Yuki Someya

Morningness–eveningness questionnaire score and metabolic parameters in patients with type 2 diabetes mellitus

“Morningness” and “Eveningness” represent lifestyle patterns including sleep–wake patterns. Although previous studies described a relationship between the morningness–eveningness trait and glycemic control in patients with type 2 diabetes mellitus (T2DM), the mechanism underlying this association remains unknown. The study participants comprised 725 Japanese T2DM outpatients free of history of cardiovascular diseases. Various lifestyles were analyzed using self-reported questionnaires, including morningness–eveningness questionnaire (MEQ). The relationships between morningness–eveningness trait and various biochemical parameters were investigated by linear regression analysis and logistic regression analysis. We classified the study patients into three groups, morning type (n = 117), neither type (n = 424) and evening type (n = 184). Subjects of the evening type had high levels of alanine aminotransferase, triglyceride, fasting blood glucose and HbA1c and low high-density lipoprotein-cholesterol level in a model adjusted for age and gender. Furthermore, multivariate analysis showed that the evening type was associated with high HbA1c and estimated glomerular filtration rate even after adjustment for other lifestyle factors known to affect metabolic control. The results suggest that T2DM patients with eveningness trait are under inadequate metabolic control independent of other lifestyle factors. Thus, the evening trait of T2DM patients represents an important target for intervention to ensure appropriate metabolic function.

Poor sleep quality is associated with increased arterial stiffness in Japanese patients with type 2 diabetes mellitus

BackgroundWhile poor sleep quality can worsen cardiovascular risk factors such as glucose and lipid profiles in patients with type 2 diabetes mellitus (T2DM), the relationship between sleep quality and atherosclerosis remains largely unknown. The aim of this study was to examine this relationship.MethodsThe study participants comprised 724 Japanese T2DM outpatients free of history of cardiovascular diseases. The relationships between sleep quality (assessed by the Pittsburgh Sleep Quality Index (PSQI)) and various clinical and laboratory parameters were investigated.ResultsThe mean PSQI was 5.1 ± 3.0 (±SD). Patients were divided into three groups based on the total PSQI score; subjects with good sleep quality (n = 462), average sleep quality (n = 185), and poor sleep quality (n = 77). In the age/gender-adjusted model, patients with poor sleep quality tended to be obese, evening type and depressed. However, other lifestyles showed no significant trends. Alanine aminotransferase, fasting blood glucose, HbA1c, systolic blood pressure, urinary albumin excretion, and brachial-ankle pulse wave velocity (baPWV) tended to be higher in patients with poor sleep quality. High baPWV was the only parameter that correlated with poor sleep in a model adjusted for several other lifestyle factors.ConclusionsOur study indicates that poor sleep quality in T2DM patients correlates with increased arterial wall stiffness, a marker of atherosclerosis and a risk factor for cardiovascular diseases.

Relationship between olfactory dysfunction and cognitive impairment in elderly patients with type 2 diabetes mellitus.

AIMS Recent clinical studies identified the relation between olfactory dysfunction and cognitive impairment in the elderly without type 2 diabetes mellitus. The aim of the present study was to define the relation between olfactory function and cognition in elderly patients with type 2 diabetes mellitus. METHODS The study participants comprised 250 elderly (age, 68-77, median 72) Japanese outpatient with type 2 diabetes mellitus free of clinically-evident cognitive impairment. Olfactory and cognitive functions were evaluated by the Open Essence (OE) test and Mini-mental State Examination (MMSE), respectively. RESULTS Based on the MMSE score, 62.0%, 24.4%, and 13.6% of the participants were considered to have no impairment, possible cognitive impairment and probable dementia, respectively. The OE test score of the probable dementia group was significantly lower than other groups. Furthermore, age and serum uric acid were significantly higher in the probable dementia group than other groups. Simple correlation analysis showed positive correlation between the MMSE score and diastolic blood pressure, education, OE test score, total cholesterol, LDL cholesterol, folic acid, and negative correlation with age, HbA1c, aspartate aminotransferase, serum adiponectin and urinary albumin excretion. Multivariate regression analysis showed that OE test score correlated significantly and independently with MMSE score (standardized coefficients β=0.542, R(2)=0.478, P<0.01), in addition to education level, HbA1c and serum adiponectin. CONCLUSIONS The results suggested the association of olfactory dysfunction with cognitive impairment in elderly patients with type 2 diabetes mellitus.

