Appetite-suppressant Lorcaserin Decreases Risk Of Developing Diabetes And Induces Remission Of High Blood Sugar In Obese And Overweight Patients
Appetite-suppressant lorcaserin decreases risk of developing diabetes and induces remission of high blood sugar in obese and overweight patients New research presented at this year's annual meeting of the European Association for the Study of Diabetes (EASD) in Berlin, Germany, and published in The Lancet, shows that the appetite-suppressant drug lorcaserin decreases risk of developing diabetes and increases the rates of remission of high blood sugar. Lorcaserin also reduces the risk of kidney complications due to diabetes in obese and overweight patients. The study is by Dr Erin Bohula and Dr Benjamin Scirica and colleagues from the Brigham and Women's Hospital investigators from the Thrombolysis in Myocardial Infarction (TIMI) Study Group, Boston, MA, and Harvard University, Cambridge, MA, USA. There is a direct relationship between increased body weight and the risk of diabetes. In CAMELLIA-TIMI 61, lorcaserin, a selective serotonin 2C receptor agonist that suppresses appetite has been shown to facilitate sustained weight loss in obese or overweight patients. As reported last month, lorcaserin facilitated modest but sustained weight loss without an increased risk of major adverse cardiovascular events in obese or overweight patients at high cardiovascular risk. The long-term effects of lorcaserin on diabetes prevention and remission, however, are unknown. CAMELLIA-TIMI 61 was a randomised, double-blind, multi-national trial of lorcaserin or placebo on a background of lifestyle modification in overweight or obese patients with or at high risk for atherosclerotic vascular disease. The prespecified endpoint of incident diabetes was assessed in patients with prediabetes at baseline. Other prespecified outcomes for efficacy included remission of hyperglycaemia (high bloo Continue reading >>
Polyphagia: The Relationship Between Hunger And Diabetes
Is hunger a sign of diabetes? If you don’t have diabetes, could hunger be one of the signs of diabetes? Is being hungry all of the time (polyphagia) a sign that you should go get checked for diabetes? After all, polyphagia is one of the “3 Poly’s,” is part of a triad of symptoms indicating diabetes. In addition to polyphagia, or increased hunger, the symptoms of polyuria and polydipsia are also signs of diabetes. Susan’s story Susan was constantly hunger. She never seemed to feel satisfied as she snacked off and on all day long from increasing hunger pangs. Susan’s hunger had gotten progressively worse over the past year. She noticed that she had been going to the bathroom more frequently, and wasn’t sure if she might be getting a urinary tract infection. Oddly enough, she hadn’t gained any weight. She had even lost a few pounds. She visited her primary care provider, and relayed her symptoms to the nurse. The doctor recommended that Susan be checked for several different conditions, but the one that stuck out in Susan’s mind was diabetes. She had an aunt with diabetes. She remembered how sick she got, and how she’d spend her days in the dialysis unit. Susan didn’t want diabetes, at least the kind that she knew about from her aunt. When Susan contacted TheDiabetesCouncil, she was concerned that she did indeed have diabetes. She was waiting for her test results, but she was eager to find out if hunger was a sure sign that she has diabetes? I suggest reading the following articles: We decided to look into it for Susan. Let’s see what we found. Polyphagia: What is it? With polyphagia, even after having just eaten, you will feel hunger, or find that you have cravings for particular foods that monopolize your thoughts. The definition of polyphagia, wh Continue reading >>
Cerebral Blood Flow And Glucose Metabolism In Appetite-related Brain Regions In Type 1 Diabetic Patients After Treatment With Insulin Detemir And Nph Insulin
OBJECTIVE To test the hypothesis that insulin detemir, which is associated with less weight gain than other basal insulin formulations, exerts its weight-modulating effects by acting on brain regions involved in appetite regulation, as represented by altered cerebral blood flow (CBF) or cerebral glucose metabolism (CMRglu). RESEARCH DESIGN AND METHODS Twenty-eight male type 1 diabetic patients (age 36.9 ± 9.7 years, BMI 24.9 ± 2.7 kg/m2, A1C 7.5 ± 0.6%) successfully completed a randomized crossover study, consisting of two periods of 12-week treatment with either insulin detemir or NPH insulin, both in combination with prandial insulin aspart. After each treatment period, patients underwent positron emission tomography scans to measure regional CBF and CMRglu. RESULTS After 12 weeks, A1C, daily insulin doses, fasting insulin, and blood glucose levels were similar between