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Warne returns to big stage
Champion leg spinner Shane Warne has signed on to play with Melbourne Stars in the inaugural Big Bash League Twenty20 tournament at the end of the year.
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Novel Biomarkers for Change in Renal Function in People With Dysglycemia
Diabetes is a major risk factor for renal function decline and failure. The availability of multiplex panels of biochemical markers provides the opportunity to identify novel biomarkers that can better predict changes in renal function than routinely available clinical markers.
The concentration of 239 biochemical markers was measured in stored serum from participants in the biomarker substudy of Outcome Reduction With Initial Glargine Intervention (ORIGIN) trial. Repeated-measures mixed-effects models were used to compute the annual change in eGFR (measured as mL/min/1.73 m2/year) for the 7,482 participants with a recorded baseline and follow-up eGFR. Linear regression models using forward selection were used to identify the independent biomarker determinants of the annual change in eGFR after accounting for baseline HbA1c, baseline eGFR, and routinely measured clinical risk factors. The incidence of the composite renal outcome (i.e., renal replacement therapy, renal death, renal failure, albuminuria progression, doubling of serum creatinine) and death within each fourth of change in eGFR predicted from these models was also estimated.
During 6.2 years of median follow-up, the median annual change in eGFR was –0.18 mL/min/1.73 m2/year. Fifteen biomarkers independently predicted eGFR decline after accounting for cardiovascular risk factors, as did 12 of these plus 1 additional biomarker after accounting for renal risk factors. Every 0.1 mL/min/1.73 m2 predicted annual fall in eGFR predicted a 13% (95% CI 12, 14%) higher mortality.
Adding up to 16 biomarkers to routinely measured clinical risk factors improves the prediction of annual change in eGFR in people with dysglycemia.
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Genetic Susceptibility Determines {beta}-Cell Function and Fasting Glycemia Trajectories Throughout Childhood: A 12-Year Cohort Study (EarlyBird 76)
Previous studies suggested that childhood prediabetes may develop prior to obesity and be associated with relative insulin deficiency. We proposed that the insulin-deficient phenotype is genetically determined and tested this hypothesis by longitudinal modeling of insulin and glucose traits with diabetes risk genotypes in the EarlyBird cohort.
EarlyBird is a nonintervention prospective cohort study that recruited 307 healthy U.K. children at 5 years of age and followed them throughout childhood. We genotyped 121 single nucleotide polymorphisms (SNPs) previously associated with diabetes risk, identified in the adult population. Association of SNPs with fasting insulin and glucose and HOMA indices of insulin resistance and β-cell function, available from 5 to 16 years of age, were tested. Association analysis with hormones was performed on selected SNPs.
Several candidate loci influenced the course of glycemic and insulin traits, including rs780094 (GCKR), rs4457053 (ZBED3), rs11257655 (CDC123), rs12779790 (CDC123 and CAMK1D), rs1111875 (HHEX), rs7178572 (HMG20A), rs9787485 (NRG3), and rs1535500 (KCNK16). Some of these SNPs interacted with age, the growth hormone–IGF-1 axis, and adrenal and sex steroid activity.
The findings that genetic markers influence both elevated and average courses of glycemic traits and β-cell function in children during puberty independently of BMI are a significant step toward early identification of children at risk for diabetes. These findings build on our previous observations that pancreatic β-cell defects predate insulin resistance in the onset of prediabetes. Understanding the mechanisms of interactions among genetic factors, puberty, and weight gain would allow the development of new and earlier disease-management strategies in children.
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Impact of Glucose Level on Micro- and Macrovascular Disease in the General Population: A Mendelian Randomization Study
To evaluate whether high glucose levels in the normoglycemic range and higher have a causal genetic effect on risk of retinopathy, neuropathy, nephropathy, chronic kidney disease (CKD), peripheral arterial disease (PAD), and myocardial infarction (MI; positive control) in the general population.
