7. Obesity Management for the Treatment of Type 2 Diabetes:<i>Standards of Medical Care in Diabetes—2018</i>

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doi:10.2337/dc18-s007

Cited by 106 publications

(30 citation statements)

References 84 publications

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“…In our Japanese patients with type 2 diabetes, the combination of EI of ≥ 1967 kcal/day and PA of ≤ 9.9 metabolic equivalents (METs) h/week for men or that of EI of ≤ 1815 kcal/day and PA of ≤ 8.3 METs h/week for women was significantly associated with obesity. In contrast to current American Diabetes Association guidelines [ 9 ], which are primarily based on the results of intervention studies, the thresholds we found were much higher for EI and much lower for PA than the recommended values needed for obese individuals to lose weight. However, our thresholds were based on cross-sectional observations of Japanese participants whether or not they were obese.…”

Section: Discussioncontrasting

confidence: 99%

Combined Effects of Energy Intake and Physical Activity on Obesity in Japanese Patients with Type 2 Diabetes (JDDM 50): A Cross-Sectional Study

et al. 2019

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Introduction The combined effects of energy intake (EI) and physical activity (PA) on obesity have been poorly investigated. We have investigated the combined effects of EI and PA quantitatively in Japanese men and women with type 2 diabetes. Methods Data on 1395 patients with type 2 diabetes who attended 25 diabetes clinics located throughout Japan, obtained by questionnaire, were analyzed. A logistic regression model was used to calculate the odds ratio for obesity. Results Multi-adjusted odds ratios for the top versus the bottom tertile of EI and the bottom versus the top tertile of PA were 1.39 (95% confidence interval [CI] 1.02–1.89) and 1.64 (95% CI 1.22–2.22), respectively. The combination of EI (kcal/day) ≥ 1967 and PA (metabolic equivalents [METs] h/week) ≤ 9.9 for men and of EI ≥ 1815 and PA ≤ 8.3 for women were significantly associated with obesity. Conclusions The existence of “allowable maximum EI” and “required minimum PA” that is significantly associated with “not being obese” is implied, suggesting the need for lifestyle education for Japanese patients with type 2 diabetes. Electronic Supplementary Material The online version of this article (10.1007/s13300-019-0610-x) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 99%

Combined Effects of Energy Intake and Physical Activity on Obesity in Japanese Patients with Type 2 Diabetes (JDDM 50): A Cross-Sectional Study

et al. 2019

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“…Healthcare professionals should consider prompt intervention in patients with high scores determined by this calculator, including setting a less stringent A1C target, adjusting antidiabetic treatment, obtaining frequent SMBG readings, applying lifestyle modifications with a regular meal schedule, and re-education. 2 , 39 …”

Section: Discussionmentioning

confidence: 99%

“… 1 International practice guidelines recommend that various classes of antidiabetic medications, along with lifestyle modifications, should be initiated to achieve glycemic goals. 2 , 3 In addition, a stepwise combination and intensification of medications are recommended for proper glycemic control in the updated guidelines. However, intensive glycemic control with antidiabetic medications or insulin injections can increase the risk of macrovascular events and mortality in patients with comorbidities and can be accompanied by the risk of hypoglycemia in patients with type 2 diabetes mellitus (T2DM).…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a risk prediction model for severe hypoglycemia in adult patients with type 2 diabetes: a nationwide population-based cohort study

