Weight Loss As A Cure For Type 2 Diabetes
Weight Loss as a Cure for Type 2 Diabetes Expert Rev Endocrinol Metab.2011;6(4):557-561. Although individuals with obesity and Type 2 diabetes are insulin resistant, pancreatic -cell failure is the core defect that distinguishes individuals who eventually develop diabetes. This process is known to occur well before the onset of hyperglycemia. Although clinical trial data support the effectiveness of intensive lifestyle modification in delaying the onset of diabetes in obese subjects, less is known about the effects of, and mechanisms underlying, bariatric surgery, particularly gastric bypass surgery, on diabetes. The paper under evaluation clarifies the role of both lifestyle intervention and gastric bypass surgery on pancreatic -cell function and raises questions regarding the role of weight loss versus incretin-related mechanisms on recovery of -cell failure. The current pandemic of Type 2 diabetes and obesity has created an urgent need to identify effective therapeutic interventions targeting both of these chronic debilitating conditions. Obesity and diabetes are closely interrelated (see Figure 1) in that risk factors such as physical inactivity and poor diet lead to weight gain and precipitate insulin resistance in important insulinsensitive tissues, particularly skeletal muscle, liver and adipose tissue. It is known that obese and insulin-resistant diabetic patients have a positive energy balance, high fat and high carbohydrate intake, increased abdominal adipose tissue, elevated free fatty acids, increased secretory products of adipocytes mediating inflammation, including TNF- and IL-6, and reduced secretion of adiponectin.[ 1 , 2 ] These factors have been shown to be part of the underlying mechanisms of glucose intolerance and contribute to reduced skeletal mus Continue reading >>
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Effects Of Weight Loss On Mechanisms Of Hyperglycemia In Obese Non-insulin-dependent Diabetes Mellitus.
Effects of weight loss on mechanisms of hyperglycemia in obese non-insulin-dependent diabetes mellitus. To quantitate the effects of weight loss on the mechanisms responsible for hyperglycemia in non-insulin-dependent diabetes mellitus (NIDDM), eight obese subjects with NIDDM were studied before and after weight reduction with posttreatment assessment after 3 wks of isocaloric (weight maintenance) refeeding. After weight loss of 16.8 +/- 2.7 kg (mean +/- SE), the fasting plasma glucose level decreased 55% from 277 +/- 21 to 123 +/- 8 mg/dl. The individual fasting glucose levels were highly correlated with the elevated basal rates of hepatic glucose output (HGO) (r = 0.91, P less than .001), which fell from 138 +/- 11 to 87 +/- 5 mg X m-2 X min-1 after weight loss. The change in fasting plasma glucose also correlated significantly with the change in the basal rates of HGO (r = 0.74, P less than .05). This was associated with reduced fasting serum levels of glucagon (from 229 +/- 15 to 141 +/- 12 pg/ml), reduced free fatty acids (from 791 +/- 87 to 379 +/- 35 mu eq/L), and unchanged basal insulin levels (17 +/- 4 to 15 +/- 2 microU/ml).(ABSTRACT TRUNCATED AT 250 WORDS). Continue reading >>
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- Differential Weight Loss Effects on Type 2 Diabetes Remission Among Adults
Weight Loss Before A Diagnosis Of Type 2 Diabetes Mellitus Is A Risk Factor For Diabetes Complications
The prevalence of diabetes mellitus (DM) has increased rapidly over the past 2 decades. [1,2] In 2015, a total of 415 million adults worldwide had diabetes, and by 2040, this figure is expected to increase to 642 million. [3] China has the most patients with DM (92.4 million) of any country in the world. [4] As a result, DM has caused more than 10 million disability-adjusted life years and was the 8th major cause of death in China in 2012; thus, DM represents a major public health problem in China. [5] Type 2 diabetes mellitus (T2DM) is the most common type of DM in China, and a substantial proportion of patients with T2DM are at risk for diabetic complications. [6] Diabetic complications are linked with disability and even death in patients with T2DM and thus constitute the main disease burden of T2DM. Therefore, identifying patients at a high risk of developing complications is important. To the best of our knowledge, clinical trials have generally focused on the association between diabetic complications