This study applied observational and one-sample Mendelian randomization (MR) analyses to individual-level data from 117,193 Danish individuals, and validation by two-sample MR analyses on summary-level data from 133,010 individuals from the Meta-Analyses of Glucose and Insulin-Related Traits Consortium (MAGIC), 117,165 from the CKDGen Consortium, and 452,264 from the UK Biobank.
Observationally, glucose levels in the normoglycemic range and higher were associated with high risks of retinopathy, neuropathy, diabetic nephropathy, PAD, and MI (all P for trend <0.001). In genetic causal analyses, the risk ratio for a 1 mmol/L higher glucose level was 2.01 (95% CI 1.18–3.41) for retinopathy, 2.15 (1.38–3.35) for neuropathy, 1.58 (1.04–2.40) for diabetic nephropathy, 0.97 (0.84–1.12) for estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, 1.19 (0.90–1.58) for PAD, and 1.49 (1.02–2.17) for MI. Summary-level data from the MAGIC, the CKDGen Consortium, and the UK Biobank gave a genetic risk ratio of 4.55 (95% CI 2.26–9.15) for retinopathy, 1.48 (0.83–2.66) for peripheral neuropathy, 0.98 (0.94–1.01) for eGFR <60 mL/min/1.73 m2, and 1.23 (0.57–2.67) for PAD per 1 mmol/L higher glucose level.
Glucose levels in the normoglycemic range and higher were prospectively associated with a high risk of retinopathy, neuropathy, diabetic nephropathy, eGFR <60 mL/min/1.73 m2, PAD, and MI. These associations were confirmed in genetic causal analyses for retinopathy, neuropathy, diabetic nephropathy, and MI, but they could not be confirmed for PAD and seemed to be refuted for eGFR <60 mL/min/1.73 m2.
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Association Between the Use of Antidepressants and the Risk of Type 2 Diabetes: A Large, Population-Based Cohort Study in Japan
This study aimed to reveal the associations between the risk of new-onset type 2 diabetes and the duration of antidepressant use and the antidepressant dose, and between antidepressant use after diabetes onset and clinical outcomes.
In this large-scale retrospective cohort study in Japan, new users of antidepressants (exposure group) and nonusers (nonexposure group), aged 20–79 years, were included between 1 April 2006 and 31 May 2015. Patients with a history of diabetes or receipt of antidiabetes treatment were excluded. Covariates were adjusted by using propensity score matching; the associations were analyzed between risk of new-onset type 2 diabetes and the duration of antidepressant use/dose of antidepressant in the exposure and nonexposure groups by using Cox proportional hazards models. Changes in glycated hemoglobin (HbA1c) level were examined in groups with continuous use, discontinuation, or a reduction in the dose of antidepressants.
Of 90,530 subjects, 45,265 were in both the exposure and the nonexposure group after propensity score matching; 5,225 patients (5.8%) developed diabetes. Antidepressant use was associated with the risk of diabetes onset in a time- and dose-dependent manner. The adjusted hazard ratio was 1.27 (95% CI 1.16–1.39) for short-term low-dose and 3.95 (95% CI 3.31–4.72) for long-term high-dose antidepressant use. HbA1c levels were lower in patients who discontinued or reduced the dose of antidepressants (F[2,49] = 8.17; P < 0.001).
Long-term antidepressant use increased the risk of type 2 diabetes onset in a time- and dose-dependent manner. Glucose tolerance improved when antidepressants were discontinued or the dose was reduced after diabetes onset.
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Epigenetic Link Between Statin Therapy and Type 2 Diabetes
To investigate the role of epigenetics in statins’ diabetogenic effect comparing DNA methylation (DNAm) between statin users and nonusers in an epigenome-wide association study in blood.
Five cohort studies’ participants (n = 8,270) were classified as statin users when they were on statin therapy at the time of DNAm assessment with Illumina 450K or EPIC array or noncurrent users otherwise. Associations of DNAm with various outcomes like incident type 2 diabetes, plasma glucose, insulin, and insulin resistance (HOMA of insulin resistance [HOMA-IR]) as well as with gene expression were investigated.
