Association of functional decline with subsequent diabetes incidence in U.S. adults aged 51 years and older: the Health and Retirement Study 1998-2010.

OBJECTIVE We assessed whether functional decline and physical disability increase the subsequent risk of diabetes. RESEARCH DESIGN AND METHODS We used a subsample of adults aged 51 years and older with no diabetes at baseline who were followed up to 12 years (1998-2010) in the Health and Retirement Study, an observational study of a nationally representative survey. We assessed baseline disability status and incident disability with subsequent risk of diabetes, accounting for death as a competing risk and controlling for BMI, age, sex, race/ethnicity, net wealth, mother's level of education, respondents' level of education, and time of follow-up.

Development and performance of a comprehensive targeted sequencing assay for pan-ethnic screening of carrier status.

Identifying individuals as carriers of severe disease traits enables informed decision making about reproductive options. Although carrier screening has traditionally been based on ethnicity, the increasing ethnic admixture in the general population argues for the need for pan-ethnic carrier screening assays. Highly multiplexed mutation panels allow for rapid and efficient testing of hundreds of mutations concurrently.

Added sugar intake and cardiovascular diseases mortality among US adults.

IMPORTANCE Epidemiologic studies have suggested that higher intake of added sugar is associated with cardiovascular disease (CVD) risk factors. Few prospective studies have examined the association of added sugar intake with CVD mortality. OBJECTIVE To examine time trends of added sugar consumption as percentage of daily calories in the United States and investigate the association of this consumption with CVD mortality.

Association of Socioeconomic Position and Demographic Characteristics with Cardiovascular Disease Risk Factors and Healthcare Access among Adults Living in Pohnpei, Federated States of Micronesia.

Background. The burden of cardiovascular disease (CVD) is increasing in low-to-middle income countries. We examined how socioeconomic and demographic characteristics may be associated with CVD risk factors and healthcare access in such countries.

Cost-effectiveness of alternative thresholds of the fasting plasma glucose test to identify the target population for type 2 diabetes prevention in adults aged ≥45 years.

Objective: The study objective was to evaluate the cost-effectiveness of alternative fasting plasma glucose (FPG) thresholds to identify adults at high risk for type 2 diabetes for diabetes preventive intervention.

Research Design And Methods: We used a validated simulation model to examine the change in lifetime quality-adjusted life years (QALYs) and medical costs when the FPG threshold was progressively lowered in 5-mg/dL decrements from 120 to 90 mg/dL. The study sample includes nondiabetic adults aged ≥45 years in the United States using 2006-2010 data from the National Health and Nutrition Examination Survey.

Law, public health, and the diabetes epidemic.

The prevalence of new cases of diabetes continues to increase, and the health burden for those with diabetes remains high. This is attributable, in part, to low adoption of evidence-based interventions for diabetes prevention and control. Law is a critical tool for health improvement, yet assessments reported in this paper indicate that federal, state, and local laws give only partial support to guidelines and evidence-based interventions relevant to diabetes prevention and control.

A TRP channel in the lysosome regulates large particle phagocytosis via focal exocytosis.

Phagocytosis of large extracellular particles such as apoptotic bodies requires delivery of the intracellular endosomal and lysosomal membranes to form plasmalemmal pseudopods. Here, we identified mucolipin TRP channel 1 (TRPML1) as the key lysosomal Ca2+ channel regulating focal exocytosis and phagosome biogenesis. Both particle ingestion and lysosomal exocytosis are inhibited by synthetic TRPML1 blockers and are defective in macrophages isolated from TRPML1 knockout mice.

Medicare Part D is associated with reducing the financial burden of health care services in Medicare beneficiaries with diagnosed diabetes.

Background: Medicare Part D, implemented in 2006, provided coverage for prescription drugs to all Medicare beneficiaries.

Objective: To examine the effect of Part D on the financial burden of persons with diagnosed diabetes.

Research Design, Subjects, And Outcome Measures: We conducted an interrupted time-series analysis using data from the 1996 to 2008 Medical Expenditure Panel Survey (11,178 persons with diabetes who were covered by Medicare, and 8953 persons aged 45-64 y with diabetes who were not eligible for Medicare coverage).

Urinary biomarkers of smokers' exposure to tobacco smoke constituents in tobacco products assessment: a fit for purpose approach.

There are established guidelines for bioanalytical assay validation and qualification of biomarkers. In this review, they were applied to a panel of urinary biomarkers of tobacco smoke exposure as part of a "fit for purpose" approach to the assessment of smoke constituents exposure in groups of tobacco product smokers. Clinical studies have allowed the identification of a group of tobacco exposure biomarkers demonstrating a good doseresponse relationship whilst others such as dihydroxybutyl mercapturic acid and 2-carboxy-1-methylethylmercapturic acid - did not reproducibly discriminate smokers and non-smokers.

Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes.

Background: Weight loss is recommended for overweight or obese patients with type 2 diabetes on the basis of short-term studies, but long-term effects on cardiovascular disease remain unknown. We examined whether an intensive lifestyle intervention for weight loss would decrease cardiovascular morbidity and mortality among such patients.

Methods: In 16 study centers in the United States, we randomly assigned 5145 overweight or obese patients with type 2 diabetes to participate in an intensive lifestyle intervention that promoted weight loss through decreased caloric intake and increased physical activity (intervention group) or to receive diabetes support and education (control group).

