Changes in Energy Balance during Dapagliflozin Therapy in Type 2 Diabetes—The Energize Study

AbstractGender and biological sex impact the pathogenesis of numerous diseases, including metabolic disorders such as diabetes. In most parts of the world, diabetes is more prevalent in men than in women, especially in middle-aged populations. In line with this, considering almost all animal models, males are more likely to develop obesity, insulin resistance and hyperglycaemia than females in response to nutritional challenges. As summarised in this review, it is now obvious that many aspects of energy balance and glucose metabolism are regulated differently in males and females and influence their predisposition to type 2 diabetes. During their reproductive life, women exhibit specificities in energy partitioning as compared with men, with carbohydrate and lipid utilisation as fuel sources that favour energy storage in subcutaneous adipose tissues and preserve them from visceral and ectopic fat accumulation. Insulin sensitivity is higher in women, who are also characterised by higher capacities for insulin secretion and incretin responses than men; although, these sex advantages all disappear when glucose tolerance deteriorates towards diabetes. Clinical and experimental observations evidence the protective actions of endogenous oestrogens, mainly through oestrogen receptor α activation in various tissues, including the brain, the liver, skeletal muscle, adipose tissue and pancreatic beta cells. However, beside sex steroids, underlying mechanisms need to be further investigated, especially the role of sex chromosomes, fetal/neonatal programming and epigenetic modifications. On the path to precision medicine, further deciphering sex-specific traits in energy balance and glucose homeostasis is indeed a priority topic to optimise individual approaches in type 2 diabetes prevention and treatment.

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Modulation of energy balance by fibroblast growth factor 21

Hormone Molecular Biology and Clinical Investigation ◽

10.1515/hmbci-2016-0023 ◽

2016 ◽

Vol 30 (1) ◽

Cited By ~ 11

Author(s):

Daniel Cuevas-Ramos ◽

Carlos A. Aguilar-Salinas

Keyword(s):

Type 2 Diabetes ◽

Adipose Tissue ◽

Energy Balance ◽

Energy Expenditure ◽

Metabolic Diseases ◽

Fibroblast Growth Factor 21 ◽

Fibroblast Growth ◽

The Metabolic Syndrome ◽

Brown Adipose

AbstractFibroblast growth factors (FGFs) are a superfamily of 22 proteins related to cell proliferation and tissue repair after injury. A subgroup of three proteins, FGF19, FGF21, and FGF23, are major endocrine mediators. These three FGFs have low affinity to heparin sulfate during receptor binding; in contrast they have a strong interaction with the cofactor Klotho/β-Klotho. FGF21 has received particular attention because of its key role in carbohydrate, lipids, and energy balance regulation. FGF21 improves glucose and lipids metabolism as well as increasing energy expenditure in animal models and humans. Conditions that induce human physical stress such as exercise, lactation, obesity, insulin resistance, and type 2 diabetes influence FGF21 circulating levels. FGF21 also has an anti-oxidant function in human metabolic diseases which contribute to understanding the FGF21 compensatory increment in obesity, the metabolic syndrome, and type 2 diabetes. Interestingly, energy expenditure and weight loss is induced by FGF21. The mechanism involved is through “browning” of white adipose tissue, increasing brown adipose tissue activity and heat production. Therefore, clinical evaluation of therapeutic action of exogenous FGF21 administration is warranted, particularly to treat diabetes and obesity.

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Diet, obesity and diabetes: a current update

Clinical Science ◽

10.1042/cs20060150 ◽

2006 ◽

Vol 112 (2) ◽

pp. 93-111 ◽

Cited By ~ 34

Author(s):

Celia G. Walker ◽

M. Gulrez Zariwala ◽

Mark J. Holness ◽

Mary C. SUGDEN

Keyword(s):