and blood pressure and the levels of blood glucose and blood lipids. Furthermore, previous studies on weight loss have typically studied the benefits of intrusive body weight control for the control of diabetes complications. [7,8] Along with increased drinking, eating, and urinating, weight loss in the absence of intentional dieting, diuretic therapy or exercise prior to the diagnosis of T2DM is generally identified as a symptom of T2DM [9] ; however, few studies have investigated the relationship between weight loss prior to the T2DM diagnosis and diabetic complications. Thus, we designed an observational study to investigate the relationship between weight loss prior to the T2DM diagnosis and diabetic complications in hospitalized patients with T2DM, which is the Continue reading >>
Diabetes: Mechanism, Pathophysiology And Management-a Review
Anees A Siddiqui1*, Shadab A Siddiqui2, Suhail Ahmad, Seemi Siddiqui3, Iftikhar Ahsan1, Kapendra Sahu1 Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Jamia Hamdard (Hamdard University), Hamdard Nagar, New Delhi (INDIA)-110062. School of Pharmacy, KIET, Ghaziabad U.P. SGC college of Pharmacy, Baghpat(UP) Corresponding Author:Anees A Siddiqui E-mail: [email protected] Received: 20 February 2011 Accepted: 02 May 2011 Citation: Anees A Siddiqui, Shadab A Siddiqui, Suhail Ahmad, Seemi Siddiqui, Iftikhar Ahsan, Kapendra Sahu “Diabetes: Mechanism, Pathophysiology and Management-A Review” Int. J. Drug Dev. & Res., April-June 2013, 5(2): 1-23. Copyright: © 2013 IJDDR, Anees A Siddiqui et al. This is an open access paper distributed under the copyright agreement with Serials Publication, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Related article at Pubmed, Scholar Google Visit for more related articles at International Journal of Drug Development and Research The prevalence of diabetes is rapidly rising all over the globe at an alarming rate. Over the last three decades, the status of diabetes has been changed, earlier it was considered as a mild disorder of the elderly people. Now it becomes a major cause of morbidity and mortality affecting the youth and middle aged people. According to the Diabetes Atlas 2006 published by the International Diabetes Federation, the number of people with diabetes in India currently around 40.9 million is expected to rise to 69.9 million by 2025 unless urgent preventive steps are taken. The main force of the epidemic of diabetes is the rapid epidemiological transition associated with changes in dietary patterns and decreased physical activity a Continue reading >>
Effects Of Weight Loss On Mechanisms Of Hyperglycemia In Obese Non-insulin-dependent Diabetes Mellitus
To quantitate the effects of weight loss on the mechanisms responsible for hyperglycemia in non-insulin-dependent diabetes mellitus (NIDDM), eight obese subjects with NIDDM were studied before and after weight reduction with posttreatment assessment after 3 wks of isocaloric (weight maintenance) refeeding. After weight loss of 16.8 ± 2.7 kg (mean ± SE), the fasting plasma glucose level decreased 55% from 277 ± 21 to 123 ± 8 mg/dl. The individual fasting glucose levels were highly correlated with the elevated basal rates of hepatic glucose output (HGO) (r = 0.91, P < .001), which fell from 138 ± 11 to 87 ± 5 mg · m2 · min1 after weight loss. The change in fasting plasma glucose also correlated significantly with the change in the basal rates of HGO (r = 0.74, P < .05). This was associated with reduced fasting serum levels of glucagon (from 229 ± 15 to 141 ± 12 pg/ml), reduced free fatty acids (from 791 ± 87 to 379 ± 35 μeq/L), and unchanged basal insulin levels (17 ± 4 to 15 ± 2 fill/ml). Peripheral glucose disposal, assessed by the euglycemic glucose-clamp technique, at insulin infusion rates of 120 and 1200 mU · m2 · min1 increased between 135 and 165%, from 128 ± 17 to 288 ± 24 mg · m2 · min1 during the 120-mU · m2 · min1 studies and from 159 ± 19 to 318 ± 24 mg · m2 · min1 during the 1200-mU · m2 · min1 clamp studies, despite comparable steady-state serum insulin levels at each infusion rate before and after weight loss. HGO during the 120-mU · m2 · min1 clamp studies increased from 85% to complete (100%) suppression after treatment. Adipocyte size was reduced 44% (851 ± 91 to 475 ± 48 pi), whereas surface area decreased by 32% (4.30 × 104 to 2.92 × 104 μm2cell). Insulin binding to isolated adipocytes was unchanged, whereas basal i Continue reading >>
