Dysglycemia-Based Chronic Disease: An American Association of Clinical Endocrinologists Position Statement

Mechanick, Jeffrey I.; Garber, Alan J.; Grunberger, George; Handelsman, Yehuda; Garvey, W. Timothy

doi:10.4158/ps-2018-0139

Cited by 71 publications

(82 citation statements)

References 173 publications

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“…The impact of cultural factors on the performance of the diabetes Chronic Care Model (307,308), as assessed by the Patient Assessment of Chronic Illness Care, remains unclear (309). In the recent AACE DBCD model (169), wherein insulin resistance, abnormal adiposity (based on (298). The configuration of increasing knowledge and self-efficacy was the most empirically relevant in this study (298).…”

Section: Clinical Practicementioning

confidence: 94%

“…In current AACE chronic care models for adipositybased chronic disease (ABCD) and dysglycemia-based chronic disease (DBCD), one of the first steps in management is behavioral, specifically motivating the patient, or creating a state of "activation for change" (109,169). This motivation occurs through experiential (consciousness awareness, self-reevaluation, dramatic relief, environmental reevaluation, and social liberation) and behavioral (selfliberation or choosing, counter-conditioning, stimulus control, reinforcement management, and helping relationships) processes and may take advantage of written materials, video, and educational tools from professional medical societies (170).…”

Section: Diabetes Carementioning

confidence: 99%

“…Asian anthropometrics differ significantly from those for Caucasians, African Americans, and Latino/Hispanics. While current epidemiologic studies have demonstrated shortcomings in the predictive and correlative power of BMI and total body fat for different ethnicities, the current AACE adiposity-and dysglycemia-based chronic disease models (109,169) may better explain how body composition affects diabetes pathophysiology and management for different populations. In general, Asian Americans have higher percentages of intra-abdominal fat according to World Health Organization and International Diabetes Federation BMI cutoffs of ≥23 kg/m 2 for overweight (≥25 kg/m 2 for non-Asians) and ≥25 kg/m 2 for obesity (≥30 kg/ m 2 for non-Asians); and WC cutoffs for central adiposity of 90 cm for men (about 100 cm or 40 inches for non-Asian men) and 80 cm for women (about 90 cm or 35 inches for non-Asian women) (229).…”

Section: Behavior and Social Determinantsmentioning

confidence: 99%

“…This model is enhanced by transculturalizing each component of the AACE diabetes chronic care disease model ( Fig. 5) (169). A summary of the core recommendations for transculturalizing diabetes care in America is provided in Table 10.…”

Section: Conclusion and Synthesismentioning

confidence: 99%

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Transcultural Diabetes Care in The United States – A Position Statement by the American Association of Clinical Endocrinologists

Mechanick¹,

Adams

Davidson

et al. 2019

Endocrine Practice

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Section: Clinical Practicementioning

confidence: 94%

Section: Diabetes Carementioning

confidence: 99%

Section: Behavior and Social Determinantsmentioning

confidence: 99%

Section: Conclusion and Synthesismentioning

confidence: 99%

See 2 more Smart Citations

Transcultural Diabetes Care in The United States – A Position Statement by the American Association of Clinical Endocrinologists

Mechanick¹,

Adams

Davidson

et al. 2019

Endocrine Practice

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“…Американской Ассоциацией клинических эндокринологов сформулирована концепция о хронических заболеваниях, ассоциированных с дизгликемией, в которой инсулинорезистентность определяется как первая стадия, которую последовательно сменяют предиабет, диабет 2 типа, а замыкает континуум стадия сосудистых осложнений. [3].…”

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Early structural and functional left ventricular disorders in young patients with hypertension: a role of insulin resistance