Morningness–eveningness questionnaire score correlates with glycated hemoglobin in middle-aged male workers with type 2 diabetes mellitus

‘Morningness’ and ‘eveningness’ represent the sleep–wake patterns of the circadian rhythm might also affect glycemic control in patients with type 2 diabetes. The aim of this study was to examine the relationship between the morningness–eveningness trait and metabolic parameters.

Efficacy and safety of nateglinide plus vildagliptin combination therapy compared with switching to vildagliptin in type 2 diabetes patients inadequately controlled with nateglinide

To investigate the efficacy and safety of vildagliptin, a potent dipeptidyl peptidase‐4 inhibitor, as add‐on to nateglinide, compared with switching to vildagliptin in Japanese type 2 diabetes patients poorly controlled with nateglinide.

Relationship between dietary patterns and risk factors for cardiovascular disease in patients with type 2 diabetes mellitus: a cross-sectional study.

BackgroundWhile some dietary patterns are associated with the incidence of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), the relationship between dietary pattern and risk factors for CVD in patients with T2DM remains to be clarified. The aim of this study was to identify dietary patterns and investigate the relationship between dietary patterns and potential risk factors for CVD in patients with T2DM.MethodsThe study participants comprised 726 Japanese T2DM outpatients free of history of CVD. Life styles were analyzed using self-reported questionnaires. The relationship between dietary patterns, identified by factor analysis, and potential risk factors for CVD was investigated by linear and logistic regression analyses.ResultsSix dietary patterns were identified by factor analysis. Especially, three dietary patterns were associated with risk factors for CVD. The “Seaweeds, Vegetables, Soy products and Mushrooms” pattern, characterized by high consumption of seaweeds, soy products and mushrooms, was associated with lower use of diabetes medication and healthier lifestyles. The “Noodle and Soup” pattern, characterized by high consumption of noodle and soup was associated with higher body mass index, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase and triglyceride levels. The “Fruit, Dairy products and Sweets” pattern was associated with lower γ-glutamyl transpeptidase levels, blood pressure, albuminuria and brachial-ankle pulse wave velocity.ConclusionsThe findings suggested that dietary patterns correlated with risk factors for CVD in T2DM patients.

Comparison of sitagliptin with nateglinide on postprandial glucose and related hormones in drug-naïve Japanese patients with type 2 diabetes mellitus: A pilot study

Dipeptidyl peptidase‐4 inhibitors and glinides are effective in reducing postprandial hyperglycemia. However, little information is available on the comparative effects of the two drugs on the levels of postprandial glucose. The aim of the present study was to compare the effects of sitagliptin and nateglinide on meal tolerance tests in drug‐naïve patients with type 2 diabetes mellitus.

Reliability and validity of the Japanese version of the Diabetes Quality-Of-Life questionnaire for Japanese patients with type 2 diabetes mellitus

