Noteworthy Diabetes Posters from TMIOA's 19th Annual WCIRDC

For 19 years, The Metabolic Institute of America’s World Congress on Insulin Resistance, Diabetes, and Cardiovascular Disease (WCIRDC) has showcased the latest research and clinically impactful data for clinicians treating patients with diabetes and other cardiorenal metabolic conditions.

This year, highlights from the 3-day meeting, which was held both in person in Los Angeles, California and virtually, included more than 16 sessions, discussions around special populations, the release of new multispecialty guidelines from a Diabetes Cardiorenal & Metabolism Institute Task Force, and oral and poster presentations. To celebrate the annual meeting, Endocrinology Network staff and advisory board members have put together a list of 5 noteworthy posters related to diabetes management presented at WCIRDC.

Title: Hyperinsulinemia Trends in U.S. Adults without Diabetes: A Joinpoint Analysis
Lead Investigator: James Churilla, PhD, MPH, University of North Florida
Summary: Using NHANES data from 1998-2018, investigators sought to assess the prevalence of and trends in hyperinsulinemia using observational data from US adults without diabetes from 1999-2018. Using data from a fasting subsample of 23,447 male and nonpregnant females without diabetes, results of the study indicate a significant upward trend in the prevalence of hyperinsulinemia from 1999-2010, which was followed by a slight downward trend from 2010-2018 (P=.10). Results also indicate a consistent and significant positive dose-response relationship exists between BMI and hyperinsulinemia, with an estimated 5-fold difference between the prevalence of hyperinsulinemia among those with and without an augmented waist circumference.

Title: Omega-3 Fatty Acids intervention and DASH Diet Ameliorates Metabolic profiling in Patients with Diabetes Mellitus Type 2
Lead Investigator: Faisal Ali, MD, PhD, University Hospital, Sana’a University
Summary: In the wake of recent data surrounding the effects of EPA and DHA on risk of developing cardiovascular disease, investigators sought to assess how use of DASH diet and omega-3 supplementation might influence the plasma lipid profile as well as identifying potential inflammatory mediators. A randomized controlled trial with 2 parallel groups, patients were instructed to follow a DASH diet for 12 weeks with 1 group consuming 1000 mg of EPA/DHA per day and the other receiving placebo. Upon analysis, significant differences were observed in body weight, BMI, blood pressure, and IL-6 and TNF-α in both groups compared to placebo, but TG levels and VLDL-cholesterol-significantly decreased (P <.05). Additionally, no statistically significant effect was observed for fasting glucose, fasting insulin, HOMA-IR levels, HbA1c, total or LDL, HDL cholesterol between the study arms.

Title: Gestational Diabetes and Non-Alcoholic Fatty Liver Disease
Lead Investigator: Mariana Sandoval Terra Campos Guelli, University Center of Volta Redonda
Summary: With previous research suggesting the physiological stress of pregnancy could increase risk of NAFLD, a team from the University Center of Volta Redonda sought to assess potential associations between gestational diabetes and NAFLD through a systematic literature review of the PubMed, Medline, SciELO, and LILACS databases. With no language or publication date restrictions, investigators sought to identify observational studies evaluating the associations between gestational diabetes and NAFLD from inception through October 2021. A total of 57 studies were identified and 6 were ultimately included in the review. Results of the review suggested NAFLD was positively associated with gestational diabetes. Results demonstrated the apparent increase in risk was associated with the severity of steatosis and steatohepatitis.

Title: How Can We Predict Diabetes Resolution After Metabolic Surgery?
Lead Investigator: Izabela Karpińska, Jagiellonian University Medical College
Summary: As the popularity of metabolic procedures as treatment for obesity continues to expand, investigators sought to assess whether new risk stratification models could serve as predictors of diabetes remission after bariatric surgery. To do so, they designed their study as a retrospective analysis of patients who underwent bariatric surgery from April 2009-October 2017 from a single tertiary referral center. Risk stratification models of interest included the Individualized Metabolic Score (IMS), DiaRem, Ad-DiaRem, DiaBetter and Robert’s scores. The primary end point of interest was diabetes remission, which was defined using the ADA definition of complete or partial remission, and this was assessed using logistic regression. Upon analysis, results suggested all proposed scores could be used in preoperative assessments of diabetes remission following bariatric surgery. Additionally, results indicated the DiaBetter score was significantly more accurate than other scores for predicting metabolic outcomes after bariatric surgery but noted further external validation of all scores at the international level was needed before drawing firmer conclusions.

Title: Continuous Glucose Monitoring and Glycemic Control in People with Type 2 Diabetes: Real-World Study
Lead Investigator: Alondra Nicole Maldonado Reyes, CICS UMA National Polytechnic Institute
Summary: As the rate of use, number of available technologies, and efficacy profile of continuous glucose monitoring continue to grow, investigators sought to assess how use of such technology might influence real-world glucose control. To do so, investigators designed their study using a cohort of 79 patients with type 2 diabetes using the FreeStyle Libre System. Results of the investigators' study indicated the monitor active percentage was 76.9% (95% CI, 74.7-82.2), the mean glucose was 157 mg/dL (95% CI, 147.3-168.5), glucose management indicator 6.9% (95% CI, 6.7-7.2), and mean glycemic variability was 29.9% CV (95% CI, 28.1-31.8). Further analysis suggested CGM use was associated with a TIR of 65.2% (95% CI, 59.5-70.9), a TAR of 30.3% (95% CI, 24.3-36.3), and a TBR of 4.1% (95% CI, 1.7-7.0). Investigators noted the mean number of low glucose events was 4.5 (95% CI, 2.9-6.1) and mean readings per day was 8.4 (95% CI, 6.6-10.3). Investigators also noted these results were similar to those described in controlled clinical trials.