Minimal Weight Gain Research Articles

Efficacy and safety of switching to insulin glargine 300 U/mL in people with type 2 diabetes uncontrolled on basal insulin in China: A post hoc subpopulation analysis of the INITIATION study.

To evaluate the efficacy and safety of insulin glargine 300 U/mL (Gla-300) in people with uncontrolled type 2 diabetes (T2D) switching from another basal insulin (BI). INITIATION was an interventional, single-arm, phase IV study conducted in China. In this post hoc subpopulation analysis, the efficacy and safety of switching to Gla-300 was investigated in individuals with uncontrolled T2D (HbA1c 7.5%-11.0% [58-97 mmol/mol]) with previous BI. The primary endpoint was HbA1c change at week 24. Other measures of glycaemia, hypoglycaemia, insulin dose and weight change were assessed. Three hundred and two participants switched to Gla-300 from another BI, including 232 from insulin glargine 100 U/mL (Gla-100) and 55 from insulin degludec (IDeg). At week 24, the mean ± standard error (SE) HbA1c change from baseline was -0.87% ± 0.06% (-9.5 ± 0.7 mmol/mol; p <0.001). Significant reductions in fasting plasma glucose (least-squares mean [LSM] change -1.13 mmol/L) and fasting self-measured blood glucose (LSM change -1.36 mmol/L) were also observed (both p <0.001). The mean daily BI dose increased from 18.86 U (0.27 U/kg) at baseline to 28.83 U (0.41 U/kg) at week 24. During the 24-week treatment period, the incidence of any hypoglycaemia was 43.8% for all hypoglycaemia and 15.1% for nocturnal hypoglycaemia; the incidence of severe hypoglycaemia was low (0.7%). Minimal body weight change was documented. Gla-300 improved glycaemic control with a relatively low hypoglycaemia risk and minimal weight gain in Chinese people with T2D uncontrolled on previous BI.

Precision medicine to identify, prevent, and treat pediatric obesity.

Pediatric obesity is a growing health concern that has many secondary adverse health implications. Personalized medicine is a tool that can be used to optimize diagnosis and treatments of many diseases. In this review, we will focus on three areas related to the genetics of pediatric obesity: (i) genetic causes predisposing to pediatric obesity, (ii) pharmacogenomics that may predict weight gain associated with pharmacotherapy, and (iii) pharmacogenomics of anti-obesity pharmacotherapy. This narrative review evaluates genetic cause of pediatric obesity and how genetic findings can be used to optimize pharmacotherapy to minimize weight gain and optimize obesity treatment in pediatric patients. Pediatric obesity has many genetic causes including genomic obesity syndromes and monogenic obesity disorders. Several genetic etiologies of obesity have current or emerging targeted genetic therapies. Pharmacogenomic (PGx) targets associated with pharmacotherapy-induced weight gain have been identified for antipsychotic, antiepileptic, antidepressant therapies, and steroids, yet to date no clinical guidelines exist for application use of PGx to tailor pharmacotherapy to avoid weight gain. As legislation evolves for genetic testing coverage and technology advances, this will decrease cost and expand access to genetic testing. This will result in identification of potential genetic causes of obesity and genes that predispose to pharmacotherapy-induced weight gain. Advances in precision medicine can ultimately lead to development of clinical practice guidelines on how to apply genetic findings to optimize pharmacotherapy to treat genetic targets of obesity and avoid weight gain as an adverse event associated with pharmacotherapy.

Corrosion resistance analysis of Al2O3-TiO2 composite ceramic coatings on carbon steel pipe surfaces