Discovery (n = 6,820) and replication (n = 1,450) phases associated five DNAm sites with statin use: cg17901584 (1.12 x 10–25 [DHCR24]), cg10177197 (3.94 x 10–08 [DHCR24]), cg06500161 (2.67 x 10–23 [ABCG1]), cg27243685 (6.01 x 10–09 [ABCG1]), and cg05119988 (7.26 x 10–12 [SC4MOL]). Two sites were associated with at least one glycemic trait or type 2 diabetes. Higher cg06500161 methylation was associated with higher fasting glucose, insulin, HOMA-IR, and type 2 diabetes (odds ratio 1.34 [95% CI 1.22, 1.47]). Mediation analyses suggested that ABCG1 methylation partially mediates the effect of statins on high insulin and HOMA-IR. Gene expression analyses showed that statin exposure and ABCG1 methylation were associated with ABCG1 downregulation, suggesting epigenetic regulation of ABCG1 expression. Further, outcomes insulin and HOMA-IR were significantly associated with ABCG1 expression.
This study sheds light on potential mechanisms linking statins with type 2 diabetes risk, providing evidence on DNAm partially mediating statins’ effects on insulin traits. Further efforts shall disentangle the molecular mechanisms through which statins may induce DNAm changes, potentially leading to ABCG1 epigenetic regulation.
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Effects of Bariatric Surgery in Early- and Adult-Onset Obesity in the Prospective Controlled Swedish Obese Subjects Study
Bariatric surgery is an effective treatment for obesity, but it is unknown if outcomes differ between adults with early- versus adult-onset obesity. We investigated how obesity status at 20 years of age affects outcomes after bariatric surgery later in life.
The Swedish Obese Subjects study is a prospective matched study performed at 25 surgical departments and 480 primary health care centers. Participants aged 37–60 years with BMI ≥34 kg/m2 (men) or ≥38 kg/m2 (women) were recruited between 1987 and 2001; 2,007 participants received bariatric surgery and 2,040 usual care. Self-reported body weight at 20 years of age was used to stratify patients into subgroups with normal BMI (<25 kg/m2), overweight (BMI 25–29.9 kg/m2), or obesity (BMI ≥30 kg/m2). Body weight, energy intake, and type 2 diabetes status were examined over 10 years, and incidence of cardiovascular and microvascular disease was determined over up to 26 years using data from health registers.
There were small but statistically significant differences in reduction of body weight among the subgroups after bariatric surgery (interaction P = 0.032), with the largest reductions among those with obesity aged 20 years. Bariatric surgery increased type 2 diabetes remission (odds ratios 4.51, 4.90, and 5.58 in subgroups with normal BMI, overweight, or obesity at 20 years of age, respectively; interaction P = 0.951), reduced type 2 diabetes incidence (odds ratios 0.15, 0.13, and 0.15, respectively; interaction P = 0.972), and reduced microvascular complications independent of obesity status at 20 years of age (interaction P = 0.650). The association between bariatric surgery and cardiovascular disease was similar in the subgroups (interaction P = 0.674). Surgical complications were similar in the subgroups.
The treatment benefits of bariatric surgery in adults are similar regardless of obesity status at 20 years of age.
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Predicting 10-Year Risk of End-Organ Complications of Type 2 Diabetes With and Without Metabolic Surgery: A Machine Learning Approach
To construct and internally validate prediction models to estimate the risk of long-term end-organ complications and mortality in patients with type 2 diabetes and obesity that can be used to inform treatment decisions for patients and practitioners who are considering metabolic surgery.
