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BMI Decreased (bmi + decreased)
Selected AbstractsThe addition of metformin in type 1 diabetes improves insulin sensitivity, diabetic control, body composition and patient well-beingDIABETES OBESITY & METABOLISM, Issue 1 2007R. J. Moon Aim:, As many overweight people with T1DM are insulin resistant, adjuvant therapy with insulin sensitising agents, such as metformin, may be beneficial. This study evaluated the effect of adjuvant metformin in T1DM on insulin sensitivity, diabetic control, body composition, quality of life (QOL) and treatment satisfaction. Materials and Methods:, A 3-month prospective open-labelled pilot study of 16 patients aged 18-40 with T1DM and body mass index (BMI) >25 kg/m2 was performed. The patients received 500-850 mg metformin twice daily. Insulin sensitivity, assessed by a frequently sampled intravenous glucose tolerance test [n=5], body composition, HbA1c and quality of life (QOL) were measured before and after treatment. A retrospective review of 30 patients with T1DM treated with metformin for at least 4 months was also performed. BMI, HbA1c and insulin requirements during metformin treatment was compared to pre-metformin data, and to patients treated with insulin only. Results:, In the pilot study, insulin sensitivity increased significantly from 0.86 ± 0.33 × 10,4/min/(µU/ml) to 1.17 ± 0.48 × 10,4/min/(µU/ml) after 3 months adjuvant therapy (p = 0.043). This was associated with a decreased insulin requirement and mean daily blood glucose. There were no significant changes in HbA1c or body composition. QOL significantly improved (p < 0.002). The retrospective review revealed an initial reduction in HbA1c (0.8 ± 1.4%, p = 0.001). This effect diminished with prolonged treatment. BMI decreased in patients remaining on metformin for a 2-year period (0.5 ± 0.5kg/m2, p = 0.042). Conclusion:, Adjuvant metformin can improve QOL, insulin sensitivity and glycaemic control in overweight adults with T1DM. [source] Effects of a natural extract of (,)-hydroxycitric acid (HCA-SX) and a combination of HCA-SX plus niacin-bound chromium and Gymnema sylvestre extract on weight lossDIABETES OBESITY & METABOLISM, Issue 3 2004H. G. Preuss Aim:, The efficacy of optimal doses of highly bioavailable (,)-hydroxycitric acid (HCA-SX) alone and in combination with niacin-bound chromium (NBC) and a standardized Gymnema sylvestre extract (GSE) on weight loss in moderately obese subjects was evaluated by monitoring changes in body weight, body mass index (BMI), appetite, lipid profiles, serum leptin and excretion of urinary fat metabolites. HCA-SX has been shown to reduce appetite, inhibit fat synthesis and decrease body weight without stimulating the central nervous system. NBC has demonstrated its ability to maintain healthy insulin levels, while GSE has been shown to regulate weight loss and blood sugar levels. Methods:, A randomized, double-blind, placebo-controlled human study was conducted in Elluru, India for 8 weeks in 60 moderately obese subjects (ages 21,50, BMI >26 kg/m2). Subjects were randomly divided into three groups. Group A was administered HCA-SX 4667 mg, group B was administered a combination of HCA-SX 4667 mg, NBC 4 mg and GSE 400 mg, while group C was given placebo daily in three equally divided doses 30,60 min before meals. All subjects received a 2000 kcal diet/day and participated in supervised walking. Results:, At the end of 8 weeks, body weight and BMI decreased by 5,6% in both groups A and B. Food intake, total cholesterol, low-density lipoproteins, triglycerides and serum leptin levels were significantly reduced in both groups, while high-density lipoprotein levels and excretion of urinary fat metabolites increased in both groups. A marginal or non-significant effect was observed in all parameters in group C. Conclusion:, The present study shows that optimal doses of HCA-SX and, to a greater degree, the combination of HCA-SX, NBC and GSE can serve as an effective and safe weight-loss formula that can facilitate a reduction in excess body weight and BMI, while promoting healthy blood lipid levels. [source] Biphasic insulin aspart vs. human insulin in adolescents with type 1 diabetes on multiple daily insulin injectionsPEDIATRIC DIABETES, Issue 1 2006Henrik Mortensen Abstract:, The aim was to compare clinical efficacy and safety of two treatment regimens: biphasic insulin aspart (BIAsp) injected at all three meals plus neutral protamine Hagedorn (NPH) insulin at bedtime vs. a human insulin regimen, premixed human insulin at breakfast and soluble insulin at lunch and dinner and NPH at bedtime. A total of 167 adolescents (80 males and 87 females) with type 1 diabetes was included in the trial (multinational, randomized, open-label, and parallel group). Each subject received either of two treatment regimens for a 4-month period. BIAsp was injected immediately before main meals, human insulin products 30 min before meals, and NPH at night. Glycemic control was monitored by eight-point evaluations (after 6 and 16 wks) and hemoglobin A1c (HbA1c) (after 2, 6, and 16 wks). Safety evaluations included adverse events and incidence of hypoglycemic episodes. HbA1c (mean ± SD) after 4 months on BIAsp (9.39 ± 0.14) was not significantly different from that with human insulin (9.30 ± 0.15). The average postprandial glucose increment in the BIAsp group was about half the increment in the human insulin group; the difference