treatments. Insulin detemir resulted in body weight loss, whereas NPH insulin induced weight gain (between-treatment difference 1.3 kg; P = 0.02). After treatment with insulin detemir relative to NPH insulin, CBF was higher in brain regions involved in appetite regulation, whereas no significant difference in CMRglu was observed. CONCLUSIONS Treatment with insulin detemir versus NPH insulin resulted in weight loss, paralleled by increased CBF in appetite-related brain regions in the resting state, in men with well-controlled type 1 diabetes. These findings lend support to the hypothesis that a differential effect on the brain may contribute to the consistently observed weight-sparing effect of insulin detemir. From January 2009 until May 2011, patients were included in this randomized controlled crossover trial; the last follow-up visit was on 13 December 2011. Thirty-five patients with type 1 diabet Continue reading >>
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Get In Touch With Your Appetite
There are many signals that tell us it's time to eat (other than a rumbling stomach): television ads, social events, smells from the food court, and the candy bowl at the office. These factors in the environment trigger our senses and other mental processes that make us think we are hungry even when were not. The Hunger Rating Scale can help you decide if you are experiencing real hunger. Remember that physical hunger builds gradually over time (usually over several hours after a meal), whereas emotional eating and cravings usually come on very suddenly. When you are genuinely hungry, you may experience one or several of the symptoms listed below: Before you eat, take a moment to rate your hunger. Think about how hungry you physically feel. Your goal is to eat between levels 4 and 6. This means you are eating when you are hungry but stopping when you are comfortably full. Try not to put off eating for too long. Waiting until level 1 or 2 when you are starving and unable to concentrate may lead to overeating. When you first start to feel any of the symptoms listed above, you should probably start to think about eating. We often let the sight of food tempt us when we are above a level 6 on the scale. Before you indulge, take a step back and think about how you feel. Did you just eat a few minutes ago? Are you eating in response to an emotion or because you are experiencing physical hunger? Think of alternatives to eating for when these temptations arise. Some ideas are: Drink a glass of cold water or another zero-calorie beverage Do another form of exercise (sit-ups, running, swimming, tennis, etc.) Do you like to knit or paint? Work on a hobby Download the Hunger Rating Scale and carry it with you in your wallet or purse. It can help you decide before you eat if you are Continue reading >>
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Byetta, Victoza, Bydureon: Diabetes Drugs And Weight Loss
Tell me about the diabetes drugs Byetta, Victoza and Bydureon. Can they really help people who have diabetes lose weight? Are there side effects? Answers from M. Regina Castro, M.D. Exenatide (Byetta, Bydureon) and liraglutide (Victoza) are taken by injection, similar to insulin, but they're not insulin. These medications are in a class of drugs called incretin mimetics, which improve blood sugar control by mimicking the action of a hormone called glucagon-like peptide 1 (GLP-1). Among other things, these drugs stimulate insulin secretion in response to rising blood sugar levels after a meal, which results in lowering of the blood sugar. Byetta, Bydureon and Victoza not only improve blood sugar control, but may also lead to weight loss. There are many proposed ways in which these medications cause weight loss. They appear to help suppress appetite. But the most prominent effect of these drugs is that they delay the movement of food from the stomach into the small intestine. As a result, you may feel "full" faster and longer, so you eat less. Byetta is injected twice daily, and Victoza is injected once a day. Bydureon, a newer formulation, is injected once a week. These drugs do have different effects and side effects to consider. Exenatide (Byetta, Bydureon). The most common side effect of exenatide is mild to moderate nausea, which improves with time in most people. Several cases of kidney problems, including kidney failure, have been reported in people who have taken exenatide. Rarely, exenatide may cause harmful inflammation of the pancreas (pancreatitis). Liraglutide (Victoza). Some studies have found that liraglutide reduces systolic blood pressure and triglycerides, in addition to improving blood sugar control. The most common side effects are headache, nausea and Continue reading >>
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Why People With Diabetes Lose Appetite?