This study investigates the corrosion resistance of Al2O3-TiO2 composite coatings reinforced with multi-walled carbon nanotubes (MWCNTs) on carbon steel pipe surfaces. Coatings were deposited using atmospheric plasma spraying (APS) and high velocity oxy-fuel (HVOF) techniques. Microstructural analysis revealed that HVOF-sprayed coatings exhibited denser and more homogeneous structures compared to APS-sprayed coatings. Electrochemical tests in 3.5 wt% NaCl solution showed that the HVOF-sprayed Al2O3-13 wt% TiO2-1.5 wt% MWCNT coating demonstrated the lowest corrosion current density of 7.6 × 10−9 A/cm2 and the most positive corrosion potential. Hot corrosion tests in a simulated boiler environment (500°C, 1000 h) revealed that this coating also exhibited minimal weight gain (0.9 mg/cm2) and thickness loss (2 μm). The corrosion rate of the optimal coating was 0.05 mm/year, significantly lower than the bare carbon steel (2.45 mm/year). XRD analysis of corroded samples showed that HVOF-sprayed coatings maintained their original phase composition without detectable substrate corrosion products. The superior corrosion resistance of the HVOF-sprayed Al2O3-13 wt% TiO2-1.5 wt% MWCNT coating is attributed to its optimized composition, dense microstructure, and the reinforcing effect of MWCNTs. These findings provide valuable insights for developing advanced coating solutions to mitigate corrosion-related challenges in the oil and gas industry and other harsh industrial environments.

Zophobas morio versus Tenebrio molitor: Diversity in gut microbiota of larvae fed with polymers

Plastics are common synthetic materials that have been abundantly present as pollutants in natural ecosystems for the past few decades. Thus scientists have investigated the capability of plastic digestion by insects. Here we compare the effectiveness of biodegradation of the specific polymers: expanded polystyrene (EPS), polyvinyl chloride (PVC), low-density polyethylene (LDPE) and polypropylene (PP) altogether with above variants of plastics with microelements and vitamins by the mealworm – the larval form of the beetle Tenebrio molitor – and larvae of the beetle Zophobas morio, known as superworms. Z. morio beetles on all diets were able to complete their life cycle from larvae through pupae and imago, gaining 19 % and 22 % in mass on LDPE and EPS; 8 % and 7 % on PVC and PP. Mealworms (T. molitor) reared on polymers had minimal weight gain, gaining 2 % on LDPE and EPS, and a slight reduction in mass was observed when reared on PP and PVC. Not all specimens of T. molitor were able to pupate and transform to the adult stage. The results suggest that larvae of Z. morio can eat and degrade some types of plastic compounds more effectively than T. molitor. The changes in microbial gut communities were compared between these two species. The highest mass gain for Z. morio is associated with higher diversity in gut microbia and it was more diverse than that of T. molitor. Citrobacter freundii, a bacterium recognized for its ability to degrade long-chain polymers, linear hydrocarbons and cyclic hydrocarbons, was found in the microflora of Z. morio. The results confirm that superworms can survive on polymer feed. Moreover, this diet supplemented with microelements and vitamins increases the number of bacterial species and the diversity in the microbial gut.

Welfare evaluation of fat-rumped lambs under stall feeding condition with different feeder design

Animal welfare is directly related to animal performance and farm profit. It is associated with their autonomy to take feed and water along with a lack of discomfort. Feeding welfare determines farm profit as major cost of a farm is associated with feed. The objective of the study was to investigate the effect of feeder design on lamb welfare evaluated through feeding behaviour and lamb performance. Sixteen growing fat-rumped lambs of 3-4 months of age were categorized into two groups with an average weight of 23.20±0.25 kg. Group I lambs were fed in conventional feeder, i.e. without divider and group II in designed feeder, i.e. with divider, respectively. The eating time was significantly low in group I with longer and strong agonistic behaviour suggesting intense competition within the group. This group showed minimal weight gain and maximal feed wastage due to extreme struggle for food during the period of the study. The time spent in comfort behaviours like lying rumination was more and agonistic behaviour was less in group II lambs. They showed significantly higher bodyweight gain. It can be concluded from the study that group feeding of growing lambs in feeder with divider allocates designated space for individual lamb, reduces agonistic behaviour and brings better growth in lambs under stall feeding conditions.

Reducing or Discontinuing Insulin or Sulfonylurea When Initiating a Glucagon-like Peptide-1 Agonist.

