Relationship between diabetes diet-related quality of life and dietary fiber intake among people with type 2 diabetes: a cross-sectional study.

Diet therapy is one of the most important treatments for people with type 2 diabetes (T2D). However, dietary restrictions due to diet therapy may reduce quality of life (QOL). This cross-sectional study aimed to investigate the association between diabetes diet-related QOL and dietary fiber intake in 238 people with T2D. The Diabetes Diet-related Quality of Life-Revised version (DDRQOL-9-R) and the brief-type self-administered diet history questionnaire were used to evaluate diabetes diet-related QOL and nutritional intake, respectively. Higher scores of each DDRQOL-9-R subscale means greater satisfaction with diet, perceived merits of diet therapy, and lower burden of diet therapy, which indicates good QOL. The median scores for perceived merits of diet therapy, satisfaction with diet, and burden of diet therapy were 58.3 [41.7-75.0], 75.0 [66.7-91.7], and 66.7 [50.0-75.0] points, respectively. HbA1c levels in people with high perceived merits of diet therapy (7.3 [6.7-7.8] vs. 7.5 [7.1-8.2] %, p = 0.007) and people with high satisfaction with diet (7.3 [6.8-7.8] vs. 7.5 [7.1-8.4] %, p = 0.010) were lower than those without. Dietary fiber intake was higher in people with high perceived merits of diet therapy (11.6 [8.8-16.7] vs. 10.0 [7.9-13.8] g/day, p = 0.010), high satisfaction with diet (11.4 [8.8-16.1] vs. 9.7 [7.8-13.2] g/day, p = 0.007), and low burden of diet therapy (11.8 [8.7-16.5] vs. 9.7 [7.8-12.6] g/day, p = 0.004) than in those without. Dietary fiber intake was related to perceived merits of diet therapy (Odds ratio [OR]1.07 [95%CI: 1.00-1.15], p = 0.049), burden of diet therapy (OR 0.90 [95%CI: 0.82-0.98], p = 0.022), and satisfaction with diet (OR 1.18 [95%CI: 1.09-1.27], p < 0.001) after adjusting for covariates. Dietary fiber intake is associated with diabetes diet-related QOL in people with T2D.

Ion Recognition beyond Size Matching: Cooperative Hydration Effect on the K+ Selectivity of Valinomycin over Na+ Revealed by Cryogenic Double Ion Trap Infrared Spectroscopy.

The naturally occurring ionophore valinomycin (VM) selectively transports K+ across the biological membrane, which makes VM a plausible antivirus and antibacterial candidate. The K+ selectivity of VM was rationalized based on a size-matching model despite structural inconsistency between experiments and computations. In this study, we investigated the conformations of the Na+VM complex with 1-10 water molecules using cryogenic ion trap infrared spectroscopy with computational calculations. It shows that the water molecule penetrates the cavity of VM deeply enough to distort the C3-symmetric structure of gas-phase Na+VM, in stark contrast to hydrated clusters of K+VM with C3-symmetric structure, where H2O is located outside the cavity. The high affinity to K+ would be ascribed to minimal hydration-induced structural deformation of K+VM compared to Na+VM. This study highlights a novel cooperative hydration effect on the K+ selectivity and will provide an updated understanding of its ionophoric properties beyond the traditional size-matching model.

Cation-responsive cavity expansion of valinomycin revealed by cryogenic ion trap infrared spectroscopy.

Valinomycin (VM) is a natural K+-selective ionophore that transports K+ through the cell membrane. VM captures K+ in its central cavity with a C3-symmetric ß-turn-like backbone. Although the binding affinity is drastically decreased for the VM-sodium (Na+VM) complex with respect to K+VM, VM holds relatively high affinity to Rb+ and Cs+. The high affinity for larger ions irrespective of ionic size seems to conflict with the expected optimal size matching model and raises questions on what factors determine ion selectivity. A combination of infrared spectroscopy with supporting computational calculations reveals that VM can accommodate larger Rb+ and Cs+ by flexibly changing its cavity size with the elongation of its folded ß-turn-like backbone. The high affinity to Rb+ and Cs+ can be ascribed to a size-dependent cavity expansion. These findings provide a new perspective on molecular recognition and selectivity beyond the conventional size matching model.

Rethinking Ion Transport by Ionophores: Experimental and Computational Investigation of Single Water Hydration in Valinomycin-K+ Complexes.

Valinomycin is a macrocyclic ionophore that transports K+ across hydrophobic membranes. Its function depends on selectivity, capture, transport, and release of the ion. While thermodynamics clearly indicate that valinomycin binds K+ preferentially over all other alkali ions, characterizing the capture/transport/release of K+ by valinomycin at the molecular level remains a challenge. The bracelet-like structure of valinomycin-K+ (K+VM) has the ion completely enveloped, facilitating transport through the cell membrane. We report that hydration by a single water molecule, (K+VM)(H2O), produces three different conformers, identified by infrared spectroscopy and supporting computational studies. For two minor conformers, the water prevents the ionophore from closing, a conformation that would inhibit diffusion through the membrane. However, the dominant conformer encloses both the ion and the water, replicating the bracelet-like K+VM and arguably enhancing diffusion through the membrane. This potential for active participation of water in transport through the hydrophobic cellular membrane has never been previously considered.