A total of 2,287 patients with type 2 diabetes who underwent metabolic surgery between 1998 and 2017 in the Cleveland Clinic Health System were propensity-matched 1:5 to 11,435 nonsurgical patients with BMI ≥30 kg/m2 and type 2 diabetes who received usual care with follow-up through December 2018. Multivariable time-to-event regression and random forest machine learning models were built and internally validated using fivefold cross-validation to predict the 10-year risk for four outcomes of interest. The prediction models were programmed to construct user-friendly web-based and smartphone applications of Individualized Diabetes Complications (IDC) Risk Scores for clinical use.
The prediction tools demonstrated the following discrimination ability based on the area under the receiver operating characteristic curve (1 = perfect discrimination and 0.5 = chance) at 10 years in the surgical and nonsurgical groups, respectively: all-cause mortality (0.79 and 0.81), coronary artery events (0.66 and 0.67), heart failure (0.73 and 0.75), and nephropathy (0.73 and 0.76). When a patient’s data are entered into the IDC application, it estimates the individualized 10-year morbidity and mortality risks with and without undergoing metabolic surgery.
The IDC Risk Scores can provide personalized evidence-based risk information for patients with type 2 diabetes and obesity about future cardiovascular outcomes and mortality with and without metabolic surgery based on their current status of obesity, diabetes, and related cardiometabolic conditions.
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Send Daily Email Digests to Friends, Colleagues or Even to Yourself
When we announced our v13 update, we mentioned a new feature called Email Digests that we’ll explain further in this…
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Get Free Local COVID-19 Alerts with Inoreader
Everyone is concerned as the novel Coronavirus spreads at rapid rates across all countries of the world. We believe every…
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Get Your Friends Into RSS With Inoreader’s New Invite Feature
Have you ever tried to convince somebody to start using an RSS reader, only to hear back from them something…
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Convert Almost Any Webpage Into RSS Feed With Inoreader’s Web Feeds
So, you wanted to follow this nice website for new content, but it doesn’t have an RSS feed yet? Don’t…
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Effectively Serving Immigrant and Dual Language Learner Families through Home Visiting Programs
Marking a policy brief's release, this webinar explores the promise of home visiting services that support new parents alongside their infants and toddlers, plus strategies for improving how these programs work with immigrant and linguistically diverse families.
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Turning the Tide: Addressing the Long-Term Challenges of EU Mobility for Sending Countries
Amid ongoing debates about the costs and benefits of free movement, this MPI webinar examines evidence from the EU-funded REMINDER project on different types of East-West mobility. Speakers examine big-picture trends of East-West migration; consider possible policy responses at regional, national, and EU levels to alleviate some of the challenges; and reflect on realistic actions that could be taken under a new European Commission.
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Employment Services for Refugees: Leveraging Mainstream U.S. Systems and Funding
On this webinar, experts and state refugee resettlement program leaders discuss activities that can be key parts of a broader strategy for sustaining and improving employment services for refugees, including partnerships with experts in workforce development strategies, access to federal workforce development funding, and other policies and resources.
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Migration & Coronavirus: A Complicated Nexus Between Migration Management and Public Health
This webinar, organized by MPI and the Zolberg Institute on Migration and Mobility at The New School, discussed migration policy responses around the globe in response to the COVID-19 pandemic, and examined where migration management and enforcement tools may be useful and where they may be ill-suited to advancing public health goals.
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Expert Podcast: Meeting Seasonal Labor Needs in the Age of COVID-19
Governments are facing urgent pandemic-related questions. One of the more pressing ones: Who is going to harvest crops in countries that rely heavily on seasonal foreign workers? In this podcast, MPI experts examine ways in which countries could address labor shortages in agriculture, including recruiting native-born workers and letting already present seasonal workers stay longer. Catch an interesting discussion as border closures have halted the movement of seasonal workers even as crops are approaching harvest in some places.
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Young Refugee Children: Their Schooling Experiences in the United States and in Countries of First Asylum
In this webinar, the authors of three papers on the experiences of refugee children present their findings, with a focus on how such experiences affect their mental health and education.