not statistically significant. The body mass index (BMI) increased in both groups, but significantly (p = 0.005) less in the BIAsp group. However, in males on BIAsp, the BMI decreased compared with those on human insulin (p = 0.007). No significant group differences were found for the rate of hypoglycemic episodes. We concluded that the BIAsp regimen was associated with similar glycemic control and similar incidence of hypoglycemic episodes as human insulin. However, the BIAsp regimen caused a significantly smaller increase in BMI, particularly in males, compared with the human insulin regimen. [source] Open label study of the effect of amantadine on weight gain induced by olanzapinePSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 2 2004WON-MYONG BAHK md Abstract, The purpose of the present paper was to investigate the effects of the dopamine agonist amantadine in those patients with weight gain induced by olanzapine. An open trial was conducted in those patients who gained >3 kg in weight induced by olanzapine use. All subjects were evaluated by weight, body mass index (BMI), the Brief Psychiatric Rating Scale (BPRS), and the Extrapyramidal Symptom Rating Scale (ESRS) before and after the use of amantadine in addition to olanzapine. Twenty-five of 30 enrolled patients completed the present study. Mean bodyweight and BMI was increased by 6.44 ± 4.42 kg and 5.04 ± 3.47 kg/m2 significantly with olanzapine alone (P < 0.001). When amantadine and olanzapine were used together, the average weight and BMI decreased by 1.07 ± 3.19 kg and 0.84 ± 2.5 kg/m2, but did not have statistical significance. The average values of BPRS showed a significant decrease (P < 0.001). No significant changes were present in ESRS. Amantadine did not have an effect on weight gain induced by olanzapine. Randomized placebo-controlled prospective studies are needed. [source] Dietary intervention increases n-3 long-chain polyunsaturated fatty acids in skeletal muscle membrane phospholipids of obese subjects.CLINICAL ENDOCRINOLOGY, Issue 2 2006Implications for insulin sensitivity Summary Objective, Cross-sectional studies suggest that the fatty acid (FA) composition of phospholipids in skeletal muscle cell membrane may modulate insulin sensitivity in humans. We examined the impact of a hypocaloric low-fat dietary intervention on membrane FA composition and insulin sensitivity. Design, Muscle membrane FA profiles were determined in muscle (vastus lateralis) biopsies from 21 obese subjects before and after 6 months of dietary restriction. Diet instructions emphasized low intake of FA of marine origin by recommending lean fish and prohibiting fatty fish and fish oil supplements. Insulin resistance was estimated by the homeostasis model assessment (HOMA-IR). Results, The mean weight loss was 5·1 kg (range ,15·3 to +1·3 kg). BMI decreased from 36·5 to 34·9 kg/m2 (P = 0·003). Saturated FA (SFA) decreased 11% (P = 0·0001). Polyunsaturated FA (PUFA)n-6 increased 4% (P = 0·003). Long-chain PUFAn-3 increased 51% (P = 0·0001), mainly due to a 75% increase (P < 0·0001) in docosahexaenoic acid. Changes in HOMA-IR correlated significantly with changes in long-chain PUFAn-3 (R = ,0·57, P < 0·01), SFA (R = 0·58, P < 0·01) and waist circumference (R = 0·46, P < 0·05). A multivariate linear regression analysis that included changes in weight, fat mass, waist circumference, plasma lipids, PUFA, SFA and long-chain PUFAn-3 indicated that SFA and long-chain PUFAn-3 were independent predictors of HOMA-IR (R2 = 0·33, P < 0·01). Conclusions, A hypocaloric low-fat dietary intervention programme increased incorporation of long-chain PUFAn-3 and reduced SFA in skeletal muscle membrane phospholipids of obese subjects, a setting that may impact on insulin action. [source] Reduced gains in fat and fat-free mass, and elevated leptin levels in children and adolescents with cystic fibrosisACTA PAEDIATRICA, Issue 9 2004ML Ahmed Aim: Bodyweight is an important prognostic indicator in children with cystic fibrosis (CF), but the relationships between body composition and clinical outcomes are less clear. We have investigated the role of leptin (a potential satiety factor) and changes in body composition, height and weight with respect to age and clinical outcome. Methods: 143 children (77 boys) with CF and a median age (range) of 5.99 (2.27,17.98) y were followed with annual measurements of height, weight, skinfolds, forced expiratory volume (FEV1), Shwachman score assessment and fasting blood sample. Our control group comprised 40 children (20 boys, 20 girls) aged 8.6,10.2 y at recruitment who were participating in a longitudinal study of growth and puberty. Results: SD scores for height, weight and BMI decreased with age; fat and fat-free mass was lower in both sexes compared to controls. Shwachman score decreased with age in both sexes and was related to fat-free mass in girls, and to both fat-free and fat mass in boys. FEV1 decreased with age only in boys and was related to fat-free mass. Leptin levels by age and by fat mass were higher in CF children compared to controls. Conclusion: Despite improvements in management, contemporary children with CF still gain less body fat and fat-free mass and are shorter than controls. The higher leptin levels we observed may be due to stimulatory effects of inflammatory cytokines and we postulate that they may contribute to the anorexia, poor weight gain and growth of these children. [source] | ||||||||||