLDL1-TG (r = 0.489, p = 0.007). There was a positive correlation between rise in HDL cholesterol and the decrease in leptin (r = 0.57, p = 0.001), or rise in adiponectin (r = 0.58, p = 0.001) levels. In conclusion, weight loss markedly decreases cardiometabolic risk particularly when remission of diabetes is achieved. Leptin, adiponectin, GDF-15 and FGF-21 changes were related to weight loss not remission of diabetes. Normalization of 10-year cardiovascular risk and heart age is possible after substantial dietary weight loss and remission of T2DM. Full article

(This article belongs to the Special Issue Nutrition and Lipid Metabolism in Type 2 Diabetes)

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20 pages, 2190 KiB

Open AccessArticle

Heterogeneity of Associations between Total and Types of Fish Intake and the Incidence of Type 2 Diabetes: Federated Meta-Analysis of 28 Prospective Studies Including 956,122 Participants

by Silvia Pastorino, Tom Bishop, Stephen J. Sharp, Matthew Pearce, Tasnime Akbaraly, Natalia B. Barbieri, Maira Bes-Rastrollo, Joline W. J. Beulens, Zhengming Chen, Huaidong Du, Bruce B. Duncan, Atsushi Goto, Tommi Härkänen, Maryam Hashemian, Daan Kromhout, Ritva Järvinen, Mika Kivimaki, Paul Knekt, Xu Lin, Eiliv Lund, Dianna J. Magliano, Reza Malekzadeh, Miguel Ángel Martínez-González, Gráinne O’Donoghue, Donal O’Gorman, Hossein Poustchi, Charlotta Rylander, Norie Sawada, Jonathan E. Shaw, Maria Schmidt, Sabita S. Soedamah-Muthu, Liang Sun, Wanqing Wen, Alicja Wolk, Xiao-Ou Shu, Wei Zheng, Nicholas J. Wareham and Nita G. Forouhi Show full author list Hide full author list

Nutrients 2021, 13(4), 1223; https://doi.org/10.3390/nu13041223 - 7 Apr 2021

Cited by 8 | Viewed by 4552

Abstract

The association between fish consumption and new-onset type 2 diabetes is inconsistent and differs according to geographical location. We examined the association between the total and types of fish consumption and type 2 diabetes using individual participant data from 28 prospective cohort studies from the Americas (6), Europe (15), the Western Pacific (6), and the Eastern Mediterranean (1) comprising 956,122 participants and 48,084 cases of incident type 2 diabetes. Incidence rate ratios (IRRs) for associations of total fish, shellfish, fatty, lean, fried, freshwater, and saltwater fish intake and type 2 diabetes were derived for each study, adjusting for a consistent set of confounders and combined across studies using random-effects meta-analysis. We stratified all analyses by sex due to observed interaction (p = 0.002) on the association between fish and type 2 diabetes. In women, for each 100 g/week higher intake the IRRs (95% CIs) of type 2 diabetes were 1.02 (1.01–1.03, I² = 61%) for total fish, 1.04 (1.01–1.07, I² = 46%) for fatty fish, and 1.02 (1.00–1.04, I² = 33%) for lean fish. In men, all associations were null. In women, we observed variation by geographical location: IRRs for total fish were 1.03 (1.02–1.04, I² = 0%) in the Americas and null in other regions. In conclusion, we found evidence of a neutral association between total fish intake and type 2 diabetes in men, but there was a modest positive association among women with heterogeneity across studies, which was partly explained by geographical location and types of fish intake. Future research should investigate the role of cooking methods, accompanying foods and environmental pollutants, but meanwhile, existing dietary regional, national, or international guidelines should continue to guide fish consumption within overall healthy dietary patterns. Full article

(This article belongs to the Special Issue Nutrition and Lipid Metabolism in Type 2 Diabetes)

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16 pages, 3417 KiB

Open AccessArticle

Serum Vitamin D Affected Type 2 Diabetes though Altering Lipid Profile and Modified the Effects of Testosterone on Diabetes Status

by Lulu Wang, Xue Liu, Jian Hou, Dandan Wei, Pengling Liu, Keliang Fan, Li Zhang, Luting Nie, Xing Li, Wenqian Huo, Tao Jing, Wenjie Li, Chongjian Wang and Zhenxing Mao