ObjectiveQuality of life (QOL) is recognized as an important medical outcome. The aim of this study was to test the validity and reliability of the Japanese version of the Diabetes Quality-Of-Life (J-DQOL) questionnaire originally developed by the Diabetes Control and Complications Trial.Patients and methodsThe standard procedure for cross-culture adaptation was followed to develop the Japanese version of the J-DQOL. After linguistic validation, reliability was assessed by evaluating the test–retest reliability and internal consistency. Validity was also assessed by examining the floor and ceiling effects, factor structure, and construct validity.ResultsThe responses of 298 of 319 patients with type 2 diabetes who volunteered to answer the questionnaire were analyzed. The J-DQOL and its four scales had high degrees of internal consistency (Cronbach’s alpha, 0.73–0.91) and test–retest reliability (intraclass correlation coefficients, 0.66–0.86). Floor effects were found in the categories of worry about social/vocational issues and diabetes. Also, factor analysis indicated that the J-DQOL structure was not completely consistent with that of the original DQOL. Construct validity was confirmed by relative correlation between J-DQOL scores only and certain components of the Diabetes Treatment Satisfaction Questionnaire, the Well-being Questionnaire, and the Beck Depression Inventory measures.ConclusionsThis study confirmed the reliability of the J- DQOL questionnaire and indicates that DQOL for Japanese patients with type 2 diabetes mellitus is not valid for assessing QOL, especially with regard to worry domains.

Type 2 Diabetes: When Does It Start?

Abstract Objective We aimed to clarify the onset of diabetes. Design Data from 27,392 nondiabetic health examinees were retrospectively analyzed for a mean of 5.3 years. Trajectories of fasting plasma glucose (FPG), body mass index (BMI), and the single point insulin sensitivity (Si) estimator (SPISE), an index of Si, 10 years before diagnosis of prediabetes (PDM; n = 4781) or diabetes (n = 1061) were separately assessed by a mixed effects model. Diabetes and PDM were diagnosed by the American Diabetes Association definition on the basis of FPG and glycosylated hemoglobin A1c values. Results In individuals who developed diabetes, mean FPG and BMI were significantly higher (P < 0.01 each) and SPISE lower than those who did not at −10 years: FPG 101.5 mg/dL vs 94.5 mg/dL, BMI 24.0 kg/m2 vs 22.7 kg/m2, and SPISE 7.32 vs 8.34, P < 0.01 each. These measurements, in subjects who developed prediabetes, were slightly but definitely different from those who did not, already at −10 years: FPG 91.8 mg/dL vs 89.6 mg/dL, BMI 22.6 kg/m2 vs 22.1 kg/m2, and SPISE 8.44 vs 8.82, P < 0.01 each. In both cases, the differences were progressively greater toward year 0, the time of diabetes, or PDM diagnosis. Conclusions FPG was significantly elevated in those who developed diabetes at least 10 years before diagnosis of diabetes, and this was also the case in those who developed PDM. Glucose dysregulation precedes diagnosis of diabetes at least for 20 years.

Slightly increased BMI at young age is a risk factor for future hypertension in Japanese men

Background Hypertension is developed easily in Asian adults with normal body mass index (BMI) (~23 kg/m2), compared with other ethnicities with similar BMI. This study tested the hypothesis that slightly increased BMI at young age is a risk factor for future hypertension in Japanese men by historical cohort study. Methods The study participants were 636 male alumni of the physical education school. They had available data on their physical examination at college age and follow-up investigation between 2007 and 2011. The participants were categorized into six categories: BMI at college age of <20.0 kg/m2, 20.0–21.0kg/m2, 21.0–22.0kg/m2, 22.0–23.0kg/m2, 23.0–24.0kg/m2, and ≥24.0kg/m2, and the incidence of hypertension was compared. Results This study covered 27-year follow-up period (interquartile range: IQR: 23–31) which included 17,059 person-years of observation. Subjects were 22 (22–22) years old at graduated college, and 49 (45–53) years old at first follow-up investigation. During the period, 120 men developed hypertension. The prevalence rates of hypertension for lowest to highest BMI categories were 9.4%, 14.6%, 16.1%, 17.5%, 30.3%, and 29.3%, respectively (p<0.001 for trend), and their hazard ratios were 1.00 (reference), 1.80 (95%CI: 0.65–4.94), 2.17 (0.83–5.64), 2.29 (0.89–5.92), 3.60 (1.37–9.47) and 4.72 (1.78–12.48), respectively (p<0.001 for trend). This trend was similar after adjustment for age, year of graduation, smoking, current exercise status and current dietary intake. Conclusion Slightly increased BMI at young age is a risk factor for future hypertension in Japanese men.