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Mental Health Risks and Resilience among Somali and Bhutanese Refugee Parents
Somali and Bhutanese refugees are two of the largest groups recently resettled in the United States and Canada. This report examines factors that might promote or undermine the mental health and overall well-being of children of these refugees, with regard to factors such as past exposure to trauma, parental mental health, educational attainment, social support, and discrimination.
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The Nutritional Health of Young Refugee Children Resettling in Washington State
Refugee children are vulnerable to health and nutrition risks that can have long-term consequences for their development and well-being. This report examines the prevalence of malnutrition—from stunting and wasting to overweight and obesity—among refugee children from birth to age 10, using data from an overseas medical screening exam before they were resettled in Washington State between 2012 and 2014.
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In the Age of Trump: Populist Backlash and Progressive Resistance Create Divergent State Immigrant Integration Contexts
As long-simmering passions related to federal immigration policies have come to a full boil, less noted but no less important debates are taking place at state and local levels with regards to policies affecting immigrants and their children. As states are increasingly diverging in their responses, this report examines how some of the key policies and programs that support long-term integration success are faring in this volatile era.
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Chilling Effects: The Expected Public Charge Rule and Its Impact on Legal Immigrant Families’ Public Benefits Use
According to leaked drafts, the Trump administration is considering a rule that could have sweeping effects on both legal immigration to the United States and the use of public benefits by legal immigrants and their families. This report examines the potential scale of the expected rule’s impact, including at national and state levels and among children, as well as Hispanic and Asian American/Pacific Islander immigrants.
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Chilling Effects: The Expected Public-Charge Rule and Its Impact on Immigrant Families
This webinar highlights findings from an MPI report examining the potential impacts of expected changes to the public charge rule by the Trump administration. Leaked draft versions suggest the rule could sharply expand the number of legally present noncitizens facing difficulty getting a green card or extending a visa as a result of their family's use of public benefits. The rule likely would discourage millions from accessing health, nutrition, and social services for which they or their U.S.-citizen dependents are eligible.
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Through the Back Door: Remaking the Immigration System via the Expected “Public-Charge” Rule
A Trump administration “public-charge” rule expected to be unveiled soon could create the potential to significantly reshape family-based legal immigration to the United States—and reduce arrivals from Asia, Latin America, and Africa—by imposing a de facto financial test that 40 percent of the U.S. born themselves would fail, as this commentary explains.
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Mitigating the Effects of Trauma among Young Children of Immigrants and Refugees: The Role of Early Childhood Programs
The first years of a child’s life are a time of immense growth, and exposure to trauma—if left unaddressed—can have significant, lifelong effects. This issue brief examines how young children of refugees and other immigrants may be affected by trauma, and what early childhood education and care programs, health-care providers, and others can do to mitigate its adverse effects.
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Addressing Trauma in Young Children in Immigrant and Refugee Families through Early Childhood Programs
During this webinar, speakers provide an overview of an MPI policy brief that seeks to raise awareness of the intersection of trauma and early childhood development, and how U.S. early childhood programs could more effectively address this trauma in young children in refugee and immigrant households. The participants discuss efforts to integrate trauma-informed approaches into early childhood systems and how home visiting services can effectively address trauma and mental health through a two-generation approach.
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Millions Will Feel Chilling Effects of U.S. Public-Charge Rule That Is Also Likely to Reshape Legal Immigration
The public-charge rule issued by the Trump administration in August 2019 will have profound effects on future immigration and on use of public benefits by millions of legal noncitizens and their U.S.-citizen family members. Complex standards for determining when an immigrant is likely to become a public charge could cause a significant share of the nearly 23 million noncitizens and U.S. citizens in benefits-using immigrant families to disenroll, as this commentary explains.
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Leveraging the Potential of Home Visiting Programs to Serve Immigrant and Dual Language Learner Families
Home visiting programs for young families are growing in popularity across the United States, and have demonstrated their effectiveness in supporting maternal health and child well-being. At the same time, more infants and toddlers are growing up in immigrant families and households where a language other than English is spoken. Why then are these children under-represented in these programs? This brief explores common barriers, ways to address them, and why it is important to do so.