Nutrients 2021, 13(1), 90; https://doi.org/10.3390/nu13010090 - 30 Dec 2020

Cited by 10 | Viewed by 2886

Abstract

Numerous studies have investigated the associations between serum vitamin D or testosterone and diabetes; however, inconsistencies are observed. Whether there is an interaction between vitamin D and testosterone and whether the lipid profile (total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)) mediates the association between vitamin D and diabetes is unclear. To investigate the effect of vitamin D and testosterone on impaired fasting glucose (IFG) or type 2 diabetes mellitus (T2DM), 2659 participants from the Henan Rural Cohort were included in the case-control study. Generalized linear models were utilized to estimate associations of vitamin D with IFG or T2DM and interactive effects of vitamin D and testosterone on IFG or T2DM. Principal component analysis (PCA) and mediation analysis were used to estimate whether the lipid profile mediated the association of vitamin D with IFG or T2DM. Serum 25(OH)D₃, 25(OH)D₂, and total 25(OH)D levels were negatively correlated with IFG (odds ratios (ORs) (95% confidence intervals (CIs)): 0.99 (0.97, 1.00), 0.85 (0.82, 0.88), and 0.97 (0.96, 0.98), respectively). Similarity results for associations between serum 25(OH)D₂ and total 25(OH)D with T2DM (ORs (95%CIs): 0.84 (0.81, 0.88) and 0.97 (0.96, 0.99)) were observed, whereas serum 25(OH)D₃ was negatively correlated to T2DM only in the quartile 2 (Q2) and Q3 groups (both p < 0.05). The lipid profile, mainly TC and TG, partly mediated the relationship between 25(OH)D₂ or total 25(OH)D and IFG or T2DM and the proportion explained was from 2.74 to 17.46%. Furthermore, interactive effects of serum 25(OH)D₂, total 25(OH)D, and testosterone on T2DM were observed in females (both p for interactive <0.05), implying that the positive association between serum testosterone and T2DM was vanished when 25(OH)D₂ was higher than 10.04 ng/mL or total 25(OH)D was higher than 40.04 ng/mL. Therefore, ensuring adequate vitamin D levels could reduce the prevalence of IFG and T2DM, especially in females with high levels of testosterone. Full article

(This article belongs to the Special Issue Nutrition and Lipid Metabolism in Type 2 Diabetes)

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19 pages, 40726 KiB

Open AccessFeature PaperArticle

Steviol Glycosides Supplementation Affects Lipid Metabolism in High-Fat Fed STZ-Induced Diabetic Rats

by Jakub Michał Kurek, Ewelina Król and Zbigniew Krejpcio

Nutrients 2021, 13(1), 112; https://doi.org/10.3390/nu13010112 - 30 Dec 2020

Cited by 19 | Viewed by 4352

Abstract

A number of health-promoting properties of Stevia rebaudiana Bertoni and its glycosides, including the antihyperglycemic activity, have been found. The mechanisms of the antidiabetic action of stevia have not been fully understood. The aim of this study was to evaluate the effects of supplementary steviol glycosides on high-fat fed streptozotocin-induced diabetic rats with particular attention to lipid metabolism. The experiment was conducted on 70 male Wistar rats, of which 60 were fed a high-fat diet for 8 weeks followed by intraperitoneal injection of streptozotocin, to induce type 2 diabetes. Afterwards, rats were divided into six groups and fed a high-fat diet supplemented with pure stevioside or rebaudioside A, at two levels (500 or 2500 mg/kg body weight (b.w.)) for 5 weeks. Three additional groups: diabetic untreated, diabetic treated with metformin, and healthy, served as respective controls. Blood and dissected internal organs were collected for hematological, biochemical, and histopathological tests. It was found that dietary supplementation with steviol glycosides did not affect blood glucose, insulin, and insulin resistance indices, antioxidant biomarkers, but normalized hyperlipidemia and affected the appetite, as well as attenuated blood liver and kidney function indices, and reduced tissular damage in diabetic rats. Steviol glycosides normalize lipid metabolism and attenuate internal organs damage in diabetes. Full article

(This article belongs to the Special Issue Nutrition and Lipid Metabolism in Type 2 Diabetes)