Hypoglycemia and weight gain are well-known adverse effects of insulin and sulfonylureas in patients with type 2 diabetes. Glucagon-like peptide-1 (GLP-1) agonist monotherapy has a low incidence of hypoglycemia, but when combined with insulin or sulfonylureas, patients have higher rates of hypoglycemia. The primary study outcome was to determine the percentage of patients with dose reductions or discontinuation of insulin or a sulfonylurea at baseline, 3, 6, and 12 months. Secondary outcomes included changes in hemoglobin A1c and body weight measured. This was a single-center, quality assurance, quality improvement, retrospective chart review of patients prescribed a GLP-1 agonist while on insulin and/or a sulfonylurea between January 1, 2019, and September 30, 2022, at a pharmacist-led patient aligned care team (PACT) clinic at the Wilkes-Barre Veterans Affairs Medical Center. This retrospective chart review included 136 patients. Throughout 12 months of following the pharmacist-led PACT clinic, 55 patients (57.3%) had ≥ 1 insulin dose reduction, 16 patients (29.6%) had ≥ 1 dose reduction of a sulfonylurea, 14 patients (14.6%) discontinued insulin, and 21 patients (38.9%) discontinued their sulfonylurea. Patients taking insulin and/or sulfonylurea in combination with a GLP-1 agonist may require a dose reduction or discontinuation of the diabetic agents. Patients on both insulin and sulfonylurea may need closer monitoring due to the higher incidences of discontinuations compared with patients on only 1 of these agents. Dose reductions or discontinuations of these diabetic agents can promote positive patient outcomes, such as preventing hypoglycemia, minimizing weight gain, increasing weight loss, and reducing hemoglobin A1c.

Fish oil minimises feed intake and improves insulin sensitivity in Zucker fa/fa rats.

Long-chain n-3 PUFA (LC n-3 PUFA) prevent, in rodents, insulin resistance (IR) induced by a high-fat and/or fructose diet but not IR induced by glucocorticoids. In humans, contrasting effects have also been reported. We investigated their effects on insulin sensitivity, feed intake (FI) and body weight gain in genetically insulin resistant male obese (fa/fa) Zucker (ZO) rats during the development of obesity. ZO rats were fed a diet supplemented with 7 % fish oil (FO) + 1 % corn oil (CO) (wt/wt) (ZOFO), while the control group was fed a diet containing 8 % fat from CO (wt/wt) (ZOCO). Male lean Zucker (ZL) rats fed either FO (ZLFO) or CO (ZLCO) diet were used as controls. FO was a marine-derived TAG oil containing EPA 90 mg/g + DHA 430 mg/g. During an oral glucose tolerance test, glucose tolerance remained unaltered by FO while insulin response was reduced in ZOFO only. Liver insulin sensitivity (euglycaemic-hyperinsulinaemic clamp + 2 deoxyglucose) was improved in ZOFO rats, linked to changes in phosphoenolpyruvate carboxykinase expression, activity and glucose-6-phosphatase activity. FI in response to intra-carotid insulin/glucose infusion was decreased similarly in ZOFO and ZOCO. Hypothalamic ceramides levels were lower in ZOFO than in ZOCO. Our study demonstrates that LC n-3 PUFA can minimise weight gain, possibly by alleviating hypothalamic lipotoxicity, and liver IR in genetically obese Zucker rats.

Lurasidone for the Treatment of Schizophrenia: Design, Development, and Place in Therapy.

