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Background: Impulsivity is a psychological trait linked to health issues such as obesity. However, few studies have explored the relation between impulsivity, dietary intake, and eating disorders (EDs) in a general population., Objective: The aim of this cross-sectional study was to assess whether impulsivity was associated with energy intake, food-group consumption, snacking, and risk of EDs., Design: In 2014, 51,368 adult participants from the NutriNet-Santé Study completed the 11th version of the Barratt Impulsiveness Scale (BIS-11), which assesses impulsivity. Food-group consumption and diet quality were evaluated by using ≥3 self-reported 24-h dietary records (n = 35,830), whereas snacking behavior was evaluated by an ad hoc question (n = 48,562). Risk of EDs was assessed with the Sick-Control-One-Fat-Food Questionnaire (SCOFF), and categories of ED (restrictive, bulimic, hyperphagic, and other types of EDs) were determined with the Expali algorithm (n = 48,824). Logistic and linear regressions were used to analyze the associations between impulsivity and energy intake, food-group consumption, diet quality, snacking, and risk of EDs, taking into account sociodemographic and lifestyle factors., Results: Positive associations were found between impulsivity and consumption of alcoholic beverages and appetizers, whereas negative associations were found for fruit and vegetables, meat and poultry, processed meat, dairy products, milk-based desserts, and starchy foods. Impulsivity was positively associated with energy intake and negatively associated with diet quality. Impulsivity was also positively associated with snacking (OR: 3.32; 95% CI: 2.99, 3.68) and risk of EDs (OR: 3.02; 95% CI: 2.74, 3.33). The strongest associations were found for bulimic disorders (OR: 4.38; 95% CI: 3.66, 5.23) and hyperphagic disorders (OR: 2.91; 95% CI: 2.56, 3.31)., Conclusion: Impulsivity was associated with food intakes, snacking, and risk of EDs and could be taken into account in the promotion of healthy eating behavior. This study was registered at clinicaltrials.gov as NCT03335644.

Objectives: The aim of this study was (1) to measure adherence in males and females with uncontrolled hypertension, and (2) to identify factors associated with non-adherence to antihypertensive medication., Patients and Methods: Each general practitioner (GP) should include the first two male and the first two female patients with uncontrolled treated hypertension. Adherence to antihypertensive treatment was estimated by the GP and using the French League Against High blood pressure (FLAH) self-administered questionnaire. A stepwise logistic regression analysis was used to identify factors associated with non-adherence on the FLAH scale, independently in males and in females., Results: A total of 1630 males and 1612 females were included in the analysis. Adherence to treatment was significantly better in females or when estimated by the GP. Lack of motivation was the first factor associated with poor adherence in both sexes. Considering hypertension as a simple anomaly and not a disease that can lead to cardiac or cerebral disorders was the second common parameter in both sexes. Other common factors were: having monthly periods of financial difficulties in facing his/her needs and absence of regular screening for colon cancer., Conclusion: Adherence to treatment is better in uncontrolled hypertensive females. Poor adherence is mainly associated with non-clinical factors. The lack of motivation is the most important element., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Objective: The aim of this article is to discuss the background and the consequences of preference on short-term rewards by individuals, which represents an obstacle to any educational programme aimed to prevent long-term complications of chronic diseases such as diabetes, hypertension or obesity., Methods: We used a trans-theoretical analysis referring to three theories: (1) Construal Level Theory (Trope and Liberman) suggests that the human mind tends to assign remote events as "high-level" criteria, abstraction, in particular, and to proximal events as "low-level" criteria, a concrete description, in particular. (2) Intertemporal Choice Theory (Ainslie) explains why people often prefer short-term small rewards over long-term large rewards. (3) The theory developed by Parfit suggests that the personal identity of human beings is made of a succession of multiple individuals, in time, who find their identity by the fact that there is a connectedness between them. Since this connectedness is weaker for prolonged periods of time, this Personal Identity Theory may explain why we may be less interested in our future., Results: In the minds of people who are supposed to benefit from such programmes, there may be a striking contrast between the objectives of preventive medicine (typically a high-level construal), which represents an abstract and long-term concept (e.g. "to avoid complications"), and that of the representation of inaction, a low-level construal which is by contrast immediate and concrete and can be readily imagined (e.g. a nap in front of the TV set)., Conclusion: The very concept of prevention entails features that jeopardize the efficiency of educational programmes used for its implementation., Practice Implications: (1) In chronic diseases, designing programmes proposing concrete and short-term preventive measures may represent a way to overcome this obstacle. (2) Habit may be used to reinforce connectedness which forms personal identity. (3) Thus, taking into account this temporal dimension of educational programmes is essential.