Pancreas is an organ of the body. Insulin is a hormone secreted by your pancreas to stimulate the glucose in the blood to get absorbed by the body’s cells. But diabetes makes the body immune to insulin. Thus, the body’s cells are no longer capable of using the glucose to produce energy. While the glucose remains in the blood- increasing blood sugar levels- the body begins to break down body fat to release energy. This process releases ketones, which are chemicals released when fat is broken down to produce energy. The ketones collect in the blood and this makes the blood more acidic. As a result, you may experience the following symptoms: Thirst or a very dry mouth Frequent urination Fatigue Dry or flushed skin Nausea or vomiting Abdominal pain Breathing difficulties Inability to concentrate Therefore, it is clear that ketone poisoning can make you very sick. When you are sick you often don’t feel like eating anything. This is considered a serious condition as it is a sign that your diabetes is out of control and you should contact your doctor. To keep things in check always monitor your blood sugar levels. Get your blood and urine checked for ketone levels. Low appetite can mean that you’re running the risk of weight-loss. Thus, it’s important to increase your calorie intake. You can help your appetite by: Taking a detox program Eating a little more than you normally do Watching what and how much you drink Doing short periods of structured exercises You can also talk to your doctor about it. Your doctor might be able to recommend something to help increase your appetite. Always talk to a nutritionist before making any changes in your eating habits. Source: Continue reading >>
Diabetes Hunger And Food Cravings
Surveys find that nearly 100% of young women and almost 70% of young men sometimes have food cravings. For most people, cravings at worst add a little weight. With diabetes, they can be a serious problem. Food cravings might cause you to eat way too much of things that spike your sugars. What are food cravings, though? Where do they come from, and how can we deal with them in a healthy way? Let’s divide cravings into two types: physical hunger and emotional distress. It’s normal to feel strong hunger if blood sugar is low, or if your stomach is too empty. Then you really need to eat. If your sugar is low, you might need some carbs; if you just feel empty, some high-fiber vegetables or water might be preferable. Diabetes can cause hunger if glucose is not getting into the cells where it’s needed. Other medical causes of excess hunger include thyroid problems (such as Graves’ disease,) pregnancy, cannabis smoking, and depression. To avoid the cravings of low sugar or empty stomach, remember to eat regularly, especially breakfast. Breakfast with protein should keep cravings away at least until the afternoon. Eating may not stop some people’s low-sugar hunger. If that happens to you, you may need insulin, an insulin-sensitizing medication, or an herb such as bitter melon to get glucose into your cells. Food cravings are not always physical, though. In addition to body hunger and stomach hunger, there is what psychologist William Polonsky, PhD, CDE, calls mouth hunger or eyeball hunger. “While your stomach may be satisfied,” says Dr. Polonsky, “your eyeballs, mouth, and brain may still feel famished. If your meal plan is too limiting [in terms of food types], you may be depriving yourself of the joy of eating and the sense of satisfaction your mind and body c Continue reading >>
Type 2 Diabetes Symptoms
The symptoms of type 2 diabetes (also called type 2 diabetes mellitus) develop gradually—so gradually, in fact, that it’s possible to miss them or to not connect them as related symptoms. Some people are actually surprised when they are diagnosed with type 2 diabetes because they’ve gone to the doctor for something else (eg, fatigue or increased urination). The symptoms develop gradually because, if you have the insulin resistant form of type 2, it takes time for the effects of insulin resistance to show up. Your body doesn’t become insulin resistant (unable to use insulin properly) overnight, as you can learn about in the article on causes of type 2 diabetes. If you’re not insulin resistant—and instead your body doesn’t produce enough insulin to process glucose well—the symptoms also develop gradually. Your body will be able to “make do” with lower insulin levels for awhile, but eventually, you will start to notice the following symptoms. Here are some of the common symptoms of type 2 diabetes: Fatigue: Your body isn’t getting the energy it needs from the food you’re eating, so you may feel very tired. Extreme thirst: No matter how much you drink, it feels like you’re still dehydrated. Your tissues (such as your muscles) are, in fact, dehydrated when there’s too much glucose (sugar) in your blood. Your body pulls fluid from the tissues to try to dilute the blood and counteract the high glucose, so your tissues will be dehydrated and send the message that you need to drink more. This is also associated with increased urination. Frequent urination: This is related to drinking so much more in an attempt to satisfy your thirst. Since you’re drinking more, you’ll have to urinate more. Additionally, the body will try to get rid of the excess g Continue reading >>