Thisreviewaims to provide a comprehensive overview of the current literature on the drug design, development, and therapy of lurasidone for the treatment of schizophrenia. Lurasidone has antagonistic effects on the dopamine D2, 5-hydroxytryptamine (5-HT)2A, and 5-HT7 receptors and a partial agonistic effect on the 5-HT1A receptor with low affinities for muscarinic M1, histamine H1, and a1 adrenergic receptors. The receptor-binding profile of lurasidone is thought to be associated with fewer side effects such as anticholinergic effects, lipid abnormalities, hyperglycemia, and weight gain. Behavioral pharmacological studies have demonstrated that lurasidone exerts anxiolytic and antidepressive effects and improves cognitive function, which are associated with the modulation of 5-HT7 and 5-HT1A receptors. Literature search using PubMed was performed to find published studies of randomized controlled trials and recent meta-analyses regarding efficacy and safety, particularly metabolic side effects of lurasidone in schizophrenia. In short-term studies, the results of randomized placebo-controlled trials and meta-analyses have suggested that lurasidone was superior to placebo in improving total psychopathology, positive symptoms, negative symptoms, and general psychopathology in patients with acute schizophrenia. Regarding safety, lurasidone had minimal metabolic side effects, and was identified as one of the drugs with the most benign profiles for metabolic side effects. Long-term trials revealed that lurasidone had the preventive effects on relapse, with minimal effects on weight gain and other metabolic side effects. Furthermore, lurasidone improves cognitive and functional performance of patients with schizophrenia, especially in long-term treatment. Patients with schizophrenia require long-term treatment with antipsychotics for relapse prevention; thus, minimizing weight gain and other side effects is crucial. Lurasidone is suitable as one of the first-line antipsychotic drugs in the acute phase, and a switching strategy should be considered during the maintenance phase, to balance efficacy and adverse effects and achieve favorable outcomes in the long-term course of schizophrenia.

NU-1223, a simplified analog of alstonine, with 5-HT2cR agonist-like activity, rescues memory deficit and positive and negative symptoms in subchronic phencyclidine mouse model of schizophrenia

The serotonin (5-HT)2 C receptor(R) is a widely distributed G-protein-coupled receptor, expressed abundantly in the central nervous system. Alstonine is a natural product that has significant properties of atypical antipsychotic drugs (AAPDs), in part attributed to 5-HT2 CR agonism. Based on alstonine, we developed NU-1223, a simplified β carboline analog of alstonine, which shows efficacies comparable to alstonine and to other 5-HT2 CR agonists, Ro-60–0175 and lorcaserin. The 5-HT2 CR antagonism of some APDs, including olanzapine, contributes to weight gain, a major side effect which limits its tolerability, while the 5-HT2 CR agonists and/or modulators, may minimize weight gain. We used the well-established rodent subchronic phencyclidine (PCP) model to test the efficacy of NU-1223 on episodic memory, using novel object recognition (NOR) task, positive (locomotor activity), and negative symptoms (social interaction) of schizophrenia (SCH). We found that NU-1223 produced both transient and prolonged rescue of the subchronic PCP-induced deficits in NOR and SI. Further, NU-1223, but not Ro-60–0175, blocked PCP and amphetamine (AMPH)-induced increase in LMA in subchronic PCP mice. These transient efficacies in LMA were blocked by the 5-HT2 CR antagonist, SB242084. Sub-chronic NU-1223 treatment rescued NOR and SI deficits in subchronic PCP mice for at least 39 days after 3 days injection. Chronic treatment with NU-1223, ip, twice a day for 21 days, did not increase average body weight vs olanzapine. These findings clearly indicate NU-1223 as a class of small molecules with a possible 5-HT2 CR-agonist-like mechanism of action, attributing to its efficacy. Additional in-depth receptor mechanistic studies are warranted, as this small molecule, both transiently and chronically rescued PCP-induced deficits. Furthermore, NU-1223 did not induce weight gain post long-term administrations vs AAPDs such as olanzapine, making NU-1223 a putative therapeutic compound for SCH.

Nuts, Energy Balance and Body Weight.

Over several decades, the health benefits of consuming nuts have been investigated, resulting in a large body of evidence that nuts can reduce the risk of chronic diseases. The consumption of nuts, being a higher-fat plant food, is restricted by some in order to minimize weight gain. In this review, we discuss several factors related to energy intake from nuts, including food matrix and its impact on digestibility, and the role of nuts in regulating appetite. We review the data from randomized controlled trials and observational studies conducted to examine the relationship between nut intake and body weight or body mass index. Consistently, the evidence from RCTs and observational cohorts indicates that higher nut consumption does not cause greater weight gain; rather, nuts may be beneficial for weight control and prevention of long-term weight gain. Multiple mechanisms likely contribute to these findings, including aspects of nut composition which affect nutrient and energy availability as well as satiety signaling.