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15 pages, 888 KiB

Open AccessFeature PaperArticle

The Link between Obesity and Inflammatory Markers in the Development of Type 2 Diabetes in Men of Black African and White European Ethnicity

by Olah Hakim, Oluwatoyosi Bello, Meera Ladwa, Janet L. Peacock, A. Margot Umpleby, Geoffrey Charles-Edwards, Stephanie A. Amiel and Louise M. Goff

Nutrients 2020, 12(12), 3796; https://doi.org/10.3390/nu12123796 - 11 Dec 2020

Cited by 7 | Viewed by 2282

Abstract

In this study, we aimed to assess ethnic differences in visceral (VAT), deep subcutaneous (dSAT), and superficial subcutaneous (sSAT) adipose tissue and their relationships with inflammatory markers between white European (WE) and black West African (BWA) men with normal glucose tolerance (NGT) and type 2 diabetes (T2D). Forty-two WE (23 NGT/19 T2D) and 43 BWA (23 NGT/20 T2D) men underwent assessment of plasma inflammatory markers using immunoassays alongside Dixon magnetic resonance imaging to quantify L4-5 VAT, dSAT and sSAT. Despite no ethnic differences in sSAT and dSAT, BWA men exhibited lower VAT (p = 0.002) and dSAT:sSAT (p = 0.047) than WE men. Adiponectin was inversely associated with sSAT in WE (p = 0.041) but positively associated in BWA (p = 0.031) men with T2D. Interleukin-6 (IL-6) was associated with VAT in WE but not in BWA men with NGT (WE: p = 0.009, BWA: p = 0.137) and T2D (WE: p = 0.070, BWA: p = 0.175). IL-6 was associated with dSAT in only WE men with NGT (WE: p = 0.030, BWA: p = 0.833). The only significant ethnicity interaction present was for the relationship between adiponectin and sSAT (P_interaction = 0.003). The favourable adipose tissue distribution and the weaker relationships between adiposity and inflammation in BWA men suggest that adipose tissue inflammation may play a lesser role in T2D in BWA than WE men. Full article

(This article belongs to the Special Issue Nutrition and Lipid Metabolism in Type 2 Diabetes)

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14 pages, 498 KiB

Open AccessArticle

The Relationship between Abdominal Fat Phenotypes and Insulin Resistance in Non-Obese Individuals after Acute Pancreatitis

by Juyeon Ko, Loren Skudder-Hill, Jaelim Cho, Sakina H. Bharmal and Maxim S. Petrov

Nutrients 2020, 12(9), 2883; https://doi.org/10.3390/nu12092883 - 21 Sep 2020

Cited by 23 | Viewed by 3406

Abstract

Both type 2 prediabetes/diabetes (T2DM) and new-onset prediabetes/diabetes after acute pancreatitis (NODAP) are characterized by impaired tissue sensitivity to insulin action. Although the outcomes of NODAP and T2DM are different, it is unknown whether drivers of insulin resistance are different in the two types of diabetes. This study aimed to investigate the associations between abdominal fat phenotypes and indices of insulin sensitivity in non-obese individuals with NODAP, T2DM, and healthy controls. Indices of insulin sensitivity (homeostasis model assessment of insulin sensitivity (HOMA-IS), Raynaud index, triglyceride and glucose (TyG) index, Matsuda index) were calculated in fasting and postprandial states. Fat phenotypes (intra-pancreatic fat, intra-hepatic fat, skeletal muscle fat, visceral fat, and subcutaneous fat) were determined using magnetic resonance imaging and spectroscopy. Linear regression and relative importance analyses were conducted. Age, sex, and glycated hemoglobin A1c were adjusted for. A total of 78 non-obese individuals (26 NODAP, 20 T2DM, and 32 healthy controls) were included. Intra-pancreatic fat was significantly associated with all the indices of insulin sensitivity in the NODAP group, consistently in both the unadjusted and adjusted models. Intra-pancreatic fat was not significantly associated with any index of insulin sensitivity in the T2DM and healthy controls groups. The variance in HOMA-IS was explained the most by intra-pancreatic fat (R² = 29%) in the NODAP group and by visceral fat (R² = 21%) in the T2DM group. The variance in the Raynaud index was explained the most by intra-pancreatic fat (R² = 18%) in the NODAP group and by visceral fat (R² = 15%) in the T2DM group. The variance in the TyG index was explained the most by visceral fat in both the NODAP group (R² = 49%) and in the T2DM group (R² = 25%). The variance in the Matsuda index was explained the most by intra-pancreatic fat (R² = 48%) in the NODAP group and by visceral fat (R² = 38%) in the T2DM group. The differing association between intra-pancreatic fat and insulin resistance can be used to differentiate NODAP from T2DM. Insulin resistance in NODAP appears to be predominantly driven by increased intra-pancreatic fat deposition. Full article