Dexamethasone induces a putative repressor complex and chromatin modifications in the CRH promoter.

Glucocorticoids down-regulate expression of hypothalamic CRH; however, mechanisms by which they do so are not fully understood. The proximal promoter cAMP response element, negative glucocorticoid response element (nGRE), and methylated CpG islands all play a role in crh down-regulation. Dexamethasone (Dex)-repressed crh expression is associated with glucocorticoid receptor (GR) and histone deacetylase 1 (HDAC1) recruitment to the region of the crh promoter.

A novel use of structural equation models to examine factors associated with prediabetes among adults aged 50 years and older: National Health and Nutrition Examination Survey 2001-2006.

Objective: To use structural modeling to test a hypothesized model of causal pathways related with prediabetes among older adults in the U.S.

Research Design And Methods: Cross-sectional study of 2,230 older adults (≥ 50 years) without diabetes included in the morning fasting sample of the 2001-2006 National Health and Nutrition Examination Surveys.

Secular changes in the age-specific prevalence of diabetes among U.S. adults: 1988-2010.

Objective: To examine the age-specific changes of prevalence of diabetes among U.S. adults during the past 2 decades.

Achievement of goals in U.S. diabetes care, 1999-2010.

Background: Tracking national progress in diabetes care may aid in the evaluation of past efforts and identify residual gaps in care.

Methods: We analyzed data for adults with self-reported diabetes from the National Health and Nutrition Examination Survey and the Behavioral Risk Factor Surveillance System to examine risk-factor control, preventive practices, and risk scores for coronary heart disease over the 1999-2010 period.

Results: From 1999 through 2010, the weighted proportion of survey participants who met recommended goals for diabetes care increased, by 7.

Secular changes in U.S. Prediabetes prevalence defined by hemoglobin A1c and fasting plasma glucose: National Health and Nutrition Examination Surveys, 1999-2010.

Objective: Using a nationally representative sample of the civilian noninstitutionalized U.S. population, we estimated prediabetes prevalence and its changes during 1999-2010.

Lung cancer biomarkers for the assessment of modified risk tobacco products: an oxidative stress perspective.

Manufacturers have developed prototype cigarettes yielding reduced levels of some tobacco smoke toxicants, when tested using laboratory machine smoking under standardised conditions. For the scientific assessment of modified risk tobacco products, tests that offer objective, reproducible data, which can be obtained in a much shorter time than the requirements of conventional epidemiology are needed. In this review, we consider whether biomarkers of biological effect related to oxidative stress can be used in this role.

Implications of risk stratification for diabetes prevention: the case of hemoglobin A1c.

Although glycated hemoglobin (HbA1c) has been widely recommended for the diagnosis of diabetes, considerable ambiguity remains about how HbA1c should be used to identify people with prediabetes or other high-risk states for preventive interventions. The current paper provides a synthesis of the epidemiologic basis and the health and economic implications of using various HbA1c-based risk-stratification approaches for diabetes prevention. HbA1c predicts diabetes and related outcomes across a wide range of HbA1c values.

Preventing type 2 diabetes in communities across the U.S.: the National Diabetes Prevention Program.

There are as many as 79 million people in the U.S. with prediabetes, and their risk of developing type 2 diabetes is four to 12 times higher than it is for people with normal glucose tolerance.

Cardiometabolic risk factors among US adolescents and young adults and risk of early mortality.

Objective: To determine the risk of mortality associated with cardiometabolic risk factors in a national sample of adolescents and young adults.

Methods: Prospective study of participants in the third NHANES (1988-1994), aged 12 to 39 years at the time of the survey (n = 9245). Risk factors included 3 measures of adiposity, glycated hemoglobin (HbA1c) level, cholesterol levels, blood pressure, self-reported smoking status, and cotinine level.

Association of an intensive lifestyle intervention with remission of type 2 diabetes.

Context: The frequency of remission of type 2 diabetes achievable with lifestyle intervention is unclear.

Objective: To examine the association of a long-term intensive weight-loss intervention with the frequency of remission from type 2 diabetes to prediabetes or normoglycemia.

Design, Setting, And Participants: Ancillary observational analysis of a 4-year randomized controlled trial (baseline visit, August 2001-April 2004; last follow-up, April 2008) comparing an intensive lifestyle intervention (ILI) with a diabetes support and education control condition (DSE) among 4503 US adults with body mass index of 25 or higher and type 2 diabetes.

Racial/ethnic variation in prevalence estimates for United States prediabetes under alternative 2010 American Diabetes Association criteria: 1988-2008.

Objective: To compare the racial/ethnic variation in United States prediabetes prevalence estimates for alternative prediabetes definitions currently approved by the American Diabetes Association (ADA) across 20 years and in detailed multivariate comparisons.

Design: Using nationally representative National Health and Nutrition Examination Survey (NHANES) data from 1988-2008, we compared trends in the prevalence of impaired fasting glucose (IFG) and impaired glycated hemoglobin (IGH) for non-Hispanic Black, non-Hispanic White, and Mexican American/other Hispanic adults. Using NHANES 2005-2008, we compared prevalence by race/ethnicity in more detail for the three current ADA prediabetes definitions--IFG, IGH, and impaired glucose tolerance (IGT)--controlling for associated factors (education, income, weight, age, sex).