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- International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #59: Mechanisms of insulin signal transduction Part 3 of 8
- Differential Weight Loss Effects on Type 2 Diabetes Remission Among Adults
Keeping The Pounds On: Causes Of Unexplained Weight Loss
Our society is obsessed with weight, if you haven’t noticed. More than two thirds of US adults are overweight or obese, there are more diet books published than we can count, and, of course, we have the privilege of watching shows like The Biggest Loser to help keep us in line. And according to government statistics, more than 85% of people with Type 2 diabetes are overweight. So it stands to reason that much of the focus of managing Type 2 diabetes is based on reaching and staying at a healthy weight. It’s important to note that thin people can get diabetes too, and not just Type 1 diabetes. In a 2008 study published in the journal Diabetes Care, adults age 60 to 79 years old with a body-mass index (BMI) of less than 18.5 (which is considered to be underweight) were 30% more likely to get Type 2 diabetes than adults with a “normal” BMI of 18.5 to 24.9. In a society where being thin equates with beauty, youth, intelligence, and success, there is often little sympathy or patience for people who are too thin and who desperately want to gain weight. If you’ve struggled with losing weight and keeping it off, you know all too well how challenging that can be. People who want to gain weight often face the same kind of battle. And to have diabetes on top of that can make it doubly difficult. First things first: identify the cause If you have diabetes, are underweight, and would like to gain weight, it’s helpful to first have a talk with your doctor. Make sure there are no health or medical reasons for you being underweight (especially if you’ve recently lost weight without trying) such as having an overactive thyroid, a digestive disorder (such as Crohn disease), or cancer, for example. A physical exam, blood work, and other tests may be needed to rule out certai Continue reading >>
Unexplained Weight Loss
Tweet Unexplained weight loss is the term used to describe a decrease in body weight that occurs unintentionally and can be a warning sign of diabetes. The amount you weigh is determined by a number of factors including age, your calorie intake and overall health. Once you reach middle adulthood, your weight should remain relatively stable from year to year. Losing or gaining a few pounds here and there is normal, but unexplained weight loss that is significant (10 lbs/4.5kg or more or over 5% of your body weight) or persistent may signal an underlying medical condition. Unexplained weight loss means weight loss that occurs without trying through dieting or exercising. What are the possible causes of unexplained weight loss? Unintentional or unexplained weight loss can be caused by a number of things, including depression, certain medication and diabetes. Potential causes of unexplained weight loss include: Addison’s disease Coeliac disease Chronic diarrhoea Dementia Diabetes mellitus Eating disorders (anorexia and bulimia) Exocrine Pancreatic Insufficiency HIV/AIDS Hypercalcemia Hyperthyroidism Malnutrition Medicines, including chemotherapy drugs, laxatives, and thyroid medications Parkinson’s disease Recreational drugs, including amphetamines and cocaine Tuberculosis Diabetes and sudden weight loss In people with diabetes, insufficient insulin prevents the body from getting glucose from the blood into the body's cells to use as energy. When this occurs, the body starts burning fat and muscle for energy, causing a reduction in overall body weight. Unexpected weight loss is often noticed in people prior to a diagnosis of type 1 diabetes but it may also affect people with type 2 diabetes. When to call your doctor If you have unintentionally lost more than 5% of your Continue reading >>
Unexplained Weight Loss With Diabetes