Loss Of Appetite Dangerous For Diabetics
Q: Dear Donovan, I enjoy your column and see where you give advice to people who want to lose weight, and some of the advice is given to people with lifestyle diseases such as diabetes. However, my issue is a bit different. What if you're a diabetic who is losing too much weight and whose appetite is waning? How can this be treated? A: Diabetes mellitus is a chronic disease which interferes with the body's ability to control the blood glucose level. Diabetes can cause a number of symptoms including a loss of appetite, which can last for a few days. In your specific situation I wish you had given me more information. For example, are you currently on medication for diabetes? How did your loss of appetite occur: gradually or sudden? What do you eat on a daily basis? Also, are you exercising? Furthermore, are you having any stomach pain, vomiting or feeling nauseous? Overall, it is very important to find out the underlying cause of your lack of appetite. I would strongly suggest that you consult with your doctor. Until your appetite returns to normal you are at great risk of malnutrition and other health problems. In diabetes mellitus, the body does not produce enough insulin or functional insulin. The cells are therefore unable to properly use glucose to produce energy. As a result, the body will break down fat for energy. This further results in the production of ketones, which can make the body acidic as well as reduce the appetite. However, it should be noted that some diabetics do experience an increase in appetite. Therefore, it is very important that you consult with your doctor. In a nutshell, if your appetite is low, this can lead to weight loss. Hence, in order for you to regain your weight you will have to get the appetite back up and increase your intake of cal Continue reading >>
Type 2 Diabetes And Gastroparesis
Gastroparesis, also called delayed gastric emptying, is a disorder of the digestive tract that causes food to remain in the stomach for a period of time that is longer than average. This occurs because the nerves that move food through the digestive tract are damaged, so muscles don’t work properly. As a result, food sits in the stomach undigested. The most common cause of gastroparesis is diabetes. It can develop and progress over time, especially in those with uncontrolled blood sugar levels. The following are symptoms of gastroparesis: heartburn nausea vomiting of undigested food early fullness after a small meal weight loss bloating loss of appetite blood glucose levels that are hard to stabilize stomach spasms acid reflux Gastroparesis symptoms may be minor or severe, depending on the damage to the vagus nerve, a long cranial nerve that extends from the brain stem to the abdominal organs, including those of the digestive tract. Symptoms can flare up any time, but are more common after the consumption of high-fiber or high-fat foods, all of which are slow to digest. Women with diabetes have a high risk for developing gastroparesis. Other conditions can compound your risk of developing the disorder, including previous abdominal surgeries or a history of eating disorders. Diseases and conditions other than diabetes can cause gastroparesis, such as: viral infections acid reflux disease smooth muscle disorders Other illnesses can cause gastroparesis symptoms, including: Parkinson’s disease chronic pancreatitis cystic fibrosis kidney disease Turner’s syndrome Sometimes no known cause can be found, even after extensive testing. People who have gastroparesis have damage to their vagus nerve. This impairs nerve function and digestion because the impulses needed to chu Continue reading >>
Diabetes: Loss Of Appetite
