Recent advances in understanding/managing type 2 diabetes mellitus

The treatment of type 2 diabetes mellitus has evolved in the present century toward safer and maybe more effective drugs, which in some cases can also reduce the risk of cardiovascular and renal outcomes. Nevertheless, we still need better strategies to reduce excess body weight in order to achieve diabetes remission, which is now a feasible target, as has been demonstrated with bariatric surgery. This review focuses on the significant advances in the management of blood glucose in type 2 diabetes mellitus, including the current understanding of the mechanisms of drug action but keeping in mind that the treatment of the disease is multifactorial.

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EFFECTS OF LONG-TERM ROUX-EN-Y GASTRIC BYPASS ON BODY WEIGHT AND CLINICAL METABOLIC COMORBIDITIES IN BARIATRIC SURGERY SERVICE OF A UNIVERSITY HOSPITAL

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-6720201600s10006 ◽

2016 ◽

Vol 29 (suppl 1) ◽

pp. 20-23 ◽

Cited By ~ 6

Author(s):

Cátia Ferreira da SILVA ◽

Larissa COHEN ◽

Luciana d'Abreu SARMENTO ◽

Felipe Monnerat Marino ROSA ◽

Eliane Lopes ROSADO ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Type 2 Diabetes ◽

Bariatric Surgery ◽

Gastric Bypass ◽

Type 2 Diabetes Mellitus ◽

Body Weight ◽

High Blood Pressure

ABSTRACT Background: Due to the high failure rate observed in the clinical treatment of morbid obesity an increase in bariatric surgery indications, as an alternative for the control of obesity and comorbidities, is noticeable. Aim: To evaluate the performance of type 2 diabetes mellitus, high blood pressure and dyslipidemia in patients submitted to Roux-en-Y gastric bypass in late follow-up. Methods: Retrospective analysis of 59 patients included in the bariatric surgery program. Anthropometric (height and body weight) and laboratory (LDLc, HDLc, VLDLc, triglyceride -TG - and glucose) data were collected on pre- and postoperative stages, through medical records. Results: Among the patients, 86% were female aged 43±11, of whom 52% had attended high school. The average postoperative time was 7±3 years. During the postoperative period, there were decreases of weight and body mass index, respectively (133±06 kg vs 91±04 kg p<0.05 e 49±74 kg/m2 vs 33±79 kg/m2, p<0.05). In comparison to the preoperative stage, lower concentrations of glucose (101.00±26.99 vs 89,11±15.19, p=0.014), total cholesterol rates (179.00±37,95 vs 167.48±28,50, p=0.016), LDLc (104.30±33.12 vs 91.46±24.58, p=0.016), VLDLc (25.40±11,12 vs 15.68±7.40, p<0.01), and TG (143.35±86.35 vs 82.45±37.39, p<0.01) and higher concentrations of HDLc (43.53±8.23 vs 57.90±15.60, p<0.01) were identified in the postoperative stage. 40% of hypertensive patients were still undergoing high blood pressure treatment during the postoperative stage. There was remission of type 2 diabetes mellitus and dyslipidemia on 81% and 94% of the cases, respectively. Conclusion: Roux-en-Y gastric bypass has proven itself to be an effective long term procedure, promoting weight loss, remission of DM2 and dyslipidemia.

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New glance at pathogenesis of type 2 diabetes mellitus: incretin and antiincretin systems.

Diabetes Mellitus ◽

10.14341/2072-0351-6220 ◽

2011 ◽

Vol 14 (3) ◽

pp. 26-29 ◽

Cited By ~ 4

Author(s):

Ekaterina Alekseevna Shestakova

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Bariatric Surgery ◽

Type 2 Diabetes Mellitus ◽

Body Weight ◽

Gastrointestinal Tract ◽

Glycemic Status ◽

Decrease Body Weight

Type 2 diabetes mellitus (T2 DM) is often seen in patients with obesity. Bariatric surgery, aimed to decrease body weight, can often help those patientsto improve glycemic status. After some of bariatric operations patients reach normoglycemia in few days, the fact that cant be explained onlyby reduction in weight. Recent trials revealed that the reorganization of gastrointestinal tract provides hypoglycemic effect of such operations. Thisarticle explains the role of proximal and distal gut in pathophysiology of T2 DM.

