Study on the Correlation between Metabolism, Insulin Sensitivity and progressive weight loss change in Type-2 Diabetes.

De-Xian Kong,Zhen-Xi Zhang,Ya-Bin Liu,Yan-Xin Xiao

doi:10.12669/pjms.36.7.3027

Abstract

Objective:To observe the changes of lipid metabolism, blood glucose level and insulin sensitivity in patients with Type-2 diabetes after progressive weight loss of their body weight, so as to lay a theoretical foundation for diabetes treatment and education in the future.Methods:One hundred obese patients with Type-2 diabetes (BMI ≥ 25 kg/m2) who visited the endocrinology department of our hospital from April 2017 to April 2018 were given diabetes health education, diabetic diet, exercise and other measures to control their weight. The changes of blood glucose, blood lipid, insulin level and insulin release test before weight loss (T1), and at the time points of weight loss reached 5% (T2), 10% (T3) and 15% (T4) were recorded respectively to understand the influence of progressive weight loss on relevant indexes of patients.Results:With the decrease of body weight, the differences of TC, TG, LDL-C and HDL-C at different weight loss points were significant (p < 0.05), and the changes of fasting blood glucose in 5% and 10% weight loss were significant (p = 0.02). The 2h postprandial blood glucose showed the most significant difference when the weight loss reached 15% (p = 0.00). There was no statistical difference in the change of glycosylated hemoglobin among different weight loss points (p = 0.08). When the weight loss reached 10%, the blood insulin level was significantly lower than that before the weight loss, while the insulin level was not significantly changed when the weight loss reached 15%, but the peak of secretion was shifted forward. It is suggested that insulin sensitivity gradually increases with weight loss.Conclusion:Obese patients with Type-2 diabetes can benefit from weight loss, with abnormal blood glucose and lipid metabolism improved, insulin resistance relieved, and insulin sensitivity increased.

Highlights

With the improvement of people’s life style and changes in their living behaviors, the incidence of Type-2 diabetes is increasing year by year, which is accompanied by the prevalence of obesity and overweight.[1]
Obese patients suffer from insulin sensitivity reduction and insulin resistance formation due to the decrease of insulin receptor density in fat, causing hyperinsulinemia, which plays an important role in the occurrence and development of cardiovascular and
total cholesterol (TC), TG, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) had significant difference in different weight loss points (p

Summary

Introduction

With the improvement of people’s life style and changes in their living behaviors, the incidence of Type-2 diabetes is increasing year by year, which is accompanied by the prevalence of obesity and overweight.[1] Obese patients suffer from insulin sensitivity reduction and insulin resistance formation due to the decrease of insulin receptor density in fat, causing hyperinsulinemia, which plays an important role in the occurrence and development of cardiovascular and. Cerebrovascular related diseases and neurological diseases of patients, and weight loss may constitute an important part of comprehensive treatment for patients with Type-2 diabetes.[2,3,4,5] It is recommended in the guidelines for obesity that appropriate 5 10% weight loss can achieve significant metabolic improvement. The metabolic benefits can be achieved by 5% weight loss, and more benefits can be realized by further weight loss.[6,7,8] At present, no studies have found that the results of 5% weight loss are different from those of 10% and 15% weight loss, whether in prospective or retrospective studies

Methods

Results

Conclusion