Type 2 Diabetes ◽

Adipose Tissue ◽

Energy Balance ◽

Whole Body ◽

Primary Defect ◽

Obesity And Diabetes ◽

Tissue Factors ◽

Metabolic Conditions ◽

The Impact

The prevalence of obesity has been increasing at a rapid rate over the last few decades. Although the primary defect can be attributed to an imbalance of energy intake over energy expenditure, the regulation of energy balance is now recognized to be complex. Adipose-tissue factors play a central role in the control of energy balance and whole-body fuel homoeostasis. The regulation of adipose-tissue function, in particular its secretion of adipokines, is impaired by increases in adipose mass associated with obesity, and with the development of insulin resistance and Type 2 diabetes. This review analyses adipose-regulated energy input and expenditure, together with the impact of dietary macronutrient composition on energy balance in relation to susceptibility to the development of obesity and Type 2 diabetes, and how these metabolic conditions may be exacerbated by the consequences of abnormal adipose function. By gaining a greater understanding of how energy balance is controlled in normal, and in obese and diabetic states, a more practical approach can be employed to prevent and better treat obesity and metabolic disorders.

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Energy Balance, Obesity and Type-2 Diabetes

Encyclopedia of Life Sciences ◽

10.1002/9780470015902.a0021317 ◽

2009 ◽

Cited By ~ 1

Author(s):

M Daniel Lane

Keyword(s):

Type 2 Diabetes ◽

Energy Balance

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Energy balance and macronutrient distribution in relation to C-reactive protein and HbA1c levels among patients with type 2 diabetes

Food & Nutrition Research ◽

10.3402/fnr.v60.29904 ◽

2016 ◽

Vol 60 (1) ◽

pp. 29904 ◽

Cited By ~ 3

Author(s):

Hiba Bawadi ◽

Rami Katkhouda ◽

Ahmad Al-Haifi ◽

Reema Tayyem ◽

Cosette Fakih Elkhoury ◽

...

Keyword(s):

Type 2 Diabetes ◽

Energy Balance ◽

C Reactive Protein ◽

Reactive Protein ◽

Macronutrient Distribution ◽

Hba1c Levels

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Long-term changes in sleep duration, energy balance and risk of type 2 diabetes

Diabetologia ◽

10.1007/s00125-015-3775-5 ◽

2015 ◽

Vol 59 (1) ◽

pp. 101-109 ◽

Cited By ~ 17

Author(s):

Elizabeth M. Cespedes ◽

Shilpa N. Bhupathiraju ◽

Yanping Li ◽

Bernard Rosner ◽

Susan Redline ◽

...

Keyword(s):

Type 2 Diabetes ◽

Energy Balance ◽

Sleep Duration ◽

Long Term Changes

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Seafood intake and the development of obesity, insulin resistance and type 2 diabetes

Nutrition Research Reviews ◽

10.1017/s0954422418000240 ◽

2019 ◽

Vol 32 (1) ◽

pp. 146-167 ◽

Cited By ~ 10

Author(s):

Bjørn Liaset ◽

Jannike Øyen ◽

Hélène Jacques ◽

Karsten Kristiansen ◽

Lise Madsen

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Trace Elements ◽

Energy Balance ◽

Energy Intake ◽

Overweight And Obesity ◽

Positive Energy ◽

High Intake ◽

Positive Energy Balance

AbstractWe provide an overview of studies on seafood intake in relation to obesity, insulin resistance and type 2 diabetes. Overweight and obesity development is for most individuals the result of years of positive energy balance. Evidence from intervention trials and animal studies suggests that frequent intake of lean seafood, as compared with intake of terrestrial meats, reduces energy intake by 4–9 %, sufficient to prevent a positive energy balance and obesity. At equal energy intake, lean seafood reduces fasting and postprandial risk markers of insulin resistance, and improves insulin sensitivity in insulin-resistant adults. Energy restriction combined with intake of lean and fatty seafood seems to increase weight loss. Marinen-3 PUFA are probably of importance throughn-3 PUFA-derived lipid mediators such as endocannabinoids and oxylipins, but other constituents of seafood such as the fish proteinper se, trace elements or vitamins also seem to play a largely neglected role. A high intake of fatty seafood increases circulating levels of the insulin-sensitising hormone adiponectin. As compared with a high meat intake, high intake of seafood has been reported to reduce plasma levels of the hepatic acute-phase protein C-reactive protein level in some, but not all studies. More studies are needed to confirm the dietary effects on energy intake, obesity and insulin resistance. Future studies should be designed to elucidate the potential contribution of trace elements, vitamins and undesirables present in seafood, and we argue that stratification into responders and non-responders in randomised controlled trials may improve the understanding of health effects from intake of seafood.

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