Aim: To explore which factors are associated with psychological insulin resistance in insulin-naive patients with Type 2 diabetes in primary care.Methods: A sample of 101 insulin-naive patients with Type 2 diabetes completed self-administered questionnaires including demographic and clinical characteristics, the Insulin Treatment Appraisal Scale and the Center for Epidemiological Studies Depression scale. Psychological insulin resistance was denoted by negative appraisal of insulin (Insulin Treatment Appraisal Scale).Results: Thirty-nine per cent of the sample were unwilling to accept insulin therapy. Unwilling participants perceived taking insulin more often as a failure to control their diabetes with tablets or lifestyle compared with willing participants (59 vs. 33%), unwilling participants were more reluctant to accept the responsibilities of everyday management of insulin therapy (49 vs. 24%). Multiple linear regression analysis revealed that depression and objection to lifelong insulin therapy were independently associated with psychological insulin resistance.Conclusions: In this study in primary care, depression and objection to lifelong insulin therapy are associated with psychological insulin resistance. Analysis of the objection to the indefiniteness of insulin therapy showed a sense of limitation of daily life and loss of independence that should not be underestimated. Insulin should be offered as a means to improve health as this might facilitate the acceptance of insulin therapy.
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This research article shows that a high intensity exercise program compared to a low intensity exercise program of the same session duration and frequency, increases insulin sensitivity to a larger extend in healthy subjects. It also shows that the short insulin tolerance test can be used to detect differences in insulin sensitivity in intervention studies.
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Chemo-enzymatic peptide synthesis is unique in enabling the fast and sustainable synthesis of cyclic peptides, complex peptides and functionalized mini-proteins. The starting materials are routinely obtained by solid-phase peptide synthesis. One of the starting materials requires an oxo-ester functionality for recognition by the enzymes active site. The SPPS-based synthesis of the oxo-ester functionality still suffers from significant byproduct formation and low overall synthesis yields. The solution to this is introduction of the oxo-ester functionality at the end of the SPPS via a so-called Passerini reaction. Such a process does not only result in a more efficient production of cyclic or long peptides, but also expand the scope towards proteins derived from biological synthesis (i.e. recombinant proteins). To highlight the relevance of this proposed methodology, we will demonstrate a site-selective modification of the pharmaceutically important drug insulin.
Over a million people in the Netherlands have type 2 diabetes (T2D), which is strongly related to overweight, and many more people are at-risk. A carbohydrate-rich diet and insufficient physical activity play a crucial role in these developments. It is essential to prevent T2D, because this condition is associated with a reduced quality of life, high healthcare costs and premature death due to cardiovascular diseases. The hormone insulin plays a major role in this. This hormone lowers the blood glucose concentration through uptake in body cells. If an excess of glucose is constantly offered, initially the body maintains blood glucose concentration within normal range by releasing higher concentrations of insulin into the blood, a condition that is described as “prediabetes”. In a process of several years, this compensating mechanism will eventually fail: the blood glucose concentration increases resulting in T2D. In the current healthcare practice, T2D is actually diagnosed by recognizing only elevated blood glucose concentrations, being insufficient for identification of people who have prediabetes and are at-risk to develop T2D. Although the increased insulin concentrations at normal glucose concentrations offer an opportunity for early identification/screening of people with prediabetes, there is a lack of effective and reliable methods/devices to adequately measure insulin concentrations. An integrated approach has been chosen for identification of people at-risk by using a prediabetes screening method based on insulin detection. Users and other stakeholders will be involved in the development and implementation process from the start of the project. A portable and easy-to-use demonstrator will be realised, based on rapid lateral flow tests (LFTs), which is able to measure insulin in clinically relevant samples (serum/blood) quickly and reliably. Furthermore, in collaboration with healthcare professionals, we will investigate how this screening method can be implemented in practice to contribute to a healthier lifestyle and prevent T2D.
In dit onderzoeksproject, Health and Wellness in a Connected Society, zal onderzocht worden hoe nieuwe (slimme) technologieën gebruikt kunnen worden om fysieke activiteit van mensen te meten, te monitoren en te stimuleren. De focus van het onderzoeksproject ligt hierbij op bevolkingsgroepen voor wie activiteit van cruciaal belang is en die hierbij extra ondersteund kunnen worden. Het onderzoeksproject vindt plaats binnen het lectoraat ICT-innovaties in de Zorg en zal worden geïntegreerd met het onderwijs van de opleiding HBO-ICT van hogeschool Windesheim. Hier zullen studenten werken aan het ontwerpen en realiseren van verschillende producten tijdens projectgestuurd onderwijs binnen verschillende semesters. De uitkomst van deze studentprojecten worden voor het onderzoeksproject ingezet om de toepasbaarheid van deze nieuwe technologieën te onderzoeken. Hiermee draagt het onderzoeksproject bij aan een duurzame, beschikbare, betaalbare en kwalitatief hoogstaande zorg. Daarnaast zal nieuwe opgedane kennis door de postdoc gebruikt worden om het bestaande onderwijs van de opleiding verder aan te vullen en te verbeteren.