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The Role of Diet and Weight Loss in Improving Secondary Hypogonadism in Men with Obesity with or without Type 2 Diabetes Mellitus

Nutrients ◽

10.3390/nu11122975 ◽

2019 ◽

Vol 11 (12) ◽

pp. 2975 ◽

Cited By ~ 9

Author(s):

Vito Angelo Giagulli ◽

Marco Castellana ◽

Isanna Murro ◽

Carla Pelusi ◽

Edoardo Guastamacchia ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Weight Loss ◽

Type 2 Diabetes Mellitus ◽

Body Weight ◽

Excess Body Weight ◽

Bidirectional Relationship ◽

Secondary Hypogonadism

Despite growing recognition of the issue, obesity represents one of the most common public health problems, and its rates are still increasing globally. Among the number of comorbidities and complications associated with obesity, hypogonadism is listed, and this disorder, although frequently neglected, is characterized by a relevant impact on both quality of life and life expectancy. It is generally accepted that hypogonadism secondary to obesity is functional since it is reversible following weight loss. This review summarizes all current research examining the bidirectional relationship between excess body weight and low testosterone levels. Specifically, it evaluates the role that diet, with or without physical activity, plays in improving body weight and hypogonadism in adult and elderly men with obesity, with or without type 2 diabetes mellitus.

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Features of the impact of differentiated hypoglycemic therapy on carbohydrate metabolism and insulin resistance in patients with type 2 diabetes mellitus with excess body weight and obesity

Medicine of Ukraine ◽

10.37987/1997-9894.2016.7-8(203-4).205589 ◽

2016 ◽

Vol 0 (7-8(203-4)) ◽

pp. 61-65

Author(s):

K. Yu. Maliar ◽

O. I. Drishliuk ◽

T. V. Holovchenko ◽

O. P. Bespiata

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Body Weight ◽

Carbohydrate Metabolism ◽

Excess Body Weight ◽

Hypoglycemic Therapy ◽

The Impact

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Pathogenetic Changes in the Expression of Apoptotic Marker Caspase-3 in Patients with Type IІ Diabetes Mellitus and Excess Body Weight and Obesity

Ukraïnsʹkij žurnal medicini bìologìï ta sportu ◽

10.26693/jmbs05.05.185 ◽

2020 ◽

Vol 5 (5) ◽

pp. 185-191

Author(s):

A. A. Solovyuk ◽

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Body Mass Index ◽

Type 2 Diabetes Mellitus ◽

Body Weight ◽

Clinical Characteristics ◽

Caspase 3 ◽

Excess Body Weight ◽

Apoptosis Marker

The determination of molecular mechanisms, genetic control pathways, and modeling of apoptotic processes are necessary for understanding the pathogenesis of type 2 diabetes mellitus, especially in combination with obesity and excess body weight, which in the future may create prerequisites for the search for pathogenetic treatment. The purpose of the study was to assess the state of apoptosis processes in patients with type 2 diabetes mellitus in combination with excess body weight and obesity, depending on the clinical characteristics of the disease. Material and methods. 98 people with diabetes mellitus were examined. The first group consisted of 64 people with excess body weight and obesity (body mass index >25). The second group included 34 people with type 2 diabetes mellitus and normal body weight (body mass index ≤25). The control group consisted of 28 practically healthy individuals, who were comparable to the first and second groups by gender and age. Results and discussion. The presence of type 2 diabetes mellitus, excess body weight and obesity in patients led to increasing the level of the marker of apoptotic death of body cells – caspase-3 by 16.52%. Patients with glycated hemoglobin HbA1c more than 8% showed an increase in caspase-3 compared with patients with compensated diabetes mellitus; the difference was more pronounced in patients with excess body weight and obesity (19.13%, p <0.05). An increase in the duration of type 2 diabetes mellitus led to the activation of apoptosis processes, which was manifested in the rise of the studied apoptosis marker, caspase-3, both in patients with and without obesity (p <0.05). The development of the complication of type 2 diabetes mellitus in obese patients increased caspase-3 levels by 29.04% (p <0.05) in the absence of significant changes in this marker in patients with type 2 diabetes mellitus without obesity. Conclusion. The dynamics of apoptotic processes in patients with type 2 diabetes mellitus combined with and obesity, depending on the clinical characteristics of patients, is closely related to the level of apoptosis marker – caspase of the cysteine proteinase group – caspase-3

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