(This article belongs to the Special Issue Nutrition and Lipid Metabolism in Type 2 Diabetes)

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Review

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19 pages, 1416 KiB

Open AccessReview

Effects of Soy Isoflavones on Glycemic Control and Lipid Profile in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

by Agnieszka Barańska, Agata Błaszczuk, Małgorzata Polz-Dacewicz, Wiesław Kanadys, Maria Malm, Mariola Janiszewska and Marian Jędrych

Nutrients 2021, 13(6), 1886; https://doi.org/10.3390/nu13061886 - 31 May 2021

Cited by 19 | Viewed by 3954

Abstract

The aim of the report was to investigate the impact of soy protein and isoflavones on glucose homeostasis and lipid profile in type 2 diabetes. The studies used in this report were identified by searching through the MEDLINE and EMBASE databases (up to 2020). Meta-regression and subgroup analyses were performed to explore the influence of covariates on net glycemic control and lipid changes. Weighted mean differences and 95% confidence intervals (CI) were calculated by using random-effect models. Changes in the lipid profile showed statistically significant decreases in total cholesterol and LDL-C concentrations: ‒0.21 mmol/L; 95% CI, ‒0.33 to ‒0.09; p = 0.0008 and ‒0.20 mmol/L; 95% CI, ‒0.28 to ‒0.12; p < 0.0001, respectively, as well as in HDL-C (−0.02 mmol/L; 95% CI, −0.05 to 0.01; p = 0.2008 and triacylglycerols (−0.19 mmol/L; 95% CI, −0.48 to 0.09; p = 0.1884). At the same time, a meta-analysis of the included studies revealed statistically insignificant reduction in fasting glucose, insulin, HbA1c, and HOMA-IR (changes in glucose metabolism) after consumption of soy isoflavones. The observed ability of both extracted isoflavone and soy protein with isoflavones to modulate the lipid profile suggests benefits in preventing cardiovascular events in diabetic subjects. Further multicenter studies based on larger and longer duration studies are necessary to determine their beneficial effect on glucose and lipid metabolism. Full article

(This article belongs to the Special Issue Nutrition and Lipid Metabolism in Type 2 Diabetes)

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19 pages, 1560 KiB

Open AccessReview

Nutritional Regulation of Human Brown Adipose Tissue

by Karla J. Suchacki and Roland H. Stimson

Nutrients 2021, 13(6), 1748; https://doi.org/10.3390/nu13061748 - 21 May 2021

Cited by 21 | Viewed by 15034

Abstract

The recent identification of brown adipose tissue in adult humans offers a new strategy to increase energy expenditure to treat obesity and associated metabolic disease. While white adipose tissue (WAT) is primarily for energy storage, brown adipose tissue (BAT) is a thermogenic organ that increases energy expenditure to generate heat. BAT is activated upon cold exposure and improves insulin sensitivity and lipid clearance, highlighting its beneficial role in metabolic health in humans. This review provides an overview of BAT physiology in conditions of overnutrition (obesity and associated metabolic disease), undernutrition and in conditions of altered fat distribution such as lipodystrophy. We review the impact of exercise, dietary macronutrients and bioactive compounds on BAT activity. Finally, we discuss the therapeutic potential of dietary manipulations or supplementation to increase energy expenditure and BAT thermogenesis. We conclude that chronic nutritional interventions may represent a useful nonpharmacological means to enhance BAT mass and activity to aid weight loss and/or improve metabolic health. Full article

(This article belongs to the Special Issue Nutrition and Lipid Metabolism in Type 2 Diabetes)