Tetrandrine Increases the Sensitivity of Human Lung Adenocarcinoma PC14 Cells to Gefitinib by Lysosomal Inhibition.

BACKGROUND/AIM: Human lung adenocarcinoma PC14 cells without mutations in the epidermal growth factor receptor (EGFR) are less sensitive to gefitinib than PC9 cells with EGFR mutations. We report the involvement of tetrandrine in autophagy flux as a mechanism that enhances the sensitivity of PC14 cells to gefitinib. MATERIALS AND METHODS: Sensitivity to gefitinib was determined by a growth inhibition assay, and quantitative real-time PCR, western blotting, and fluorescent immunostaining were used to detect autophagy. RESULTS: In PC14 cells, combined treatment with gefitinib and tetrandrine caused a significant increase in gefitinib sensitivity and autophagy-related mRNAs and proteins (LC3, etc.), and the LC3 protein accumulated in lysosomes. Furthermore, an autophagy flux assay revealed that tetrandrine inhibited lysosomes and that gefitinib promoted autophagy. Finally, the sensitivity of PC14 cells to gefitinib was enhanced with chloroquine. CONCLUSION: Tetrandrine possibly increases the susceptibility of PC14 cells to gefitinib by lysosomal inhibition.

Reliability and validity of revised and short form versions of diabetes diet-related quality of life scale.

OBJECTIVE: To develop both a revised version of the Diabetes Diet-Related Quality of Life (DDRQOL-R) scale that can be applied to patients with nephropathy and a short form of the DDRQOL-R. METHOD: A total of 184 outpatients with type 2 diabetes were asked to complete the self-administered DDRQOL-R scale to confirm its psychometric properties. A short-form version was developed, based on two methods: the result of the developed DDRQOL-R scale and consensus using the Delphi method among medical experts. RESULTS: Correlations were generally strong between the DDRQOL-R factors extracted by factor analysis and each SF-36 subscale. Cronbach's α coefficients were at least 0.7, and intraclass correlation coefficients were between 0.59 and 0.78. The nine items that showed high factor loadings were also assessed as important by the medical experts and were selected for the short form of the scale. The reliability and validity of the short form were found to be similar to those of the DDRQOL-R scale. DISCUSSION: Our findings indicate that the DDRQOL-R scale and its short form have acceptable reliability and validity. The revised version is highly versatile, and the short form can be conveniently administered.

Effect of the chemical specificity of benzoic acid and its analogs on osmotic fragility in erythrocytes of Sprague-Dawley rats in vitro.

We examined the chemical specificity of benzoic (benzene-carboxylic) acid and its derivatives in increasing osmotic fragility (OF) in rat red blood cells (RBCs) in vitro. Benzoic acid increased the OF in the rat RBCs in a dose-dependent manner. Replacement of the carboxylic group with a phosphoric group also increased the OF in RBCs, whereas substitution of the carboxylic group by a sulfonic, amide or hydroxy group did not affect the OF. Replacement of the benzene nucleus with a cyclohexane ring or a straight hydrocarbon chain with six carbons resulted in a greater increase in OF than that induced by benzoic acid. Introduction of a methyl group, chloride or bromide at the m- and p-positions of the benzene ring considerably enhanced the increase in OF induced by benzoic acid. Substitution of the amino and hydroxy group at the m- and p- positions abolished the increase in OF induced by benzoic acid. The introduction of these elements at the o-position showed an almost equal increase in OF as that observed for benzoic acid. A molecule of benzoic acid is composed of both hydrophilic (carboxylic group) and hydrophobic (benzene ring) components. Replacement of the hydrophilic component changed the balance formed between hydrophobic and hydrophilic components in the moiety, resulting alterations to its interaction with the RBC membrane. The size, form and elements introduced into the benzene ring also affected its affinity to the cell membrane, and changed the osmotic resistance in rat RBCs.

Impact of a Booklet about Diabetes Genetic Susceptibility and Its Prevention on Attitudes towards Prevention and Perceived Behavioral Change in Patients with Type 2 Diabetes and Their Offspring.

