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Århus, Denmark

Schmidt S.,Copenhagen University | Schmidt S.,Danish Diabetes Academy | Schelde B.,Aarhus University Hospital | Norgaard K.,Copenhagen University
Diabetic Medicine | Year: 2014

Aim: Advanced carbohydrate counting, a systematic method for insulin bolus calculation, is recommended in the management of Type 1 diabetes. The aim of this systematic review was to summarize all available evidence from randomized and observational studies of the effects of advanced carbohydrate counting on glycaemic control (HbA1c), psychosocial measures, weight and hypoglycaemic events in patients of all age groups with Type 1 diabetes on a basal-bolus insulin regimen. Methods: An electronic search of Scopus, MEDLINE and The Cochrane Library conducted in January 2013 identified 27 relevant articles. Six were randomized controlled trials and 21 were observational studies. Large heterogeneity existed across studies with regard to study design and patient populations. Reporting of statistical measures was insufficient to serve as a basis for a meta-analysis. Results: Overall, the studies demonstrated a positive trend in change in HbA1c after introduction of advanced carbohydrate counting. Reductions in HbA1c ranged from 0.0 to 13 mmol/mol (0.0-1.2%). Most psychosocial measures improved; however, only few improvements were considered clinically relevant. Both weight gain and reduction were registered, but most studies found no significant weight changes. The majority of studies assessing the incidence of hypoglycaemic events found a significant reduction in the event rate and none reported an increase in the incidence. Conclusions: In summary, the currently available literature does not provide sufficient evidence to definitively determine the effects of advanced carbohydrate counting on HbA1c, psychosocial measures, weight or hypoglycaemic events. Nevertheless, the method still appears preferable to other insulin dosing procedures, which justifies continued use and inclusion of advanced carbohydrate counting in clinical guidelines. © 2014 Diabetes UK.

Kjolby M.,University of Aarhus | Kjolby M.,Danish Diabetes Academy | Kjolby M.,Danish Research Institute of Translational Neuroscience | Kjolby M.,Aarhus University Hospital | And 2 more authors.
Current Atherosclerosis Reports | Year: 2015

Several genome-wide association studies have linked novel loci to a wide range of cardiovascular phenotypes including low-density lipoprotein (LDL)-cholesterol, early onset myocardial infarction, coronary artery calcification, coronary artery stenosis, and abdominal aorta aneurysm. Especially, one locus, namely, 1p13.3, has attracted much attention. This locus harbors four candidate genes, CELSR2, PSRC1, MYBPHL, and SORT1. SORT1 encodes sortilin, a type I sorting receptor that has recently been implicated in LDL-cholesterol metabolism, VLDL secretion, PCSK9 secretion, and development of atherosclerotic lesions. Furthermore, sortilin also seems to be involved in the development of atherosclerosis, by mechanisms not directly involving LDL-cholesterol, but possibly resulting from the attenuated secretion of proinflammatory cytokines, such as IL6 and TNFα, which accompanies lack of sortilin in immune cells. Sortilin seems to play an important role in the development of cardiovascular disease and have functions beyond regulating LDL-cholesterol. © 2015, Springer Science+Business Media New York.

Larsen K.T.,University of Southern Denmark | Huang T.,University of Southern Denmark | Moller N.C.,University of Southern Denmark | Andersen L.B.,University of Southern Denmark | Ried-Larsen M.,Danish Diabetes Academy
BMC Public Health | Year: 2014