Comparison of intermittent fasting and voluntary wheel running on physical and cognitive abilities in high-fat diet-induced obese rats.

Regular physical activity is a proven routine for weight management in addressing obesity. Another method that has gained attention for its health benefits is intermittent fasting (IF). Physical and cognitive abilities while on these routines are poorly understood in the obese population. Sixty-five male Sprague Dawley rats at 7 weeks of age were subjected to diet-induced obesity by feeding a high-fat diet (HFD) or a standard diet (SD) for 8 weeks, after which behavioral testing was performed to detect any changes in physical and cognitive abilities. Rats from the HFD-fed (now considered obese) and SD-fed groups were then subjected to IF (18-hour fast and 6-hour feeding daily), voluntary wheel running (VWR), or control conditions for 3 weeks before repeating the same behavioral testing protocol. IF resulted in less weight gain (p<0.05) and elevated ketone levels (p<0.05) in both SD and HFD-fed groups. IF improved physical activity when compared to VWR and control animals in both SD and HFD-fed groups (p<0.05) while the VWR group in the SD-fed rats exhibited less physical fatigue compared to IF and controls (p<0.05). Additionally, elevated ketone levels were weakly correlated with decreased physical (p<0.0001) and exploratory behavior (p<0.01). These results suggest that IF is more effective than VWR in HFD and SD-fed rats in minimizing weight gain and retaining physical activity, and ketones may play a part in establishing the reported physical benefits. Exploration of physiological mechanisms between ketones, diet, and exercise will help fight obesity and many associated diseases.

Effects of the Seed Oil of Carica papaya Linn on Food Consumption, Adiposity, Metabolic and Inflammatory Profile of Mice Using Hyperlipidic Diet.

Background: Studies indicate that different parts of Carica papaya Linn have nutritional properties that mean it can be used as an adjuvant for the treatment of various pathologies. Methods: The fatty acid composition of the oil extracted from the seeds of Carica papaya Linn was evaluated by gas chromatography, and an acute toxicity test was performed. For the experiment, Swiss mice were fed a balanced or high-fat diet and supplemented with saline, soybean oil, olive oil, or papaya seed oil. Oral glucose tolerance and insulin sensitivity tests were performed. After euthanasia, adiposity, glycemia, total cholesterol and fractions, insulin, resistin, leptin, MCP-1, TNF-α, and IL-6 and the histology of the liver, pancreas, and adipose tissue were evaluated. Results: Papaya seed oil showed predominance of monounsaturated fatty acids in its composition. No changes were observed in the acute toxicity test. Had lower food intake in grams, and caloric intake and in the area of adipocytes without minimizing weight gain or adiposity and impacting the liver or pancreas. Reductions in total and non-HDL-c, LDL-c, and VLDL-c were also observed. The treatment had a hypoglycemic and protective effect on insulin resistance. Supplementation also resulted in higher leptin and lower insulin and cytokine resistance. Conclusions: Under these experimental conditions, papaya seed oil led to higher amounts of monounsaturated fatty acids and had hypocholesterolemic, hypotriglyceridemic, and hypoglycemic effects.

Glycemic Treatment Effect of Oral Semaglutide Plus Other Antidiabetic Medications

A long-acting oral glucagon-like peptide-1 (GLP-1) receptor agonist, semaglutide is a new armamentarium to glycemic treatments. The Peptide Innovation for Early Diabetes Treatment (PIONEER) 3, 4, 5, 6, and 10 provided the necessary evidence on the efficacy of semaglutide in type 2 diabetes. The American Diabetes Association considers GLP-1 receptor agonists and insulin a high glycemic efficacy therapy. Further, a GLP-1 receptor agonist is recommended when there is a need for minimizing weight gain or promoting weight loss. There are no reports or clinical trials on oral semaglutide in Indian subjects with type 2 diabetes. We present seven case reports where semaglutide was initiated with other antidiabetic medications to bring the glycated hemoglobin (HbA1c) under target and promote weight loss. Between 45 days and 60 days of treatment with antidiabetic drugs, including semaglutide, resulted in a 1.5% reduction in HbA1c. A reduction in body weight ranged from 1.7 kg to 10 kg. Large-scale randomized trial in Indian patients is warranted to confirm our findings.

