Maturity onset diabetes mellitus: response to intensive dietary management.

Hadden, D. R.; Montgomery, D. A. D.; Skelly, Robert; Trimble, E.R.; Weaver, J. A.; Wilson, Emery A.; Buchanan, K. D.

doi:10.1136/bmj.3.5978.276

Cited by 101 publications

(26 citation statements)

References 8 publications

(2 reference statements)

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“…We have documented previously the triglyceride response to intensive dieting in Type 2 diabetes [6,8] which we again observed in the present study. Low serum HDL cholesterol concentrations have been associated with the increased incidence of coronary heart disease in women with diabetes [9].…”

Section: Discussionsupporting

confidence: 88%

The effect of intensive dietary therapy on serum high density lipoprotein cholesterol in patients with type 2 (non-insulin-dependent) diabetes mellitus: A prospective study

et al. 1982

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Summary. Intensive dietary therapy in 57 newly diagnosed Type 2 (non-insulin-dependent) diabetic patients led to an increase, compared with pre-treatment levels, in serum high density lipoprotein (HDL) cholesterol and the HDL/total cholesterol ratio after 3 and 6 months (0.05 < p < 0.1). The increase in HDL cholesterol was related to the degree of weight loss achieved. In 28 patients whose weight decreased by > 10% average body weight during the 6 months, HDL cholesterol rose from 1.22 + 0.06 to 1.36 + 0.06 retool/1 (p < 0.001), whereas patients who lost less weight showed no significant increase in HDL cholesterol. The increase in mean serum HDL-cholesterol levels in female patients was associated with a mean weight reduction of 12.1% average body weight. Patients who were obese at diagnosis lost more weight during the study than non-obese patients (mean 13.2 versus 5.6% average body weight), and showed a significant increase in serum HDL-cholesterol levels. We conclude that intensive dietary therapy may lead to a less atherogenic lipid profile in Type 2 diabetes, particularly in patients who achieve a major weight reduction.Key words: HDL-cholesterol, triglyceride, glucose tolerance, dietary therapy, weight loss, Type 2 diabetes.HDL cholesterol levels are inversely related to the risk of coronary heart disease, and it has been suggested that a low HDL cholesterol or HDL/total cholesterol ratio are major lipid risk factors [1,2]. Several studies have demonstrated that HDL cholesterol levels are reduced in patients with Type 2 diabetes, a condition associated with an increased incidence of atherosclerosis [3][4][5]. It is not clear, however, whether treatment by diet or oral hypoglycaemic drugs influences HDL cholesterol levels.As part of a prolonged prospective study of intensive dietary therapy in Type 2 diabetes [6], we have measured HDL cholesterol and other lipids in 57 newly diagnosed patients before and during 6 months dieting. Patients and MethodsFifty-seven newly diagnosed Type 2 diabetic patients were studied. All had symptoms attributable to hyperglycaemia or glycosuria at diagnosis. Their ages ranged from 43 to 69 years (mean 57 years) and there were 28 males and 29 females. Thirty-four patients were obese (> 110% average body weight) and 23 non-obese (< 110% average body weight) at diagnosis. Twenty-one were known cigarette smokers and 34 were known alcohol consumers. Six patients were known to be taking thiazide diuretics, two to be taking fl-adrenergic blocking agents and two more to be taking both these drugs at time of diagnosis. To our knowledge, they continued on that therapy during the study period. At the time of diagnosis, a 50 g oral glucose tolerance test, with measurement of plasma insulin, was performed. Serum cholesterol, HDL cholesterol and triglyceride levels were measured after a 14-h overnight fast. The patients were then prescribed a diet in which 40%45% of total energy was derived from carbohydrate with exclusion of foods rich in refined sugars. In the majority, the recommended e...

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Section: Discussionsupporting

confidence: 88%

The effect of intensive dietary therapy on serum high density lipoprotein cholesterol in patients with type 2 (non-insulin-dependent) diabetes mellitus: A prospective study

et al. 1982

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“…The beneficial effects of such programmes are usually seen rapidly, within weeks to months, and often before there has been substantial weight loss [41]. Weight loss of as little as 4 kg will often ameliorate hyperglycaemia.…”

Section: Principles In Selecting Antihyperglycaemic Interventionsmentioning

confidence: 99%

Management of hyperglycaemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy

et al. 2006

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“…[42][43][44][45] In addition to the beneficial effects of weight loss on glycemia, weight loss and exercise improve coincident CVD risk factors, such as blood pressure and atherogenic lipid profiles, and ameliorate other consequences of obesity. 41,46,47 There are few adverse consequences of such lifestyle interventions other than difficulty in incorporating them into usual lifestyle and sustaining them and the usually minor musculoskeletal injuries and potential problems associated with neuropathy, such as foot trauma and ulcers, that may occur as a result of increased activity. Theoretically, effective weight loss, with its pleiotropic benefits, safety profile, and low cost, should be the most cost-effective means of controlling diabetes-if it could be achieved and maintained over the long term.…”

Section: Lifestyle Interventionsmentioning

confidence: 99%

Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy

et al. 2009

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Maturity onset diabetes mellitus: response to intensive dietary management.

Cited by 101 publications

References 8 publications

The effect of intensive dietary therapy on serum high density lipoprotein cholesterol in patients with type 2 (non-insulin-dependent) diabetes mellitus: A prospective study

The effect of intensive dietary therapy on serum high density lipoprotein cholesterol in patients with type 2 (non-insulin-dependent) diabetes mellitus: A prospective study

Management of hyperglycaemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy

Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy

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