Diabetes in adults is now a global health problem, and populations of developing countries, minority groups, and disadvantaged communities in industrialized countries now face the greatest risk.

We observed considerably greater IMT among persons with established diabetes but no significant increase in persons with IGT. These data suggest that the increased risk of CHD observed in persons with diabetes may largely develop after the onset of overt diabetes.

OBJECTIVE -Depression is associated with poor glycemic control and complications in people with type 1 diabetes. We assessed the prevalence of depression and antidepressant medication use among adults with and without type 1 diabetes and the association between depression and diabetes complications. -In 2006, the Coronary Artery Calcification in Type 1 Diabetes Study applied the Beck Depression Inventory II (BDI-II) to 458 participants with type 1 diabetes (47% male, aged 44 Ϯ 9 years, type 1 diabetes duration 29 Ϯ 9 years) and 546 participants without diabetes (nondiabetic group) (51% male, aged 47 Ϯ 9 years). Use of antidepressant medication was self-reported. Depression was defined as a BDI-II score Ͼ14 and/or use of antidepressant medication. Occurrence of diabetes complications (retinopathy, blindness, neuropathy, diabetes-related amputation, and kidney or pancreas transplantation) was self-reported. RESEARCH DESIGN AND METHODSRESULTS -Mean BDI-II score, adjusted for age and sex, was significantly higher in participants with type 1 diabetes than in nondiabetic participants (least-squares mean Ϯ SE: 7.4 Ϯ 0.3 vs. 5.0 Ϯ 0.3; P Ͻ 0.0001). Type 1 diabetic participants reported using more antidepressant medications (20.7 vs. 12.1%, P ϭ 0.0003). More type 1 diabetic than nondiabetic participants were classified as depressed by BDI-II cut score (17.5 vs. 5.7%, P Ͻ 0.0001) or by either BDI-II cut score or antidepressant use (32.1 vs. 16.0%, P Ͻ 0.0001). Participants reporting diabetes complications (n ϭ 209) had higher mean BDI-II scores than those without complications (10.7 Ϯ 9.3 vs. 6.4 Ϯ 6.3, P Ͻ 0.0001).CONCLUSIONS -Compared with nondiabetic participants, adults with type 1 diabetes report more symptoms of depression and more antidepressant medication usage. Depression is highly prevalent in type 1 diabetes and requires further study on assessment and treatment. Diabetes Care 32:575-579, 2009

This ecological analysis suggests that low-level nitrate exposure through drinking water may play a role in the etiology of IDDM, perhaps as a promoter through the generation of free radicals.

Chromogranin A (ChgA) is a beta cell secretory granule protein and a peptide of ChgA, WE14, was recently identified as a ligand for diabetogenic CD4 T cell clones derived from the NOD mouse. In this study we compared responses of human CD4 T cells from recent onset type 1 diabetic (T1D) and control subjects to WE14 and to an enzymatically modified version of this peptide. T cell responders to antigens were detected in PBMCs from study subjects by an indirect CD4 ELISPOT assay for IFN-γ. T1D patients (n=27) were recent onset patients within one year of diagnosis, typed for HLA-DQ8. Controls (n=31) were either 1st degree relatives with no antibodies or from the HLA-matched general population cohort of DAISY/TEDDY. A second cohort of patients (n=11) and control subjects (n=11) was tested at lower peptide concentrations. We found that WE14 is recognized by T cells from diabetic subjects vs. controls in a dose dependent manner. Treatment of WE14 with transglutaminase increased reactivity to the peptide in some patients. This work suggests that ChgA is an important target antigen in human T1D subjects and that post-translational modification may play a role in its reactivity and relationship to disease.

Clonal CD8+ T-cell expansions have been identified in the peripheral blood of healthy adults and occasionally in children. These expansions are often large, yet their etiology is unknown. This study evaluated the relationship between age and the prevalence of these expansions in a healthy population (n = 147) aged 9 months to 85 years. Expansions were determined using immunofluorescence staining with monoclonal antibodies to different T-cell receptor (TCR)-variable regions. The overall prevalence was 13.6% and increased linearly with age as follows: 0% for 9-month-olds, 2.7% for 4- to 12-year-olds, 13.3% for 20- to 30-year-olds, 20.7% for 35- to 50-year-olds, and 33.4% for 65- to 85-year-olds. Multiple expansions were observed only in the oldest group. Certain TCR-variable regions appeared to be preferentially utilized by these expansions, which suggests a response to a particular antigenic stimulus. Childhood illness and vaccination histories did not provide insight into the etiology of these expansions. Age was the only measured factor that was associated with these expansions.

Higher fasting insulin and C-peptide levels are associated with higher blood pressure, but these relationships are modified by sex and degree of obesity.

Adherence to the DASH diet is inversely associated with T2DM risk. Metabolic changes due to DASH adherence and their potential relationship with incident T2DM have not been described. The objective is to determine metabolite clusters associated with adherence to a DASH-like diet in the Insulin Resistance Atherosclerosis Study (IRAS) cohort and explore if the clusters predicted 5-year incidence of T2DM. The current study included the 570 non-diabetic multi-ethnic participants aged 40 - 69 years. Adherence to a DASH-like diet was determined a priori through an 80-point scale for absolute intakes of the eight DASH food groups. Quantitative measurements of 87 metabolites (acylcarnitines, amino acids, bile acids, sterols, and fatty acids) were obtained at baseline. Metabolite clusters related to DASH adherence were determined through partial least squares (PLS) analysis using R. Multivariable-adjusted logistic regression (MLR) was used to explore the associations between metabolite clusters and incident T2DM. A group of acylcarnitines and fatty acids loaded strongly on the two components retained under PLS. Among strongly loading metabolites, a select group of acylcarnitines had over 50% of their individual variance explained by the PLS model. Component 2 was inversely associated with incident T2DM (Odds ratio (OR): 0.89; 95% Confidence interval (CI) 0.80-0.99, p-value = 0.043) after adjustment for demographic and metabolic covariates. Component 1 was not associated with T2DM risk (OR: 1.02; 95% CI 0.88-1.19, p-value = 0.74). Adherence to a DASH-type diet may contribute to reduced T2DM risk in part through modulations in acylcarnitine and fatty acid physiology.