et al. 2020

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Ремоделирование миокарда относится к факторам, повышающим риск сердечно-сосудистых событий у лиц с артериальной гипертонией (АГ). Структурно-функциональные изменения миокарда могут быть следствием не только отчетливого влияния гемодинамических причин, но и ряда метаболических нарушений. Цель. Анализ ассоциаций инсулинорезистентности и ремоделирования левого желудочка (ЛЖ) в когорте молодых пациентов с нелеченой неосложненной АГ и высоким нормальным артериальным давлением (АД). Материал и методы. В когортное поперечное исследование включено 105 человек, у которых проанализированы клинико-демографические, антропометрические характеристики, выполнены биохимический анализ крови (креатинин, калий, липидный спектр, глюкоза, инсулин, мочевая кислота) с расчетом индексов инсулинорезистентности (HOMA-IR, METs-IR, TyG), анализ крови на гликированный гемоглобин, определяли соотношение альбумина/креатинина в разовой порции мочи. Всем обследованным измеряли офисное АД, выполняли суточное мониторирование АД, эхокардиографию с технологией 2D-спекл трекинг. Результаты. Медиана возраста составила 23 года, 85% мужчин. Избыточную массу тела или ожирение имели 51%, 39% -дислипидемию, 21% -инсулинорезистентность. Признаки ремоделирования ЛЖ наблюдались у 38 (40%) обследованных, из них у 32 (34%) -концентрическое ремоделирование, у 5 (5%) -концентрическая гипертрофия ЛЖ (ГЛЖ), у 1 (1%) -эксцентрическая ГЛЖ, нарушение глобального продольного систолического стрейна ЛЖ у 44 (47%) лиц молодого возраста с АГ и предгипертонией. При ступенчатом многофакторном регрессионном анализе независимым предиктором нарушения глобальной продольной деформации ЛЖ оказался индекс TyG (b=0,38, p=0,001). Заключение. В когорте молодых лиц с АГ и высоким нормальным АД отмечается высокая частота как инсулинорезистентности, метаболических нарушений, так и ранних признаков ремоделирования ЛЖ и субклинического снижения его систолической функции. Индекс TyG, доступный для расчета на основании рутинного биохимического обследования, является независимым фактором, влияющим на глобальную продольную деформацию ЛЖ.Ключевые слова: артериальная гипертония, молодые, предгипертония, инсулинорезистентность, гипертрофия левого желудочка, нарушение деформации левого желудочка, глобальный продольный систолический стрейн левого желудочка, 2D-спекл трекинг эхокардиография. Отношения и деятельность: нет.

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Clinical Nutrition Research and the COVID‐19 Pandemic: A Scoping Review of the ASPEN COVID‐19 Task Force on Nutrition Research

Mechanick

Carbone

Dickerson

et al. 2020

J Parenter Enteral Nutr

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The purpose of this scoping review by the American Society for Parenteral and Enteral Nutrition (ASPEN) Coronavirus Disease 2019 (COVID‐19) Nutrition Task Force was to examine nutrition research applicable to the COVID‐19 pandemic. The rapid pace of emerging scientific information has prompted this activity to discover research/knowledge gaps. This methodology adhered with recommendations from the Joanna Briggs Institute. There were 2301 citations imported. Of these, there were 439 articles fully abstracted, with 23 main topic areas identified across 24 article types and sourced across 61 countries and 51 specialties in 8 settings and among 14 populations. Epidemiological/mechanistic relationships between nutrition and COVID‐19 were reviewed and results mapped to the Population, Intervention, Comparator, Outcome, and Time (PICO‐T) questions. The aggregated data were analyzed by clinical stage: pre–COVID‐19, acute COVID‐19, and chronic/post–COVID‐19. Research gaps were discovered for all PICO‐T questions. Nutrition topics meriting urgent research included food insecurity/societal infrastructure and transcultural factors (pre–COVID‐19); cardiometabolic‐based chronic disease, pediatrics, nutrition support, and hospital infrastructure (acute COVID‐19); registered dietitian nutritionist counseling (chronic/post–COVID‐19); and malnutrition and management (all stages). The paucity of randomized controlled trials (RCTs) was particularly glaring. Knowledge gaps were discovered for PICO‐T questions on pediatrics, micronutrients, bariatric surgery, and transcultural factors (pre–COVID‐19); enteral nutrition, protein‐energy requirements, and glycemic control with nutrition (acute COVID‐19); and home enteral and parenteral nutrition support (chronic/post–COVID‐19). In conclusion, multiple critical areas for urgent nutrition research were identified, particularly using RCT design, to improve nutrition care for patients before, during, and after COVID‐19.

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Dysglycemia-Based Chronic Disease: An American Association of Clinical Endocrinologists Position Statement

Cited by 71 publications

References 173 publications

Transcultural Diabetes Care in The United States – A Position Statement by the American Association of Clinical Endocrinologists

Transcultural Diabetes Care in The United States – A Position Statement by the American Association of Clinical Endocrinologists

Early structural and functional left ventricular disorders in young patients with hypertension: a role of insulin resistance

Clinical Nutrition Research and the COVID‐19 Pandemic: A Scoping Review of the ASPEN COVID‐19 Task Force on Nutrition Research

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