High temperature oxidation behavior of thermal and plasma processed aluminide coated Ti6Al4V alloys

In this study, the high temperature cyclic oxidation behavior of thermal and plasma-treated aluminide coated Ti6Al4V alloy was investigated at 800 °C up to 360 h in 24 h cyclic exposures. The microstructural characteristics, phase analysis, morphological features, and microhardness of resultant oxidized samples were evaluated and compared with those of untreated Ti6Al4V alloy. The weight gain studies conducted from the cyclic oxidation tests revealed very minimal weight gain in plasma treated (PT) aluminide coated samples as compared to the thermal treated (TT) and uncoated (UC) samples. XRD results indicate that the UC samples oxidized at 800 °C exhibits the formation of a thick oxide layer consisting of only the rutile phase (TiO2). The TT and PT samples oxidized at 800 °C revealed presence of both alumina (Al2O3) and rutile (TiO2) phases. However, PT samples revealed stable α-Al2O3 phase whereas the TT samples showed metastable θ-Al2O3 phases in the oxide layer. The surface morphological features reveal that the oxide film formed on the surface of the PT samples had enough stability at 800 °C irrespective of the oxidation time. The PT samples exhibited higher hardness and improved oxidation resistance as compared to TT and UC samples. Increase in thermal stability, mechanical and oxidation properties of PT samples could be attributed to the formation of stable alumina (α-Al2O3) and presence of nanocrystalline aluminide phases (TiAl3 & TiAl2) in the diffusion layers during the oxidation tests. Therefore, a strong emphasis was placed on correlating the interfacial processes to the high temperature oxidation behavior.

A New Medical Probiotic Formulation for the Nutritional Management of Type 2 Diabetes.

Clinical Pharmacology Update| October 14 2022 A New Medical Probiotic Formulation for the Nutritional Management of Type 2 Diabetes Jennifer D. Goldman 0000-0002-9617-3998 ; Jennifer D. Goldman 1Massachusetts College of Pharmacy and Health Sciences, Boston, MA2Well Life Medical, Peabody, MA Corresponding author: Jennifer D. Goldman, jennifer.goldman@mcphs.edu Search for other works by this author on: This Site PubMed Google Scholar Lana Dvorkin Camiel Lana Dvorkin Camiel 1Massachusetts College of Pharmacy and Health Sciences, Boston, MA Search for other works by this author on: This Site PubMed Google Scholar Corresponding author: Jennifer D. Goldman, jennifer.goldman@mcphs.edu Clin Diabetes 2022;40(4):500–502 https://doi.org/10.2337/cd22-0070 PubMed: 36385968 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Cite Icon Cite Get Permissions Citation Jennifer D. Goldman, Lana Dvorkin Camiel; A New Medical Probiotic Formulation for the Nutritional Management of Type 2 Diabetes. Clin Diabetes 14 October 2022; 40 (4): 500–502. https://doi.org/10.2337/cd22-0070 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsClinical Diabetes Search Advanced Search According to the Centers for Disease Control and Prevention (CDC), the prevalence of obesity among U.S. adults was 42.4% in 2017–2018 (1). The World Health Organization reports that >1 billion people worldwide have obesity. Complications associated with obesity include, but are not limited to, cardiovascular disease, diabetes, cancer, musculoskeletal disorders, and poorer outcomes from coronavirus disease 2019 (2). Type 2 diabetes rates go hand in hand with rates of obesity. The CDC estimates that 130 million U.S. adults are living with diabetes or prediabetes (3). The International Diabetes Federation estimates that 537 million adults worldwide have diabetes, and this number is predicted to increase to 643 million by 2030 and 783 million by 2045 (4). For people with type 2 diabetes, the American Diabetes Association (ADA) supports, in addition to lifestyle change, the use of pharmacological agents that minimize weight gain or... You do not currently have access to this content.

