The impact of type 2 diabetes on circulating adipokines in patients with metabolic syndrome.

AIM: The aim of the study was to investigate, whether type 2 diabetes independently influences adipokines and inflammatory markers in patients with metabolic syndrome. METHODS: 36 patients with metabolic syndrome without type 2 diabetes and 39 patients with metabolic syndrome with type 2 diabetes, carefully matched for age, sex, and BMI, were investigated. Primary outcome measures were circulating adipokines and inflammatory markers (adiponectin, leptin, visfatin, vaspin, resistin, TNF-α, IL-6, monocyte chemoattractant protein-1 (MCP-1), retinol binding protein 4 (RBP-4), growth differentiation factor-15 (GDF-15)). In addition, we determined parameters of glucose and lipid metabolism. RESULTS: Patients with metabolic syndrome and type 2 diabetes had significantly lower levels of plasma total cholesterol, low-density lipoprotein cholesterol and triglycerides (p < 0.05). They displayed higher GDF-15 concentrations (1,113 ± 135 vs. 656 ± 63 pg/ml, p = 0.005) and lower visfatin concentrations (3.7 ± 0.3 vs. 4.8 ± 0.2 ng/ml, p = 0.009). There were no differences in other adipokines and inflammatory markers between both groups. CONCLUSIONS: In patients with metabolic syndrome, type 2 diabetes leads to decreased visfatin and increased GDF-15 serum levels when compared to carefully matched non-diabetic subjects. Whether the increase in GDF-15 is an indicator or a causal factor for the increased cardiovascular risk in diabetic subjects remains to be investigated in further studies.

Nutrition and diabetes mellitus: an overview of the current evidence.

Overwhelming evidence exists supporting the benefit of lifestyle and nutritional interventions to prevent or delay type 2 and gestational diabetes and improve glycemic control and co-morbidities in patients of all sub-types of diabetes mellitus. Therefore, nutritional therapy is an indispensable and fundamental treatment component, which has to be based on evidence-based recommendations, adapted for dietary intake and medication, and periodically adapted according to diagnosis and individual course of illness. This overview is based on the currently valid evidence-based nutritional recommendations of the European and American Diabetes Associations for the management of diabetes mellitus. It describes the quality and quantity of beneficial macronutrient (carbohydrates, fat, and protein) and micronutrient intake, alcohol consumption, and food groups. Moreover, the evidence for supplements and functional foods is summarized and the role of body weight and different weight loss diets are discussed.