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  • 1.
    Prystupa, Katsiaryna
    et al.
    Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, Eberhard Karls Universität Tübingen, Tubingen, Germany; Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tubingen, Germany.
    Renklint, Rebecka
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Chninou, Youssef
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Otten, Julia
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Fritsche, Louise
    German Center for Diabetes Research (DZD), Neuherberg, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tubingen, Germany.
    Hoerber, Sebastian
    German Center for Diabetes Research (DZD), Neuherberg, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tubingen, Germany; Institute for Clinical Chemistry and Pathobiochemistry, Department for Diagnostic Laboratory Medicine, University Hospital of Tübingen, Tubingen, Germany.
    Peter, Andreas
    German Center for Diabetes Research (DZD), Neuherberg, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tubingen, Germany; Institute for Clinical Chemistry and Pathobiochemistry, Department for Diagnostic Laboratory Medicine, University Hospital of Tübingen, Tubingen, Germany.
    Birkenfeld, Andreas L.
    Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, Eberhard Karls Universität Tübingen, Tubingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tubingen, Germany.
    Fritsche, Andreas
    Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, Eberhard Karls Universität Tübingen, Tubingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tubingen, Germany.
    Heni, Martin
    Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, Eberhard Karls Universität Tübingen, Tubingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tubingen, Germany; Institute for Clinical Chemistry and Pathobiochemistry, Department for Diagnostic Laboratory Medicine, University Hospital of Tübingen, Tubingen, Germany; Division of Endocrinology and Diabetology, Department of Internal Medicine I, Ulm University Hospital, Ulm, Germany.
    Wagner, Robert
    Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, Eberhard Karls Universität Tübingen, Tubingen, Germany; Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany; Medical Faculty, Department of Endocrinology and Diabetology, Heinrich Heine University, Düsseldorf, Germany.
    Comprehensive validation of fasting-based and oral glucose tolerance test-based indices of insulin secretion against gold standard measures2022In: BMJ Open Diabetes Research & Care, ISSN 2052-4897, Vol. 10, no 5, article id e002909Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: With pre-diabetes and diabetes increasingly recognized as heterogeneous conditions, assessment of beta-cell function is gaining clinical importance to identify disease subphenotypes. Our study aims to comprehensively validate all types of surrogate indices based on oral glucose tolerance test (OGTT) and fasting measurements in comparison with gold standard methods.

    RESEARCH DESIGN AND METHODS: The hyperglycemic clamp extended with glucagon-like peptide 1 (GLP-1) infusion and intravenous glucose tolerance test (IVGTT), as well as OGTT, was performed in two well-phenotyped cohorts. The gold standard-derived indices were compared with surrogate insulin secretion markers, derived from fasting state and OGTT, using both Pearson's and Spearman's correlation coefficients. The insulin-based and C-peptide-based indices were analyzed separately in different groups of glucose tolerance and the entire cohorts.

    RESULTS: The highest correlation coefficients were found for area under curve (AUC) (I0-30)/AUC (G0-30), I30/G30, first-phase Stumvoll and Kadowaki model. These indices have high correlation coefficients with measures obtained from both insulin and C-peptide levels from IVGTT and hyperglycemic clamp. AUC (I0-120)/AUC (G0-120), BIGTT-AIR0-60-120, I30/G30, first-phase Stumvoll and AUC (I0-30)/AUC (G0-30) demonstrated the strongest association with incretin-stimulated insulin response.

    CONCLUSIONS: We have identified glucose-stimulated and GLP-1-stimulated insulin secretion indices, derived from OGTT and fasting state, that have the strongest correlation with gold standard measures and could be potentially used in future researches and clinical practice.

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  • 2.
    Tarekegne, Fitsum Eyayu
    et al.
    Mailman School of Public Health, Centre for International Programs, Columbia University, Addis Ababa, Ethiopia.
    Padyab, Mojgan
    Umeå University, Faculty of Social Sciences, Department of Social Work. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Schröders, Julia
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Stewart Williams, Jennifer
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Research Centre for Generational Health and Ageing, University of Newcastle, Callaghan, Australia.
    Sociodemographic and behavioral characteristics associated with self-reported diagnosed diabetes mellitus in adults aged 50+ years in Ghana and South Africa: results from the WHO-SAGE wave 12018In: BMJ Open Diabetes Research & Care, ISSN 2052-4897, Vol. 6, no 1, article id e000449Article in journal (Refereed)
    Abstract [en]

    Objective: The objective is to identify and describe thesociodemographic and behavioral characteristics of adults,aged 50 years and over, who self-reported having beendiagnosed and treated for diabetes mellitus (DM) in Ghanaand South Africa.

    Research design and methods: This is a cross-sectionalstudy based on the WHO Study on global AGEing and adulthealth (SAGE) wave 1. Information on sociodemographicfactors, health states, risk factors and chronic conditionsis captured from questionnaires administered in face-tofaceinterviews. Self-reported diagnosed and treated DM isconfirmed through a ‘yes’ response to questions regarding1having previously been diagnosed with DM, and2 havingtaken insulin or other blood sugar lowering medicines.Crude and adjusted logistic regressions test associationsbetween candidate variables and DM status. Analysesinclude survey sampling weights. The variance inflationfactor statistic tested for multicollinearity.

    Results: In this nationally representative sample ofadults aged 50 years and over in Ghana, after adjustingfor the effects of sex, residence, work status, bodymass index, waist-hip and waist-height ratios, smoking,alcohol, fruit and vegetable intake and householdwealth, WHO-SAGE survey respondents who were older,married, had higher education, very high-risk waistcircumference measurements and did not undertakehigh physical activity, were significantly more likelyto report diagnosed and treated DM. In South Africa,respondents who were older, lived in urban areas andhad high-risk waist circumference measurements weresignificantly more likely to report diagnosed andtreated DM.

    Conclusions: Countries in sub-Saharan Africa arechallenged by unprecedented ageing populations andtransition from communicable to non-communicablediseases such as DM. Information on those who arealready diagnosed and treated needs to be combinedwith estimates of those who are prediabetic or, as yet,undiagnosed. Multisectoral approaches that includesocioculturally appropriate strategies are needed toaddress diverse populations in SSA countries.

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