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12 pages, 587 KiB

Open AccessReview

A Brief Review of the Mechanisms of β-Cell Dedifferentiation in Type 2 Diabetes

by Phyu-Phyu Khin, Jong-Han Lee and Hee-Sook Jun

Nutrients 2021, 13(5), 1593; https://doi.org/10.3390/nu13051593 - 10 May 2021

Cited by 29 | Viewed by 6229

Abstract

Diabetes is a metabolic disease characterized by hyperglycemia. Over 90% of patients with diabetes have type 2 diabetes. Pancreatic β-cells are endocrine cells that produce and secrete insulin, an essential endocrine hormone that regulates blood glucose levels. Deficits in β-cell function and mass play key roles in the onset and progression of type 2 diabetes. Apoptosis has been considered as the main contributor of β-cell dysfunction and decrease in β-cell mass for a long time. However, recent studies suggest that β-cell failure occurs mainly due to increased β-cell dedifferentiation rather than limited β-cell proliferation or increased β-cell death. In this review, we summarize the current advances in the understanding of the pancreatic β-cell dedifferentiation process including potential mechanisms. A better understanding of β-cell dedifferentiation process will help to identify novel therapeutic targets to prevent and/or reverse β-cell loss in type 2 diabetes. Full article

(This article belongs to the Special Issue Nutrition and Lipid Metabolism in Type 2 Diabetes)

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27 pages, 2489 KiB

Open AccessReview

Dietary Management of Type 2 Diabetes in the MENA Region: A Review of the Evidence

by Nahla Hwalla, Zeinab Jaafar and Sally Sawaya

Nutrients 2021, 13(4), 1060; https://doi.org/10.3390/nu13041060 - 24 Mar 2021

Cited by 18 | Viewed by 5519

Abstract

The alarmingly rising trend of type 2 diabetes constitutes a major global public health challenge particularly in the Middle Eastern and North African (MENA) region where the prevalence is among the highest in the world with a projection to increase by 96% by 2045. The economic boom in the MENA region over the past decades has brought exceptionally rapid shifts in eating habits characterized by divergence from the traditional Mediterranean diet towards a more westernized unhealthy dietary pattern, thought to be leading to the dramatic rises in obesity and non-communicable diseases. Research efforts have brought a greater understanding of the different pathways through which diet and obesity may affect diabetes clinical outcomes, emphasizing the crucial role of dietary interventions and weight loss in the prevention and management of diabetes. The purpose of this review is to explore the mechanistic pathways linking obesity with diabetes and to summarize the most recent evidence on the association of the intake of different macronutrients and food groups with the risk of type 2 diabetes. We also summarize the most recent evidence on the effectiveness of different macronutrient manipulations in the prevention and management of diabetes while highlighting the possible underlying mechanisms of action and latest evidence-based recommendations. We finally discuss the need to adequately integrate dietetic services in diabetes care specific to the MENA region and conclude with recommendations to improve dietetic care for diabetes in the region. Full article

(This article belongs to the Special Issue Nutrition and Lipid Metabolism in Type 2 Diabetes)

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16 pages, 653 KiB

Open AccessFeature PaperReview

Beta-Cell Mass in Obesity and Type 2 Diabetes, and Its Relation to Pancreas Fat: A Mini-Review

by Jun Inaishi and Yoshifumi Saisho

Nutrients 2020, 12(12), 3846; https://doi.org/10.3390/nu12123846 - 16 Dec 2020

Cited by 52 | Viewed by 5554

Abstract

Type 2 diabetes (T2DM) is characterized by insulin resistance and beta-cell dysfunction. Although insulin resistance is assumed to be a main pathophysiological feature of the development of T2DM, recent studies have revealed that a deficit of functional beta-cell mass is an essential factor for the pathophysiology of T2DM. Pancreatic fat contents increase with obesity and are suggested to cause beta-cell dysfunction. Since the beta-cell dysfunction induced by obesity or progressive decline with disease duration results in a worsening glycemic control, and treatment failure, preserving beta-cell mass is an important treatment strategy for T2DM. In this mini-review, we summarize the current knowledge on beta-cell mass, beta-cell function, and pancreas fat in obesity and T2DM, and we discuss treatment strategies for T2DM in relation to beta-cell preservation. Full article

(This article belongs to the Special Issue Nutrition and Lipid Metabolism in Type 2 Diabetes)

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