Obesity Prevention is the Key to a Nation’s Health

The overweight and obesity is increasing problem for the health care system and for the health of the general population. The number of overweight people with varying degrees of obesity is growing in most countries around the world each year, a third of the world’s population suffers from this condition. According to scientists, lack of sleep, stress, use of certain pharmacological drugs can lead to obesity. The causes and factors of weight gain are varied, not only in personal life, such as eating habits and physical activity, but also include factors that can not be controlled, such as environmental factors, socio-economic factors, genetic factors and more. Obesity is a major risk factor for many diseases such as diabetes, cardiovascular disease, stroke and some cancers. Obesity prevention should be one of the top priorities for the health care system. Preventive measures aimed to prevent the development of overweight and obesity have three levels of intervention: primary, secondary and tertiary. The purpose of the primary prevention is to minimize weight gain and prevent the development of overweight or obesity. Secondary prevention aimes to reduce the impact of the existing disease. Tertiary prevention concentraits on reduction of the complications that have developed as a result of the disease. To prevent overweight and obesity, doctors advise to limit the caloric content of diet by reducing the consumption of fats and sugars; increase the consumption of fruits and vegetables, as well as whole grains and nuts; perform regular exercise. Regular weighing by health professionals can help identify patterns and factors that contribute to weight gain. The success of obesity therapy depends on the patient’s trust to his doctor and the knowledge of the clinician in this area.

The Negative Impact of Routine, Dietary Pattern, and Physical Activity on Obesity and Dysglycemia During the COVID-19 Pandemic.

The global coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak, has disrupted routines in education, work, exercise, and dining habits. To prevent viral spread, communal spaces including offices, schools, restaurants, and gyms have closed or drastically limited their capacity. Additionally, government-mandated lockdown orders have forced people to spend more time at home. Studies have shown that these COVID-19 restrictions have led to unhealthier eating patterns, increased sedentary behaviors, and decreased physical activity, leading to weight gain, dysglycemia, and increased metabolic risk. While strict social distancing measures have been necessary to curb the spread of the SARS-CoV-2 virus, people have been forced to adapt by altering their daily routines. Based on existing literature, a model is proposed for intentionally creating daily routines to ensure healthy habits, minimize weight gain, and prevent worsening dysglycemia.

Apply Binary Logistic Regression Model to Recognize the Risk Factors of Diabetes through Measuring Glycated Hemoglobin Levels

This study aimed to identify diabetes risk factors in the Kurdistan Region of Iraq and explain why diabetes is rapidly spreading there, which examined some sociodemographic characteristics factors that might affect type 2 diabetes such as age, gender, alcohol consumption, and smoking, diabetes family history, and body weight. The data was collected from the hospital of diabetes named the center of diabetes in Sulaymaniyah city of Iraq, in which 218 diabetic cases were used for that purpose. According to the findings, some factors influence type 2 diabetes, such as Gender, Smoking, and Body Weight. For Gender, Females are more likely to have diabetes than males. Also, someone that smokes is more likely to have diabetes than those who do not smoke. Furthermore, with increasing each kilogram of body weight, the diabetes degree increases as well. On the other hand, regarding the results, some factors such as Age, Consumption of Alcoholic, and Diabetes Family History do not affect type 2 diabetes. Depending on the findings, it is recommended that people engage in regular physical activity and consume nutritious foods to minimize weight gain, which is one of the primary causes of diabetes as well as they should quit smoking.

