Cost effectiveness of dietetic intervention in management of type 2 diabetes — Journal of Human Nutrition and Dietetics Notes

Siopsis et al., JHND Early View Background The management of diabetes costs in excess of $1.3 trillion per annum worldwide. Diet is central to the management of type 2 diabetes. It is not known whether dietetic intervention is cost effective. This scoping review aimed to map the existing literature concerning the cost effectiveness of medical […]

Cost effectiveness of dietetic intervention in management of type 2 diabetes — Journal of Human Nutrition and Dietetics Notes

Of 2387 abstracts assessed for eligibility, four studies combining 22 765 adults with type 2 diabetes were included. Dietetic intervention was shown to be cost‐effective in terms of diabetes‐related healthcare costs and hospital charges, at the same time as also reducing the risk of cumulative days at work lost to less than half and the risk of disability ‘sick’ days at work to less than one‐seventh.

Conclusions: The findings highlight the importance of advocacy for medical nutrition therapy for people with type 2 diabetes, with respect to alleviating the great global economic burden from this condition. Further studies are warranted to elucidate the factors that mediate and moderate cost effectiveness and to allow for the generalisation of the findings.

First published: 14 October 2020
https://doi.org/10.1111/jhn.12821

NAFLD – Why are Life Insurers Taking This Risk at Standard Rates?

Conclusion All NAFLD histological stages were associated with significantly increased overall mortality, and this risk increased progressively with worsening NAFLD histology. Most of this excess mortality was from extrahepatic cancer and cirrhosis, while in contrast, the contributions of cardiovascular disease and HCC were modest.

Mortality in biopsy-confirmed nonalcoholic fatty liver disease: results from a nationwide cohort — https://gut.bmj.com/content/early/2020/10/09/gutjnl-2020-322786?rss=1

Diet. That’s it. That’s my post.

COVID-19 and Diabetes, Sub-types of DM2, B Vitamins in Diabetes Incidence and more

This article provides an overview of the clinical evidence on the poorer clinical outcomes of COVID-19 infection in patients with diabetes versus patients without diabetes, including in specific patient populations, such as children, pregnant women, and racial and ethnic minorities.

COVID-19 and Diabetes: A Collision and Collusion of Two Diseases — Diabetes 2020 Oct; dbi200032. https://doi.org/10.2337/dbi20-0032

In the article above the researchers reviewed nearly 90 studies.

Novel diabetes subtype characteristics. Overview of distribution and characteristics of subtypes generated by clustering based on clinical parameters in the Swedish ANDIS cohort.

Type 2 diabetes (T2D) is defined by a single metabolite, glucose, but is increasingly recognized as a highly heterogeneous disease, including individuals with varying clinical characteristics, disease progression, drug response, and risk of complications. Identification of subtypes with differing risk profiles and disease etiologies at diagnosis could open up avenues for personalized medicine and allow clinical resources to be focused to the patients who would be most likely to develop diabetic complications, thereby both improving patient health and reducing costs for the health sector. More homogeneous populations also offer increased power in experimental, genetic, and clinical studies. Clinical parameters are easily available and reflect relevant disease pathways, including the effects of both genetic and environmental exposures. We used six clinical parameters (GAD autoantibodies, age at diabetes onset, HbA1c, BMI, and measures of insulin resistance and insulin secretion) to cluster adult-onset diabetes patients into five subtypes. These subtypes have been robustly reproduced in several populations and associated with different risks of complications, comorbidities, genetics, and response to treatment. Importantly, the group with severe insulin-deficient diabetes (SIDD) had increased risk of retinopathy and neuropathy, whereas the severe insulin-resistant diabetes (SIRD) group had the highest risk for diabetic kidney disease (DKD) and fatty liver, emphasizing the importance of insulin resistance for DKD and hepatosteatosis in T2D. In conclusion, we believe that subclassification using these highly relevant parameters could provide a framework for personalized medicine in diabetes.

Subtypes of Type 2 Diabetes Determined From Clinical Parameters — Diabetes 2020 Oct; 69(10): 2086-2093. https://doi.org/10.2337/dbi20-0001

Not just potential for personalized medicine in the treatment of diabetes but perhaps a framework for better risk stratification and selection in life insurance.