The aim of this study was to analyze the absence of adjustment of insulin doses in type 1 diabetic patients with poorly controlled diabetes. Twenty-eight patients (HbA(1)c higher than 8.5% during the last 6 months, performing at least three capillary blood glucose determinations per day), completed a questionnaire on the degree of confidence in their own knowledge, the nature of their health beliefs, their fear of hypoglycemia, their own appreciation on how they adjust their insulin doses (subjective score). An analysis of their diabetes logbook provided an objective score of the adjustment of doses actually performed. The results show that the subjective and objective scores of adjustment were not significantly correlated. Further there was a significant negative correlation between the score of uncertainty on knowledge and the subjective score of adjustment of the insulin doses, but not with the objective score. There was a significant correlation between the score of positive health beliefs and the subjective score of adjustment of the insulin doses, but not with the objective score. No correlation was found between the score of fear of hypoglycemia and the subjective score of adjustment of the insulin doses. Correlation with the objective score was higher, but not significant. Actually, the fear of hypoglycemia was the most frequently given reason for not adjusting the insulin doses, when the question was asked to the patients with an open answer. This study illustrates the difference between thinking and doing. It also shows that the degree of confidence in one's own knowledge, the health beliefs, and the fear of hypoglycemia differently influence the perception that the patients have of their behavior, and what they really do.

Obesity is a risk factor for the appearance of type 2 diabetes: this notion, largely based on clinical experience, dictates the essential principles of the treatment of type 2 diabetes. At odds with this conventional wisdom, Elliot Danforth Jr. has recently proposed that "too few adipocytes predisposes to type 2 diabetes". A further thought on this controversy is discussed herein. In the context of the "orthodox" view which links obesity and diabetes, and its relation to the controversy, we analyse on one hand the effects of thiazolidine-diones on insulin sensitivity and on adipogenesis and, on the other hand, those of extreme situations represented by lipoatrophic diabetes and morbid obesity. This analysis shows that fat tissue indeed favors the appearance of diabetes but is also able to be anti-diabetogenic, and a dynamic solution of this paradox is put forward. We propose a dual evolutionist hypothesis leading to the selection of an intermediary adipogenic genotype based on the limitation of both insulin secretion and adipogenic potential, which would explain both the necessity of the existence of adipose tissue in man and the limitations of its development.

This paper describes the rationale and different approaches for developing islets of Langerhans xenotransplantation. Implementing this therapeutic strategy in the treatment of human diabetes mellitus requires careful consideration of its potential risks and benefits, taking into account the current status of the treatment of this disease.

Unlabelled: The aim of this study was to determine the optimal conditions (effect of culture time before and after cryopreservation) for cryopreservation of specific pathogen-free pig islet cells., Methods: (1) Glucose-induced insulin secretion by fresh islet cells cultured for 10 days was compared to that by islet cells cryopreserved 7 days after isolation and cultured 3 days after thawing. (2) Islet cells were cryopreserved 1, 7, or 14 days after isolation and cultured 3, 7, 14, or 21 days after thawing. Islet cell number, insulin content, and insulin response under perifusion tests were investigated., Results: (1) Insulin response by cryopreserved islet cells was identical to that by fresh islet cells (basal/stimulation index: 2. 13 +/- 0.19 vs 2.17 +/- 0.16, n = 4, NS), although the amount of secreted insulin was reduced by 40% (area under the curve: 2136 +/- 198 pM/10(4) cells/180 min vs 3564 +/- 636 pM/10(4) cells/180 min, P = 0.104). (2) Cell number 6 days after thawing was reduced by 54, 40, and 63% when cryopreservations were carried out at D1, D7, and D14. (3) Insulin content in cultured or cryopreserved islet cells increased between 7 and 14 days of culture. (4) Whatever the culture time before and after cryopreservation, insulin secretion in response to glucose was maintained. The insulin release was the highest for islet cells cryopreserved 14 days after isolation and cultured 14 days after thawing (stimulation index: 6.19 +/- 2.68)., Conclusions: SPF pig islet cells remained functional after cryopreservation in polyethylene glycol and it may be important to culture islet cells over 14 days before and after cryopreservation., (Copyright 1999 Academic Press.)

The development of an artificial pancreas, a system in which insulin delivery would be regulated continuously by concomitant glucose levels, has been for a long time considered as a dream by diabetologists and diabetic patients. Two approaches are possible. The first one, electromechanical, consists of a glucose sensor, a computer and an insulin pump. Its development may be hindered by the inadequate biocompatibility of the glucose sensor. This led to consider at first the use of a disposable glucose sensor as part of a continuous glucose monitoring system. The second approach aims at developing a bioartificial pancreas, in which isolated islets of Langerhans would be protected against immune rejection by an artificial membrane permeable to glucose and insulin but not so to factors responsible for immune rejection. Thus, it may become possible to transplant a large number of patients before the onset of diabetic complications with xenogeneic islets, without need for any immunosuppression. Promises and obstacles of these two approaches are described herein.

Recently, glucagon and its second messenger, cyclic AMP, have been shown to stimulate the transcription rate of several upper eukaryotic genes (1-5). We show here that glucagon can also block gene transcription. Both glucagon and cyclic AMP were found to inhibit the transcription of the genes encoding three liver glycolytic enzymes, including L-type pyruvate kinase and aldolase B. Thus, cyclic AMP proves to be not only an activator but also an inhibitor of gene transcription in eukaryotes.

The isolated perfused rat kidney allows a simultaneous kinetic study of both the renal metabolism and the urinary excretion of cortisol and its metabolites in the rat. In this system, cortisol was completely metabolized within 120 minutes. The main renal metabolites of cortisol (cortisone, 20 reduced cortisol and 20 reduced cortisone) were found in the recirculating perfusate and in urine. The formation of these metabolites was quantitatively evaluated and compared to a theoretical model.