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Health Insurance Coverage of Immigrants and Latinos in the Kansas City Metro Area
Latinos and immigrants are at least twice as likely to lack health insurance coverage as the overall population in the Kansas City metropolitan area. This gap that has significant implications for the region, as Latinos and immigrants will form an ever-growing share of the area’s labor force and tax base amid anticipated declines in the native-born, non-Latino population.
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Green Cards and Public Charge: Who Could Be Denied Based on Benefits Use?
On this webinar MPI experts discuss their estimates of the populations that could be deemed ineligible for a green card based on existing benefits use. They also discuss the broader consequences of the public-charge rule implemented in February 2020, through its "chilling effects" and imposition of a wealth test aimed at assessing whether green-card applicants ever would be likely to use a public benefit in the future.
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The Public-Charge Rule: Broad Impacts, But Few Will Be Denied Green Cards Based on Actual Benefits Use
While the Trump administration public-charge rule is likely to vastly reshape legal immigration based on its test to assess if a person might ever use public benefits in the future, the universe of noncitizens who could be denied a green card based on current benefits use is quite small. That's because very few benefit programs are open to noncitizens who do not hold a green card. This commentary offers estimates of who might be affected.
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Green Cards and Public Charge: Who Could Be Denied Based on Benefits Use?
On this webinar, MPI experts discussed the public-charge rule and released estimates of the populations that could be deemed ineligible for a green card based on existing benefits use. They examined the far larger consequences of the rule, through its "chilling effects" and imposition of a test aimed at assessing whether green-card applicants are likely to ever use a public benefit in the future. And they discussed how the latter holds the potential to reshape legal immigration to the United States.
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As U.S. Health-Care System Buckles under Pandemic, Immigrant & Refugee Professionals Could Represent a Critical Resource
In a time of critical shortages of U.S. health-care workers during the COVID-19 pandemic, retired doctors are being called back to work and medical students are graduating on a fast track. There is another important pool that could be tapped: Immigrants and refugees who have college degrees in health fields but are working in low-skilled jobs or out of work. MPI estimates 263,000 immigrants are experiencing skill underutilization and could be a valuable resource.
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Barriers to COVID-19 Testing and Treatment: Immigrants without Health Coverage in the United States
As millions of U.S. workers lose jobs and the health insurance associated with them, Medicaid and similar programs are increasingly important for people seeking COVID-19 testing and treatment. Yet many low-income uninsured noncitizens, including green-card holders, are excluded from such programs because of their immigration status, as this fact sheet explores.
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The Digital Transformation Playbook: Rethink Your Business for the Digital Age
Every business begun before the Internet now faces the same challenge: How to transform to compete in a digital economy? This is the leadership challenge examined by BRITE founder and Columbia Business School faculty member David Rogers in his newest book, The Digital Transformation Playbook (April 5, 2016; Columbia Business School Publishing). In the book, […]
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Gestational Diabetes in High-Risk Populations
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Medical Nutrition Therapy: A Key to Diabetes Management and Prevention
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Diabetes Self-management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics
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Clarifying the Role of Insulin in Type 2 Diabetes Management
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Opportunities and Challenges for Biosimilars: What's on the Horizon in the Global Insulin Market?
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Diabetes Management Issues for Patients With Chronic Kidney Disease
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Management of Diabetic Peripheral Neuropathy
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Engaging Patients in Education for Self-Management in an Accountable Care Environment
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Helping Patients Make and Sustain Healthy Changes: A Brief Introduction to Motivational Interviewing in Clinical Diabetes Care
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Hospital Management of Hyperglycemia
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Diabetes Self-Management in a Community Health Center: Improving Health Behaviors and Clinical Outcomes for Underserved Patients
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Cardiac Manifestations of Congenital Generalized Lipodystrophy
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Hypoglycemia in Type 1 and Type 2 Diabetes: Physiology, Pathophysiology, and Management
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