Diabetes mellitus is a chronic disease that interferes with the body’s ability to control the level of glucose in the blood. No matter what type of diabetes you have, symptoms develop as a result of high blood glucose levels, according to MayoClinic.com. Complications can cause a loss of appetite that lasts for more than a couple of days. Video of the Day When trying to determine the cause for your loss of appetite, your health care provider may ask whether you feel nauseous, have stomach pain or vomiting or are currently taking any medications. Your doctor may also ask if your loss of appetite came on gradually or suddenly and if you've recently lost weight. Mention how long it has been since you first noticed changes in your appetite. Tell your doctor if there is a family history of diabetes. Until your appetite returns to normal, you are at risk for malnutrition and other health problems; therefore, you need to find out the underlying cause for your decrease in appetite. Complications can occur when diabetes goes undiagnosed for an extended length of time. Suffering a loss of appetite for a few weeks or more can lead to malnutrition, a condition where your body does not get the nutrients it needs. Aside from possible malnutrition, if left untreated, diabetes can damage the eyes, kidneys and nerves. Undiagnosed diabetes can also cause circulation problems, heart attack and stroke. Although there is no cure for the disease, you can prevent complications from occurring by maintaining a healthy weight and controlling blood glucose levels. Monitoring blood pressure and cholesterol levels, eating a balanced diet, being physically active and seeing your doctor regularly are additional steps you can take to help manage your diabetes. If hyperglycemia goes untreated, diabet Continue reading >>
How Diabetes Medications Affect Your Appetite
Many of my patients with type 2 diabetes are overweight or obese. For them, losing weight is an important way to gain better control over their diabetes and improve their health in general. But losing weight by diet and exercise alone can be very difficult. In fact, the latest science about obesity suggests the hormones controlling appetite in an obese body are dysregulated. To put it very simply, that means obese patients’ brains may tell them they’re hungry when they’re actually full. It shows us we may need pharmacological assistance to rebalance leptin, ghrelin, and other appetite hormones to get the body functioning correctly. On top of tracking your diet and blood sugar, regular exercise is a key part of managing your diabetes. And while any exercise is better than none, certain activities have specific benefits for people with diabetes. 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement. While researchers are still learning more about appetite hormones, many of my patients wonder about the effect of their diabetes medications on their appetite. While the more standard diabetes treatments don’t suppress appetite or cause weight loss, newer therapies have come to the market in recent years that do offer these benefits. However, they’re so new that they lack long-term data on safety. Until we get more information, I tend to stick with the standards for most of my patients. Still, there are niches these drugs can fill. The classic treatment prescribed for diabetes, insulin, has the potential to cause weight gain, and doesn’t suppress appetite–which can be a huge drawback to ins Continue reading >>
Should I Eat If I'm Not Hungry?
I have been a diabetic for over 40 years and have been on the insulin pump. I am not hungry for the most part all day long, and sometimes a week at a time. My A1C is 6.1 and my endocrinologist is very happy with my blood sugars. Should I force myself to eat, whether I am hungry or not? I do not feel weak or anything like that — I'm just not hungry. — Margo, New Hampshire The short answer is yes. You must try to eat for two reasons: to prevent hypoglycemia, and more importantly, to prevent malnutrition. Even though you do not feel weak, your body requires nutrients continuously for its vital functions. I recommend eating small portions frequently and choosing nutrient-dense foods to ensure that you have adequate intake. Work with your doctor or a nutritionist to calculate your caloric needs. I also suggest that, with your doctor’s help, you find the cause of your loss of appetite. Since you say you have had diabetes for 40 years, you might be experiencing gastrointestinal neuropathy, a type of neuropathy that affects the gut and can cause you to feel full. There are several other possible reasons for loss of appetite that should be explored with your doctor. If you have not been sleeping well, have felt down, and have difficulty concentrating, the loss of your appetite might be due to depression. Bring this to your doctor’s attention, as depression is treatable. She will also work with you to investigate other reasons for your loss of appetite. One final note: In those who have had diabetes for a long time, or have had repeated episodes of low blood sugar, the warning signs and symptoms of hypoglycemia can be blunted. In other words, you may not feel its symptoms until your blood sugar dips to a dangerously low level. You should be vigilant about checking your su Continue reading >>
The Effect Of Acute Hyperglycaemia On Appetite And Food Intake In Type 1 Diabetesmellitus.