Background. Offspring of type 2 diabetic patients are at a high risk of type 2 diabetes. Information on diabetes genetic susceptibility and prevention should be supplied to the offspring. Methods. A six-page booklet on diabetes genetic susceptibility and prevention was distributed to 173 patients who ere ordered to hand it to their offspring. The patients answered a self-administered questionnaire on booklet delivery and attitudinal and behavioral changes toward diabetes and its prevention in themselves and their offspring. Results. Valid responses were obtained from 130 patients. Forty-nine patients had actually handed the booklet. Booklet induces more relief than anxiety. From the patient's view, favorable attitudinal and/or behavioral changes occurred in more than half of the offspring who were delivered the booklet. Conclusion. The booklet worked effectively on attitudes and behaviors toward diabetes and its prevention both in patients and their offspring. However, the effectiveness of patients as information deliverers was limited.

Influence of dietary therapy appraisal on future perceived control of type 2 diabetes.

We sought to elucidate the causal effect of patients' self-appraisal of their dietary regimen on their control beliefs among adults with type 2 diabetes. Data from 176 outpatients were assessed using a two-wave cross-lagged panel model. We found that a cross-lagged path connecting dietary appraisal at baseline to perceived control at one year (ß = .30, p = .003) was larger than a path connecting perceived control at baseline to dietary appraisal at one year (ß = -.16, p = .07). We conclude that dietary appraisal has a feedback effect on the future perceived control of type 2 diabetes.

Dietary intake and body composition of Japanese ulcerative colitis patients in remission.

The purpose of this pilot study (N=26) was to investigate dietary intake and body composition and problems associated with dietary intake (such as unnecessary dietary restriction) in Japanese patients in remission from ulcerative colitis. Findings revealed the macronutrient intake and dietary fiber (absolute amount) were lower than the national average in men, but this may have been due to differences in the methods used to measure dietary intake. Although the fat intake (%E) of ulcerative colitis patients in this study was similar to that of the Japanese population, it differed greatly from that of people in Western countries. No significant differences in weight, height, or body mass index were found when comparing the sample of individuals living with ulcerative colitis with the general Japanese population. Seventeen patients (65.4%) reported being cautious about what they ate even though in remission, and 6 patients were even more cautious about what they ate now than they had been in the past. The authors suggest further research to clarify the problems that unnecessary dietary restriction cause for ulcerative colitis patients who are in remission.

Development of a diabetes diet-related quality-of-life scale.

OBJECTIVE: The purpose of this study was to assess the reliability and validity of the Diabetes Diet-Related Quality-of-Life (DDRQOL) scale, which is a measure of the influence of diet therapy on patients' quality of life (QOL). RESEARCH DESIGN AND METHODS: Patients with type 2 diabetes (n = 236) who were being treated on an outpatient basis were asked to complete the self-administered DDRQOL instrument. The factor validity, convergent and discriminant validity, internal consistency, and reproducibility of the DDRQOL scale were then assessed. Spearman's rank correlation coefficients among the DDRQOL scale and each of the SF-36 subscale scores were calculated to evaluate its convergent and discriminant validity. RESULTS: Based on the results of the factor analysis, the following seven subscales were adopted for the DDRQOL: "satisfaction with diet," "burden of diet therapy," "perceived merits of diet therapy," "general perception of diet," "restriction of social functions," "vitality," and "mental health." As hypothesized, the DDRQOL scale was associated with each of the SF-36 subscales, with convergent and discriminant validity being generally exhibited. Cronbach's alpha-coefficient was between 0.71 and 0.84, suggesting strong internal consistency. The intraclass correlation coefficient of the subscales, with the results of a test-retest conducted 2 weeks later, was between 0.46 and 0.75, suggesting some degree of reproducibility. CONCLUSIONS: These findings indicate that the DDRQOL scale has a reasonable degree of reliability and validity, and its application for the assessment of the needs of a patient's diet and the evaluation of diet education with regard to QOL is awaited.

Socio-psychological problems of patients with late adolescent onset type 1 diabetes--analysis by qualitative research--.

PURPOSE: To identify the serious emotional impacts as socio-psychological problems encountered by patients with late adolescent onset type 1 diabetes since their disease onset. SUBJECTS AND METHODS: Thirteen patients (aged 21-35 years) with type 1 diabetes, onset age from 17 to 28, were interviewed. To extract their disturbing experiences from the content of the interviews, a qualitative analysis was carried out. We categorized their experiences as socio-psychological problems. RESULTS: Twenty-two items of socio-psychological problems which posed obstacles to the control of diabetes were found. Problems with particularly strong impacts included a fulminant crisis prior to hospitalization; surprise and shock of patients themselves and family members upon diagnosis; unacceptable feelings against insulin injections and diabetes; difficulty and anxiety over frequent and unexpected occurrences of hypoglycemia; noncompliance with diet therapy; stress of disclosing the disease to fiancés and their parents; no understanding of or knowledge about diabetes on the part of people around them; restricted range in occupation selection, travel and daily life; existence of stigma; no place for performing insulin injections; resistant or negative feelings against disclosing to others that they had diabetes; acceptance of the disease using various emotional coping behaviors. CONCLUSIONS: These results suggest that for patients with such problems we should seek a more effective sort of intervention to improve their quality of life (QOL).