Han¹,

Yun²,

Park³

et al. 2018

CLEP

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PurposeThere is a scarcity of long-term prediction models for severe hypoglycemia (SH) in subjects with type 2 diabetes mellitus (T2DM). In this study, a model was developed and validated to predict the risk of SH in adult patients with T2DM.Patients and methodsBaseline and follow-up data from patients with T2DM who received health evaluations from January 1, 2009, to December 31, 2010 (n=1,676,885) were analyzed as development (n=1,173,820) and validation (n=503,065) cohorts using the National Health Insurance Database (DB) in Korea. New SH episodes were identified using ICD-10 codes. A Cox proportional hazards regression model and Cox model coefficients were used to derive a risk scoring system, and 14 predictive variables were selected. A risk score nomogram based on the risk prediction model was created to estimate the 1-year risk of SH.ResultsIn the development cohort, a total of 5,325 (0.45%) patients experienced SH episodes during the follow-up period. After multivariable adjustment, older age, female sex, current smoker, drinking, low body mass index, lack of exercise, previous SH events, insulin or multiple oral hypoglycemic agent use, presence of hypertension or chronic kidney disease, longer duration of diabetes, low or high glucose level, and high Charlson Comorbidity Index score were found to be significant risk factors for the development of SH and were incorporated into the risk model. The concordance indices were 0.871 (95% confidence interval, 0.863–0.881) in development cohort and 0.866 (95% CI, 0.856–0.879) in the validation cohort. The calibration plot showed a nearly 45° line, which indicates that this model predicts well an absolute SH event.ConclusionThis 14-variable prediction model for SH events may be a useful tool to identify high-risk patients and guide prevention of SH in adult patients with T2DM.

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“…Current therapeutic strategies for attenuating obesity and insulin resistance include lifestyle modifications (e.g., diet, exercise, weight loss) prior to the administration of pharmacological agents (e.g., insulin-sensitizing drugs), which are prescribed only for patients with a body mass index (BMI) ≥27 kg/m 2 . Bariatric surgery is considered only for patients with a BMI of 30-40 kg/m 2 [9,10]. Due to the complications of insulin-sensitizer drugs, alternative remedies in the form of dietary agents to attenuate insulin resistance are receiving more interest.…”

Section: Introductionmentioning

confidence: 99%

Yarrow Supercritical Extract Ameliorates the Metabolic Stress in a Model of Obesity Induced by High-Fat Diet

et al. 2019

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Nowadays, obesity and its associated metabolic disorders, including diabetes, metabolic syndrome, cardiovascular disease, or cancer, continue to be a health epidemic in westernized societies, and there is an increased necessity to explore anti-obesity therapies including pharmaceutical and nutraceutical compounds. Considerable attention has been placed on the identification of bioactive compounds from natural sources to manage the metabolic stress associated with obesity. In a previous work, we have demonstrated that a CO2 supercritical fluid extract from yarrow (Yarrow SFE), downregulates the expression of the lipogenic master regulator SREBF1 and its downstream molecular targets FASN and SCD in a tumoral context. Since obesity and diabetes are strongly considered high-risk factors for cancer development, herein, we aimed to investigate the potential therapeutic role of Yarrow SFE in the metabolic stress induced after a high-fat diet in mice. For this purpose, 32 C57BL/6 mice were distributed in four groups according to their diets: standard diet (SD); SD supplemented with Yarrow SFE (SD + Yarrow); high-fat diet (HFD); and HFD supplemented with Yarrow SFE (HFD + Yarrow). Fasting glycemia, insulin levels, homeostasis model assessment for insulin resistance (HOMA-IR), lipid profile, gene expression, and lipid content of liver and adipose tissues were analyzed after three months of treatment. Results indicate improved fasting glucose levels in plasma, enhanced insulin sensitivity, and diminished hypercholesterolemia in the HFD + Yarrow group compared to the HFD group. Mechanistically, Yarrow SFE protects liver from steatosis after the HFD challenge by augmenting the adipose tissue buffering capacity of the circulating plasma glucose.

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7. Obesity Management for the Treatment of Type 2 Diabetes:Standards of Medical Care in Diabetes—2018

Cited by 106 publications

References 84 publications

Combined Effects of Energy Intake and Physical Activity on Obesity in Japanese Patients with Type 2 Diabetes (JDDM 50): A Cross-Sectional Study

Combined Effects of Energy Intake and Physical Activity on Obesity in Japanese Patients with Type 2 Diabetes (JDDM 50): A Cross-Sectional Study

Development and validation of a risk prediction model for severe hypoglycemia in adult patients with type 2 diabetes: a nationwide population-based cohort study

Yarrow Supercritical Extract Ameliorates the Metabolic Stress in a Model of Obesity Induced by High-Fat Diet

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