The effect of acute hyperglycaemia on appetite and food intake in Type 1 diabetesmellitus. Russell AW(1), Horowitz M, Ritz M, MacIntosh C, Fraser R, Chapman IM. (1)University of Adelaide Department of Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia. AIMS: To determine the effects of acute hyperglycaemia on appetite and foodintake in Type 1 diabetes mellitus.METHODS: Two separate studies, each involving eight adults with uncomplicatedType 1 diabetes, were performed: one in the fasted state (A) and the other after a nutrient preload (B). In both studies, perceptions of appetite (hunger andfullness) and food intake at a buffet meal were evaluated during euglycaemia(blood glucose, approximately 6 mmol/l) and hyperglycaemia (blood glucose,approximately 14 mmol/l). Both experiments were randomized and single-blind. Instudy A, appetite was assessed in the fasted state for 90 min before the buffetmeal. In study B, a nutrient 'preload' of Ensure and milk containing 13C-octanoicacid was consumed 90 min before the meal. Gastric emptying of the preload wasquantified with a radioisotopic breath test technique.RESULTS: There was no significant difference in plasma insulin concentrationsbetween euglycaemia and hyperglycaemia in either study. In study A, there were nodifferences in hunger, fullness or energy intake between the two treatment days. In study B, subjects were slightly less hungry between the preload and buffetmeal during hyperglycaemia than euglycaemia (P = 0.04), and tended to have slowergastric emptying during hyperglycaemia (emptying coefficient, 3.89 +/- 0.16 vs.3.57 +/- 0.21; P = 0.052), but there was no difference in food intake betweenhyperglycaemia and euglycaemia.CONCLUSIONS: Acute hyperglycaemia suppresses hunger after a nutrient preload, butnot in th Continue reading >>
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Understanding The Link Between Diabetes And Appetite
Why Has My Appetite Changed? One of the odd things about diabetes is that it can cause people to lose their appetite, or conversely, can cause them to feel hungrier than usual. Both extremes are usually a warning sign of some possible issue to your health so it’s important (even if you have not been diagnosed with diabetes) to know about how your appetite can signify a potentially more serious health problem. Loss of Appetite Many people would be delighted to lose their appetite if that made it easier to lose some weight, but when appetite loss is linked to diabetes it can be dangerous. Gastrparesis One possible cause of loss of appetite is gastroparesis, a condition where food moves too slowly through the digestive tract. This happens when over time high blood glucose levels damage the vagus nerve — the nerve that supplies nerve fibers to the pharynx (throat), larynx (voice box), trachea (windpipe), lungs, heart, esophagus, and intestinal tract. When this occurs, the muscles in the gut can no longer move food easily out of the stomach into the small intestine to continue the digestion process. This state is called gastroparesis. As well as loss of appetite, symptoms of gastroparesis include weight loss, heartburn, abdominal bloating, reflux, nausea and vomiting undigested food. Additional symptoms might present as high or low blood glucose levels and stomach spasms. The condition makes blood glucose levels more difficult to control. Ketoacidosis Another diabetes-related condition that can cause appetite loss is diabetic ketoacidosis — a complication that occurs when hyperglycaemia (high blood sugar) goes untreated and high levels of ketones build up in the blood and urine. When your body does not produce enough insulin, the cells are unable to use glucose for fue Continue reading >>