You might be aware that as a metabolic disorder, some forms of diabetes come with excessive weight. But diabetes might also cause a sudden drop in weight too. In fact, many patients who are ultimately diagnosed with diabetes first go to their doctor with concerns about unexplained weight loss. Several mechanisms are behind this symptom. Weight loss can occur as a consequence of high blood sugar, dehydration, muscle breakdown and problems with your thyroid. Video of the Day Although both type 1 and type 2 diabetes can involve fairly dramatic weight loss over several days at the onset of the disease, it tends to be more common among people with type 1. In both cases, the cause is that your body fails to adequately deal with insulin. The job of insulin is to transport glucose from the foods you eat into your cells to provide energy for all the work that’s required to keep you alive. However, most type 1 diabetics don’t produce insulin. Type 2 diabetics either don’t produce enough insulin or their bodies don’t respond to it properly. Consequently, even if you eat normally, that blood sugar simply builds up and gets excreted in your urine. This causes weight loss, but it could also damage your organs if you don't receive treatment. If you experience an unexplained weight loss, surpassing 5 percent of your body weight within days, see your health care provider as soon as possible. Another symptom of diabetes associated with weight loss is frequent urination. When you urinate more frequently and don’t drink enough to replace the lost fluid, you become dehydrated. Urination increases in diabetes, because your kidneys have to work harder to filter the excess glucose building up in your system. The increased glucose in the urine draws fluid from your tissues. When you l Continue reading >>
One Man's Weight Loss Was A Sign Of Type 2 Diabetes
Kim Palmaffy was diagnosed with diabetes at age 51. (KIM PALMAFFY) If you have type 2 diabetes, you may feel abnormally thirsty and have a need to urinate frequently. One other possibility? You may lose weight without even trying. If it sounds like a weight-loss dream come true, it's actually more of a nightmare. Because your body doesn't have enough insulin or is losing sensitivity to insulin, you can't shuttle blood sugar into muscle cells. Blood sugar rises to toxic levels and you begin to excrete that excess sugar into the urine. At this point some people may shed pounds without dieting. Kim Palmaffy, 61, a contractor in Maplewood, N.J., was close to 300 pounds when he began to show signs of type 2 diabetes ten years ago. At 5'10", he knew he needed to lose weight. And then it started happening all on its own. The pounds started flying off, sometimes up to three pounds a week. "I got down to like 250 pounds over a period of weeks." You may feel exhausted His clothes began to fit better, but Palmaffy was feeling terrible. "I couldn't sleep, I started to urinate all the time, and I was always thirsty." It began to interfere with his work. "I had to get off the roof and take a leak all the time, as dumb as it sounds," he says. A visit to his doctors showed that Palmaffy's blood glucose, the type of sugar the body uses for energy, was a whopping 450 mg/dL, four times what's considered normal on a fasting blood glucose test110 mg/dL. "He started me on a whole battery of medications; I found that the medications were very positive," he said. "We finally settled on Glucotrol (glipizide), five milligrams twice a day." He also takes a cholesterol-lowering drug. Palmaffy had to make some dietary changes to cope with the diagnosis. He found it wasn't that difficult. His Continue reading >>
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Type 1 Diabetes Mellitus
Pathophysiology This section reviews the consequences of insulin deficiency resulting from loss of beta cell mass and function. The earliest abnormalities of beta cell function, detectable before clinical onset, include loss of pulsatile insulin secretion and loss of the first-phase insulin response (FPIR) to intravenous glucose. Insulin secretion declines rapidly before and following onset of symptoms, and reduced insulin action results in increased glucose output by the liver and reduced glucose uptake by insulin sensitive tissues including muscle and fat. Blood glucose rises and spills into the urine, producing an osmotic diuresis. Glucose deprivation in other tissues triggers breakdown of fat and structural proteins, causing rapid weight loss. These changes account for the three leading symptoms of uncontrolled diabetes: thirst, polyuria and weight loss. The underlying metabolic abnormalities are largely − but incompletely − reversed by standard insulin therapy. In the absence of insulin, the 'accelerated starvation' of uncontrolled diabetes is followed by overproduction of acidic ketone bodies, and culminates in the metabolic emergency of diabetic ketoacidosis, the hallmark of type 1 diabetes. Changes in insulin secretion The beta cells within each islet are linked into a single functional mass by junctions between the membrane of one cell and the next. This allows depolarization of the cell membrane to propagate throughout the beta cell mass such that the beta cells of each islet release insulin in unison. A neural network links the million or so islets scattered though the pancreas to a putative 'pancreatic pacemaker', enabling them to secrete insulin in synchronous pulses. These pulses, which account for ~70% of insulin production by the liver, were initiall Continue reading >>