Intakes of Folate, Vitamin B6, and Vitamin B12 in Relation to Diabetes Incidence Among American Young Adults: A 30-Year Follow-up Study

RESULTS During 30 years (mean 20.5 ± 8.9) of follow-up, 655 incident cases of diabetes occurred. Intake of folate, but not vitamin B6 or vitamin B12, was inversely associated with diabetes incidence after adjustment for potential confounders. Compared with the lowest quintile of total folate intake, the multivariable-adjusted hazard ratios (95% CI) in quintiles 2–5 were 0.85 (0.67–1.08), 0.78 (0.60–1.02), 0.82 (0.62–1.09), and 0.70 (0.51–0.97; Ptrend = 0.02). Higher folate intake was also associated with lower plasma homocysteine (Ptrend < 0.01) and insulin (Ptrend < 0.01). Among supplement users, folate intake was inversely associated with serum C-reactive protein levels (Ptrend < 0.01).

CONCLUSIONS Intake of folate in young adulthood was inversely associated with diabetes incidence in midlife among Americans. The observed association may be partially explained by mechanisms related to homocysteine level, insulin sensitivity, and systemic inflammation.

Intakes of Folate, Vitamin B6, and Vitamin B12 in Relation to Diabetes Incidence Among American Young Adults: A 30-Year Follow-up Study — Diabetes Care 2020 Oct; 43(10): 2426-2434. https://doi.org/10.2337/dc20-0828

Folate is a B vitamin that occurs naturally in foods such as green leafy vegetables, citrus fruit, and beans. So eat your greens and beans. Taking a supplement can’t hurt either. My multivitamin has plenty of folate.

Meanwhile From Iran… more Covid-19 Research!

In recent months, nearly all countries tried to decrease human-to-human contact as the principal mode of transmission of SARS-CoV-2. However, other modes of transmission also need to be clarified in more depth, especially, the foodborne transmission. We assessed the effect of animal origin foods consumption on the pandemic of COVID-19. For this purpose, we studied the relationship among 20 food supply as independent variables, and the parameter of Total Cases as dependent variable. Here we show a relationship between a group of animal origin foods and total cases. Regression, Bayes, and Lasso results showed that eggs and fresh water fish have positive coefficient. So, among the transmission ways of COVID_19, the role of foodborne transmission should be more significant than previously thought. The possibility of animal origin foodborne transmission should be taken into more consideration. The perspective is to expand the surveillance of SARS-Cov-2 during the food production chain. In conclusion, the results of the present study indicate that one important vehicle for SARS-Cov2 may be some of animal origin foods. It is recommended that virologists examine the possibility of freshwater fish and chickens eggs being as excellent vehicles/preservatives for SARS-Cov2.

Keen relationship between COVID_19 and food supply suggest some animal origin foods as excellent vehicle of SARS-Cov-2 — https://doi.org/10.1101/2020.06.16.20132464 This article is a preprint and has not been certified by peer reviewhttps://www.medrxiv.org/content/10.1101/2020.06.16.20132464v5

Seriously people I don’t want you to get the idea I sit around on a Sunday afternoon reading research studies on the preprint server.

OK, maybe this Sunday…

DALE FISHER, SINGAPORE-BASED DISEASE EXPERT AND CHAIR OF THE GLOBAL OUTBREAK ALERT AND RESPONSE NETWORK COORDINATED BY THE WORLD HEALTH ORGANIZATION:

If we want to store virus, we freeze it. So if virus is packed with frozen product then it would survive. We normally talk about less than a week, but we know that the colder it is, the longer it will last

Can frozen or chilled food spread coronavirus? — https://www.reuters.com/article/us-health-coronavirus-china-food-factbox/factbox-can-frozen-or-chilled-food-spread-coronavirus-idUSKBN23N1JL

Hmm…

The first person in the cluster to test positive was a woman in her 50s who had been symptomatic for five days. Of the woman’s six family contacts, three also tested positive Tuesday: a baby boy, a woman in her 20s, and her husband, who is thought to be the first to become infected and developed symptoms approximately July 31, according to the The New Zealand Herald. One of the family members works at the lending company Finance Now, and the man works at a facility operated by Americold, an Atlanta, Georgia-based company that transports and stores goods at controlled temperatures. Americold operates in the United States, Canada, Australia, and Argentina, as well as New Zealand.

The infected Americold employee’s job involved handling frozen foods destined for grocery stores and food service companies. He had been on sick leave for nine days at the time that he tested positive, according to Americold NZ Managing Director Richard Winnall, who spoke to the Herald.

New Zealand baffled by new COVID-19 cases, eyes frozen-food packaging — https://arstechnica.com/science/2020/08/new-zealand-baffled-by-new-covid-19-cases-eyes-frozen-food-packaging/

I don’t know why I love connecting the dots so much.