Background: Childhood overweight has noticeable psychological and social consequences for the child and leads to an increased risk of mortality and morbidity later in life. With the high prevalence of overweight in children and adolescents, it is important to identify effective approaches for the prevention and treatment of overweight in children and young individuals. The primary aim of the study is to assess the effect of an intensive day-camp intervention on body mass index (BMI) in overweight children. Methods. The Odense Overweight Intervention Study is a semi-blinded randomized controlled trial. Overweight children from the Municipality of Odense, Denmark, were invited to participate in the trial. Based on power calculations 98 participants were found to be sufficient to randomize in order to find an effect of minimum 1.5 BMI points. Gender-stratified concealed block randomization with a ratio of 1:1 and random block sizes of two, four, and six ensured balance between study arms. The intervention consisted of a six-week multi-component day camp including increased physical activity, healthy diet and health education followed by 46 weeks of family-based habitual intervention. The standard care arm was offered two weekly hours of physical activity training for six weeks. The outcomes were measured at baseline and at six-week and 52-week follow-ups. Furthermore, BMI will be assessed again at 48-month follow-up. Test personnel were kept blinded. The intervention effect will be evaluated using mixed model analyses. During 2012 and 2013, 115 children were enrolled in the study. Fifty-nine children were randomized to the day-camp intervention arm and 56 to the standard intervention arm. Discussion. This study will provide novel information about the long-term health effects of an intense day-camp intervention program on overweight children, due to the design and the follow-up period. Moreover, it will add to the knowledge on designing and implementing feasible camp settings for preventing overweight in children. Trial registration. NCT01574352 at on the 8th of March 2012. © 2014 Larsen et al.; licensee BioMed Central Ltd.

Laustsen C.,Aarhus University Hospital | Hansen E.So.S.,Aarhus University Hospital | Hansen E.So.S.,Danish Diabetes Academy | Kjaergaard U.,Aarhus University Hospital | And 3 more authors.
Magnetic Resonance in Medicine | Year: 2015

Purpose Our aim was to determine the quantitative reproducibility of metabolic breakdown products in the kidney following intravenous injection of hyperpolarized [1-13C]pyruvate and secondly to investigate the metabolic effect on the pyruvate metabolism of oral sucrose load using dissolution dynamic nuclear polarization. By this technique, metabolic alterations in several different metabolic related diseases and their metabolic treatment responses can be accessed. Methods In four healthy pigs the lactate-to-pyruvate, alanine-to-pyruvate and bicarbonate-to-pyruvate ratio was measured following administration of regular cola and consecutive injections of hyperpolarized [1-13C]pyruvate four times within an hour. Results The overall lactate-to-pyruvate metabolic profile changed significantly over one hour following an acute sucrose load leading to a significant rise in blood glucose. Conclusion The reproducibility of hyperpolarized magnetic resonance spectroscopy in the healthy pig kidney demonstrated a repeatability of more than 94% for all metabolites and, furthermore, that the pyruvate to lactate conversion and the blood glucose level is elevated following endogastric sucrose administration. Magn Reson Med 74:558-563, 2015. © 2015 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.

Benatti F.B.,Copenhagen University | Benatti F.B.,University of Sao Paulo | Ried-Larsen M.,Copenhagen University | Ried-Larsen M.,Danish Diabetes Academy
Medicine and Science in Sports and Exercise | Year: 2015

Introduction Prolonged time spent in sedentary behaviors (i.e., activities performed while sitting or reclining) has been consistently shown as an independent risk factor for increased cardiometabolic risk and all-cause mortality, whereas breaking up sedentary time is associated with improved cardiometabolic profile. However, there is still great controversy with the respect to what would be the optimal or minimum type, intensity, and frequency of physical activity necessary to revenue such positive outcomes in different populations. Objective In this review, we aimed to discuss the available evidence from prospective experimental studies regarding the beneficial effects of breaking up prolonged sitting time on cardiometabolic risk factors, and the influence of intensity, frequency, and volume of the physical activity replacing sitting. Methods A structured computer-based search on the electronic databases PUBMED and SCOPUS was independently conducted by two researchers. Only prospective intervention studies (controlled and uncontrolled) evaluating the effects of explicitly replacing sitting time with physical activity (including standing) on metabolic parameters as outcomes were included. Results Seventeen studies were included in the review. Discussion The currently available prospective experimental studies do advocate that breaking up sitting time and replacing it with light-intensity ambulatory physical activity and standing may be a stimulus sufficient enough to induce acute favorable changes in the postprandial metabolic parameters in physically inactive and type 2 diabetic subjects, whereas a higher intensity or volume seems to be more effective in rendering such positive outcomes in young habitually physically active subjects. Conclusion Prospective experimental studies provide considerable evidence of the positive effects of breaking up prolonged time spent sitting on metabolic outcomes. However, it seems that the type, intensity, and frequency of physical activity necessary to effectively counteract the detrimental effects of prolonged sitting may differ according to the subjects' characteristics, especially with respect to the subjects' habitual physical activity level. © 2015 by the American College of Sports Medicine.

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