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Insulin And Weight Gain: Keep The Pounds Off
Insulin and weight gain often go hand in hand, but weight control is possible. If you need insulin therapy, here's how to minimize — or avoid — weight gain. Weight gain is a common side effect for people who take insulin — a hormone that regulates the absorption of sugar (glucose) by cells. This can be frustrating because maintaining a healthy weight is an important part of your overall diabetes management plan. The good news is that it is possible to maintain your weight while taking insulin. The link between insulin and weight gain When you take insulin, glucose is able to enter your cells, and glucose levels in your blood drop. This is the desired treatment goal. But if you take in more calories than you need to maintain a healthy weight — given your level of activity — your cells will get more glucose than they need. Glucose that your cells don't use accumulates as fat. Avoid weight gain while taking insulin Eating healthy foods and being physically active most days of the week can help you prevent unwanted weight gain. The following tips can help you keep the pounds off: Count calories. Eating and drinking fewer calories helps you prevent weight gain. Stock the refrigerator and pantry with fruits, vegetables and whole grains. Plan for every meal to have the right mix of starches, fruits and vegetables, proteins, and fats. Generally, experts recommend that meals consist of half non starchy vegetable, one-quarter protein and one quarter a starch such as rice or a starchy vegetable such as corn or peas. Trim your portion sizes, skip second helpings and drink water instead of high-calorie drinks. Talk to your doctor, nurse or a dietitian about meal-planning strategies and resources. Don't skip meals. Don't try to cut calories by skipping meals. When you skip Continue reading >>
Type 2 Diabetes: How To Lose Weight
Weight loss is a common recommendation for treatment for type 2 diabetes. Many people are overweight when they’re first diagnosed, and that extra fat actually increases their insulin resistance (when their bodies can’t properly use the hormone insulin). By losing weight, people with type 2 diabetes can become less insulin resistant, and they’re able to use insulin better. (To learn more about how the hormone insulin works, read our article on how insulin regulates blood glucose levels.) If you’ve recently been diagnosed with type 2 diabetes and you're overweight, you should get started as soon as possible on a weight loss plan. It is important to work with a registered dietitian to help you figure out a plan that will work for you—a healthy meal plan, physical activity, and realistic goals will help you reach a healthy weight. There are many advantages to losing weight (and not just diabetes-related ones): Boost your energy level Lower your cholesterol levels (especially important for people with type 2 diabetes) Protect your heart (also important for people with diabetes, since heart-related complications are very common) Make it easier to control your blood glucose level As you may already know, losing weight can be a challenge, but don’t let that stop you. Do whatever you need to in order to stay motivated. It is the amount of calories we eat that contributes to weight gain. Make small changes. Learn portion sizes and reduce the amount of snacks in your day to reduce the total amount of calories you consume each day. Find cookbooks with healthier recipes using low-fat options. For a little fun, take our carb counting quiz to see how well you know the carb content of certain foods; this can help you make healthier choices. Work with a registered dietitian Continue reading >>
Mechanisms Of Weight Loss, Diabetes Control And Changes In Food Choices After Gastrointestinal Surgery.
