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The aim of this study was to assess recovery, cell death, and cell composition of post-thaw cultured human islets. Cryopreserved islets were provided by the Clinical Islet Transplant Program, Edmonton, Canada. Islets were processed using media prepared in accordance with Pre-Edmonton and Edmonton protocols. Cryopreserved islets were rapidly thawed and cultured for 24 h, 3 d, 5 d, and 7 d, following which they were processed for histology. Islet quantification, integrity, morphology and tissue turnover were studied via hematoxylin and eosin stained sections. Ultrastructure was studied by electron microscopy and endocrine cell composition by immunohistochemistry. Using the Pre-Edmonton protocol, islet recovery was 50.1% and islet survival was 50% at 24 h while for the Edmonton protocol, the islet recovery was 69.4% (p

A city’s planning, design, and construction can have a profound influence on health, specifically on non-communicable diseases such as diabetes and obesity, which are often referred to as “diabesity.” This study describes the designs and methods to understand the relationship between food and physical activity environments on diabesity. Materials and Methods: This study was a community-based cross-sectional door-to-door survey conducted as part of a large National Institute of Health and Care Research-funded surveillance project. For this study, two wards in Chennai were selected randomly. In each ward, five community enumeration blocks were selected using systematic random sampling technique. A consecutive sampling approach was used to select the study participants. Two categories of data were collected: (1) health data and (2) built environment (BE) data. Health and lifestyle questionnaires, anthropometric, and biochemical data were collected from all the study participants. For categorizing BE, an online questionnaire was developed using the KoBo toolbox to collect information about food and physical activity environments, as well as geographic locations. Expected Outcome: This study is expected to reveal data on the relationship between food and physical activity environments and diabesity. It will help policy-makers to understand the importance of access to healthy foods and spaces for physical activity in prevention and control of diabesity. It can also enable community-based interventions to improve health outcomes and help urban planners to plan cities that promote active lifestyles for its residents. [ABSTRACT FROM AUTHOR]

Objective: This study tests the effectiveness of expert guidelines for diabetes prevention: lifestyle intervention with addition of metformin, when required, among people with prediabetes.Research Design and Methods: The Diabetes Community Lifestyle Improvement Program (D-CLIP) is a randomized, controlled, translation trial of 578 overweight/obese Asian Indian adults with isolated impaired glucose tolerance (iIGT), isolated impaired fasting glucose (iIFG), or IFG+IGT in Chennai, India. Eligible individuals were identified through community-based recruitment and randomized to standard lifestyle advice (control) or a 6-month, culturally tailored, U.S. Diabetes Prevention Program-based lifestyle curriculum plus stepwise addition of metformin (500 mg, twice daily) for participants at highest risk of conversion to diabetes at ≥4 months of follow-up. The primary outcome, diabetes incidence, was assessed biannually and compared across study arms using an intention-to-treat analysis.Results: During 3 years of follow-up, 34.9% of control and 25.7% of intervention participants developed diabetes (P = 0.014); the relative risk reduction (RRR) was 32% (95% CI 7-50), and the number needed to treat to prevent one case of diabetes was 9.8. The RRR varied by prediabetes type (IFG+IGT, 36%; iIGT, 31%; iIFG, 12%; P = 0.77) and was stronger in participants 50 years or older, male, or obese. Most participants (72.0%) required metformin in addition to lifestyle, although there was variability by prediabetes type (iIFG, 76.5%; IFG+IGT, 83.0%; iIGT, 51.3%).Conclusions: Stepwise diabetes prevention in people with prediabetes can effectively reduce diabetes incidence by a third in community settings; however, people with iIFG may require different interventions. [ABSTRACT FROM AUTHOR]

OBJECTIVE To assess the prevalence of diabetes and prediabetes and the associated risk factors in two Asian Indian populations living in different environments. RESEARCH DESIGN AND METHODS We performed cross-sectional analyses, using representative samples of 2,305 Asian Indians aged 40-84 years living in Chennai, India, from the Centre for cArdiometabolic Risk Reduction in South-Asia study (CARRS) (2010-2011), and 757 Asian Indians aged 40-84 years living in the greater San Francisco and Chicago areas from the U.S. Mediators of Atherosclerosis in South Asians Living in America (MASALA) study (2010-2013). Diabetes was defined as self-reported use of glucose-lowering medication, fasting glucose ≥126 mg/dL, or 2-h glucose ≥200 mg/dL. Prediabetes was defined as fasting glucose 100-125 mg/dL and/or 2-h glucose 140-199 mg/dL. RESULTS Age-adjusted diabetes prevalence was higher in India (38% [95% CI 36-40]) than in the U.S. (24% [95% CI 21-27]). Age-adjusted prediabetes prevalence was lower in India (24% [95% CI 22-26]) than in the U.S. (33% [95% CI 30-36]). After adjustment for age, sex, waist circumference, and systolic blood pressure, living in the U.S. was associated with an increased odds for prediabetes (odds ratio 1.2 [95% CI 0.9-1.5]) and a decreased odds for diabetes (odds ratio 0.5 [95% CI 0.4-0.6]). CONCLUSIONS These findings indicate possible changes in the relationship between migration and diabetes risk and highlight the growing burden of disease in urban India. Additionally, these results call for longitudinal studies to better identify the gene-environment-lifestyle exposures that underlie the elevated risk for type 2 diabetes development in Asian Indians. [ABSTRACT FROM AUTHOR]