Dysbetalipoproteinamia: Implications for Pre-Conception, Pregnancy and Beyond

Lead Author's Financial Disclosures Nothing to disclose. Study Funding None. Background/Synopsis A 41-year-old Chinese woman was referred to our Lipid Disorders Clinic with an elevated total cholesterol measuring 8.7mmol and triglycerides of 10.1mmol. She denied any previous history of pancreatitis. Her past medical history otherwise, was relatively unremarkable. She had an uncomplicated pregnancy and delivery 2 years ago. Family history did not reveal premature cardiovascular disease. Our patient's mother was diagnosed with hypercholesterolemia in her 60′s. Upon examination, there was no clinical stigmata of dyslipidemia. She was normotensive but overweight with a BMI of 28kg/m2. At initial review in clinic, she was 9 weeks pregnant in an unplanned pregnancy. She unfortunately lost this pregnancy a few weeks later. Genetic testing confirmed she was homozygous for ApoE2 allele. In addition, 2 variants were identified in ApoA5 showing c.553G>T and c.-644T>C. CT coronary calcium measured zero but hepatic steatosis was noted incidentally on imaging. Objective/Purpose This case raised a few challenges. Our patient was very keen to attempt a further pregnancy following a recent miscarriage. We discussed implications of dysbetalipoproteinamia in the pre-conception setting and strategies to manage a successful pregnancy safely. We also considered the longe-term cardiovascular risk to our patient in the setting of her genetic abnormalities. Methods The most common genetic cause of dysbetalipoproteinamia is homozygosity of the ApoE variant. ApoE2 can be regarded as a normal variant but in the presence of a metabolic stress such as elevated BMI in our patient's case, this may precipitate the dysbetalipoproteinamia phenotype in a recessive manner. In addition, current literature suggests her genetic mutations in ApoA5 is likely pathogenic, increasing her risk of atherosclerosis further. Our patient's ApoB was within normal limits measuring 0.87g/L. However, in dysbetalipoproteinamia, ApoB concentrations may be lower and thereby, cannot be relied on accurately to assess cardiovascular risk. Her recent calcium score of zero is reassuring but she has been counselled regarding the increased risk of cardiovascular and peripheral artery disease with her genotype. Results Current literature surrounding management of dysbetalipoproteinamia in pregnancy is limited; however, broad principles include lowering triglyceride levels to minimize risk of acute pancreatitis which carries significant morbidity in a pregnant individual. Our patient was on a statin prior to review in the lipid disorders clinic. This was discontinued as she was planning for a future pregnancy in the short term. A multidisciplinary approach was undertaken with referral to the dietician and a dedicated pre-conception clinic. Following adoption of a low fat diet, her lipid profile improved showing total cholesterol 5.9mmol, triglycerides 4.1mmol, LDL 3.0mmol and HDL 1.0mmol. She has also been advised to minimize weight gain in future pregnancies. Conclusions This is an interesting case of a young woman who presented with asymptomatic hypertriglyceridemia and subsequently found to be homozygous for ApoE2 with additional genetic mutation in ApoA5. As her primary concern was to conceive in the near future, management has been largely conservative with dietary modification and ongoing close monitoring of her lipid profile. Beyond pregnancy, it is vital her cardiovascular health is monitored closely due to increased atherogenic potential with her genotype. Nothing to disclose.

Determinants of severe bradycardia in adolescents hospitalized for anorexia nervosa.

Severe bradycardia is an indication supporting hospitalization in adolescents with eating disorders. Some adolescents with anorexia nervosa (AN) and significant weight loss present with a normal pulse rate at admission, whereas others have severe bradycardia, suggesting that total weight loss is not the most important determinant of bradycardia. The aims of this study were to define the prevalence of severe bradycardia as the cause for hospital admission in adolescents with AN, to evaluate correlations between known determinants of severe bradycardia and pulse rate at admission, and to evaluate the average time required to recover from severe bradycardia after re-feeding. Ninety-nine hospitalized patients with AN were enrolled. Weight loss history, anthropometric, laboratory, and electrocardiogram data were collected at admission to and at discharge from hospital. Multivariate analysis was performed to detect the most important determinants of severe bradycardia. Forty-eight percent of the AN patient admissions were due to severe bradycardia (AN-B+ group). Patients in this group had a higher maximum lifetime weight (P = 0.0045), greater premorbid weight loss (P = 0.0011), and more rapid weight loss (P = 0.0001). Multivariate analysis showed that recent weight loss is an independent predictor of bradycardia at hospital admission (R2 : 0.35, P = 0.0001). Severe bradycardia normalized after minimal weight gain of 0.25 ± 0.18 kg/day for 3-10 days. This study confirms that recent weight loss is probably the most important determinant of severe bradycardia in adolescents with AN.