Curr Atheroscler Rep. 2012 Dec;14(6):616-23. doi: 10.1007/s11883-012-0283-7. Mechanisms of weight loss, diabetes control and changes in food choices after gastrointestinal surgery. Imperial Weight Centre, Imperial College London, Fulham Palace Road, London W6 8RF, UK. [email protected] The long-term effects of lifestyle changes, diet and medical therapy on obesity are limited. Bariatric surgery is the most effective long-term treatment with the greatest chances for amelioration of obesity-associated complications, including type 2 diabetes mellitus (T2DM). There is increasing evidence in the literature that bariatric operations have a profound effect on human physiology, by reducing hunger, increasing satiety, paradoxically increasing energy expenditure, and even promoting healthy food preferences. Some of these operations improve glucose homeostasis in patients with T2DM independently of weight loss. Changes in the gut hormone levels of glucagon-like peptide 1, peptide YY and ghrelin have been proposed as some of the mediators implicated in changing physiology. The aim of this review is to critically explore the current knowledge on the putative mechanisms of the change in weight and improvement in T2DM glycaemic control after the most commonly performed bariatric operations. Continue reading >>
The Dilemma Of Weight Loss In Diabetes
People with diabetes receive mixed messages about weight loss from magazines, newspapers, friends, family, and, yes, even health professionals. Few subjects have accumulated as much misleading and potentially dangerous folklore as the subject of obesity. A common message is that losing weight is just a matter of willpower, and if you have been losing weight and reach a plateau, it's because you've lost your willpower and are no longer following your diet. Furthermore, for people with type 2 diabetes, the message often is that weight loss is the answer to improving glucose control: “If you just lose 20 lb, you won't need insulin.” What does research tell us about these issues, and what should our messages as health professionals be to people with diabetes? Obesity is a serious worldwide problem and is associated with the risk of developing diabetes. Today, more than 1.1 billion adults worldwide are overweight, and 312 million of them are obese.1 In the past 20 years, the rates of obesity have tripled in developing countries that have adopted a Western lifestyle, with the Middle East, Pacific Islands, Southeast Asia, India, and China facing the greatest increase. Consequently, the number of people with diabetes in these countries is expected to increase from 84 million in 2000 to 228 million by 2030. Thus, preventing obesity is a high priority for the prevention of diabetes and other chronic diseases. According to some obesity researchers, it may not be possible to decrease the current numbers of overweight and obese people in the United States, but we need to try to slow or prevent the increase that has been occurring at an alarming rate.2 The hope is that slowing the rising prevalence of obesity will also slow the diabetes epidemic. Can this be accomplished? Thus fa Continue reading >>
Why Does Diabetes Cause Weight Loss In Some People And Weight Gain In Some Others?
To understand dynamics of body weight first we have to understand Energy balance equation which states Calorie intake - calorie lost = Weight So if, Calorie intake > calorie lost = Weight Gain Calorie intake < calorie lost = Weight Loss Calorie intake = calorie lost = Weight is maintained Let's try to understand it in patients with diabetes Scenarios causing weight gain in Diabetes 1. In patients with type 2 Diabetes some may have predominantly insulin resistance ( cells are not as much sensitive to action of insulin as they should be ) This makes their pancreas to secrete excess insulin in an attempt to overcome this resistance . Excessive insulin coupled with high calorie intake causes weight gain 2. A patient of Type 1 Diabetes or type 2 Diabetes who has good control of glucose but consumes excess calories than he needs is bound to gain weight . A good number of patients resort to defensive eating for the fear of hypoglycemia and this also causes weight gain Scenarios causing weight loss in Diabetes 1. Any patient with uncontrolled diabetes will usually have weight loss . This is due to the fact that cells of our body are deprived of glucose as a source of energy and therefore body resorts to using fat and protein as alternative sources causing weight loss 2. A patient of Type 1 Diabetes or type 2 Diabetes who has good control of glucose but consumes less calories than he needs loses weight . In addition associated thyroid disorders may also have some influence on weight . Continue reading >>