Background The rising prevalence of diabetes and obesity in India can be attributed, at least in part, to increasing levels of physical inactivity. However, there has been no nationwide survey in India on physical activity levels involving both the urban and rural areas in whole states of India. The aim of the present study was to assess physical activity patterns across India - as part of the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study. Methods Phase 1 of the ICMR-INDIAB study was conducted in four regions of India (Tamilnadu, Maharashtra, Jharkhand and Chandigarh representing the south, west, east and north of India respectively) with a combined population of 213 million people. Physical activity was assessed using the Global Physical Activity Questionnaire (GPAQ) in 14227 individuals aged ≥ 20 years [urban- 4,173; rural- 10,054], selected from the above regions using a stratified multistage design. Results Of the 14227 individuals studied, 54.4% (n = 7737) were inactive (males: 41.7%), while 31.9% (n = 4537) (males: 58.3%) were active and 13.7% (n = 1953) (males: 61.3%) were highly active. Subjects were more inactive in urban, compared to rural, areas (65.0% vs. 50.0%; p < 0.001). Males were significantly more active than females (p < 0.001). Subjects in all four regions spent more active minutes at work than in the commuting and recreation domains. Absence of recreational activity was reported by 88.4%, 94.8%, 91.3% and 93.1% of the subjects in Chandigarh, Jharkhand, Maharashtra and Tamilnadu respectively. The percentage of individuals with no recreational activity increased with age (Trend χ2: 199.1, p < 0.001). Conclusions The study shows that a large percentage of people in India are inactive with fewer than 10% engaging in recreational physical activity. Therefore, urgent steps need to be initiated to promote physical activity to stem the twin epidemics of diabetes and obesity in India. [ABSTRACT FROM AUTHOR]

Aims: To examine the clinical utility of 30-min plasma glucose (30-min-PG) measurement during an oral glucose tolerance (OGTT) in predicting type 2 diabetes (T2DM).Research Design and Methods: Data from a 3-year, randomized, controlled, primary prevention trial among 548 Asian Indians with prediabetes were analyzed. Participants underwent OGTT with PG measurements at fasting, 30-min, and 2-h at baseline and annually until the end of the study. Multivariable Cox regression models were constructed to calculate the risk of developing diabetes based on 30-min-PG levels. Improvement in prediction performance gained by adding an elevated level of 30-min-PG over prediabetic categories was calculated using the area-under-curve (AUC), net-reclassification (NRI), and integrated discrimination improvement (IDI) statistics.Results: At the end of follow-up, 30.4% of individuals had been diagnosed with T2DM by ADA criteria. Based on the maximally selected log-rank statistics, the optimal 30-min-PG cut point for predicting incident T2DM was >182 mg/dl. Multivariable-adjusted Cox regression models showed an independent association between elevated 30-min-PG (>182 mg/dl) and incident diabetes (hazard ratio (95% CI): 1.85 [1.32, 2.59]; Dxy = 0.353, c-statistic = 0.676). The addition of an elevated 30-min-PG (>182 mg/dl) model significantly improved the prediction of diabetes (Δdeviance: -15.4; ΔAUC: 0.11; NRIcontinuous: 0.51; IDI: 0.08) compared with IFG model alone) in individuals with prediabetes.Conclusion: In prediabetic individuals, baseline 30-min-PG independently predicted T2DM and significantly improved reclassification and discrimination. Therefore, 30-min-PG should be considered as part of the routine testing in addition to FPG and 2-h-PG for better risk stratification. [ABSTRACT FROM AUTHOR]

Aims: The Diabetes Community Lifestyle Improvement Program (D-CLIP) was a lifestyle education program to prevent diabetes in South Asians with prediabetes. This paper examines the impact of the D-CLIP intervention on moderate-to-vigorous intensity physical activity (MVPA).Methods: This randomized controlled trial to prevent diabetes included 573 individuals with prediabetes from Chennai, India. The intervention was designed to increase MVPA to ≥150 minutes per week. MVPA was measured by questionnaire at baseline, six, 12, 18, 24, 30 and 36 months of follow-up. Random effects models were used to examine the relationship between treatment group and odds of reporting ≥150 weekly minutes of MVPA and to examine the impact of the intervention on weekly MVPA.Results: With the exception of the proportion of respondents at baseline with a high waist circumference, selected sample characteristics did not differ at baseline between the intervention and control groups. The intervention significantly (p < 0.05) increased the proportion of respondents who reported ≥150 weekly minutes of MVPA by 28.5%, 13.6% and 14.0% at six, 12 and 18 months respectively. Mean minutes of weekly MVPA significantly (p < 0.05) increased by an additional 56.7, 34.3, 23.6 and 24.3 minutes/week at six, 12, 18, and 24 months, respectively.Conclusion: The D-CLIP intervention significantly increased MVPA at six, 12 and 18 months of follow-up. Interventions to prevent diabetes in South Asians with prediabetes can significantly increase MVPA in this population. [ABSTRACT FROM AUTHOR]