Non-obese Diabetics Research Articles

Metformin Increases Cortisol Regeneration by 11βHSD1 in Obese Men With and Without Type 2 Diabetes Mellitus.

Context:The mechanism of action of metformin remains unclear. Given the regulation of the cortisol-regenerating enzyme 11βhydroxysteroid dehydrogenase 1 (11βHSD1) by insulin and the limited efficacy of selective 11βHSD1 inhibitors to lower blood glucose when co-prescribed with metformin, we hypothesized that metformin reduces 11βHSD1 activity.Objective:To determine whether metformin regulates 11βHSD1 activity in vivo in obese men with and without type 2 diabetes mellitus.Design:Double-blind, randomized, placebo-controlled, crossover study.Setting:A hospital clinical research facility.Participants:Eight obese nondiabetic (OND) men and eight obese men with type 2 diabetes (ODM).Intervention:Participants received 28 days of metformin (1 g twice daily), placebo, or (in the ODM group) gliclazide (80 mg twice daily) in random order. A deuterated cortisol infusion at the end of each phase measured cortisol regeneration by 11βHSD1. Oral cortisone was given to measure hepatic 11βHSD1 activity in the ODM group. The effect of metformin on 11βHSD1 was also assessed in human hepatocytes and Simpson-Golabi-Behmel syndrome adipocytes.Main Outcome Measures:The effect of metformin on whole-body and hepatic 11βHSD1 activity.Results:Whole-body 11βHSD1 activity was approximately 25% higher in the ODM group than the OND group. Metformin increased whole-body cortisol regeneration by 11βHSD1 in both groups compared with placebo and gliclazide and tended to increase hepatic 11βHSD1 activity. In vitro, metformin did not increase 11βHSD1 activity in hepatocytes or adipocytes.Conclusions:Metformin increases whole-body cortisol generation by 11βHSD1 probably through an indirect mechanism, potentially offsetting other metabolic benefits of metformin. Co-prescription with metformin should provide a greater target for selective 11βHSD1 inhibitors.

Linearity of β-cell response across the metabolic spectrum and to pharmacology: insights from a graded glucose infusion-based investigation series

The graded glucose infusion (GGI) examines insulin secretory response patterns to continuously escalating glycemia. The current study series sought to more fully appraise its performance characteristics. Key questions addressed were comparison of the GGI to the hyperglycemic clamp (HGC), comparison of insulin secretory response patterns across three volunteer populations known to differ in β-cell function (healthy nonobese, obese nondiabetic, and type 2 diabetic), and characterization of effects of known insulin secretagogues in the context of a GGI. Insulin secretory response was measured as changes in insulin, C-peptide, insulin secretion rates (ISR), and ratio of ISR to prevailing glucose (ISR/G). The GGI correlated well with the HGC (r = 0.72 for ISR/G, P < 0.01). The insulin secretory response in type 2 diabetes (T2DM) was significantly blunted (P < 0.001), whereas it was significantly increased in obese nondiabetics compared with healthy nonobese (P < 0.001). Finally, robust (P < 0.001 over placebo) pharmacological effects were observed in T2DM and healthy nonobese volunteers. Collectively, the findings of this investigational series bolster confidence that the GGI has solid attributes for assessing insulin secretory response to glucose across populations and pharmacology. Notably, the coupling of insulin secretory response to glycemic changes was distinctly and uniformly linear across populations and in the context of insulin secretagogues. (Clinical Trial Registration Nos. NCT00782418, NCT01055340, NCT01373450).

Metabolic Status of Lean, Overweight, and Obese Type 2 Diabetes Mellitus Patients

ABSTRACT Aims To compare metabolic status of lean vs overweight/ obese type 2 diabetes mellitus (T2DM) patients and correlate biochemical parameters with anthropometric measures. Materials and methods A total of 100 T2DM patients were categorized as lean and overweight/obese according to body mass index (BMI); 50 age- and sex-matched healthy controls were selected. Anthropometric measures of BMI, waist circumference (WC), and waist:hip (W:H) were recorded. Fasting blood samples were assayed for fasting plasma glucose (FPG), serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), and nonesterified free fatty acids (NEFA). Low-density lipoprotein (LDL) was calculated by Friedewald's formula and TG: HDL was measured as measure of insulin resistance (IR). Results Anthropometric measures of overall (BMI 31.65 ± 5.49, 20.34 ± 2.45 vs 22.29 ± 3.21) and visceral adiposity (WC 91.98 ± 6.8, 75.45 ± 4.34 vs 74.19 ± 3.98 and W:H 0.99 ± 0.12, 0.78 ± 0.21 vs 0.76 ± 0.32) were significantly higher in overweight/ obese (p &lt; 0.05) compared with lean T2DM and controls. Total cholesterol, TG, LDL, and NEFA were significantly raised and HDL decreased in T2DM compared with those of controls. But much higher values were observed in overweight/obese than in lean group. Triglycerides: HDL was significantly higher in obese than in lean patients (4.66 ± 1.89 vs 7.91 ± 3.01), confirming significantly decreased insulin sensitivity among obese than non-obese diabetics. Positive correlation was observed between BMI, WC, W:H and TC, TG, LDL, NEFA, and TG:HDL, while negative correlation was observed with HDL in obese group. Lean individuals with normal BMI, WC had deranged lipids with IR. Conclusion Lean and obese T2DM have dyslipidemia and IR. Poor metabolic profile is associated with overall and visceral adiposity in obese and not in lean T2DM individuals. How to cite this article Asegaonkar SB, Kareem I, Aghade S, Pagdhune A, Thorat A, Borkar MS. Metabolic Status of Lean, Overweight, and Obese Type 2 Diabetes Mellitus Patients. Indian J Med Biochem 2016;20(1):6-10.

Comparative lipid profile of Type 2 obese diabetics and obese nondiabetics: A hospital based study from hilly terrains of Mandi, Himachal Pradesh

Comparative lipid profile of Type 2 obese diabetics and obese nondiabetics: A hospital based study from hilly terrains of Mandi, Himachal Pradesh

A humoral immune defect distinguishes the response to Staphylococcus aureus infections in mice with obesity and type 2 diabetes from that in mice with type 1 diabetes.

Obesity and diabetes are among the greatest risk factors for infection following total joint arthroplasty. However, the underlying mechanism of susceptibility is unclear. We compared orthopedic implant-associated Staphylococcus aureus infections in type 1 (T1D) versus type 2 (T2D) diabetic mouse models and in patients with S. aureus infections, focusing on the adaptive immune response. Mice were fed a high-fat diet to initiate obesity and T2D. T1D was initiated with streptozotocin. Mice were then given a trans-tibial implant that was precoated with bioluminescent Xen36 S. aureus. Although both mouse models of diabetes demonstrated worse infection severity than controls, infection in T2D mice was more severe, as indicated by increases in bioluminescence, S. aureus CFU in tissue, and death within the first 7 days. Furthermore, T2D mice had an impaired humoral immune response at day 14 with reduced total IgG, decreased S. aureus-specific IgG, and increased IgM. These changes were not present in T1D mice. Similarly, T2D patients and obese nondiabetics with active S. aureus infections had a blunted IgG response to S. aureus. In conclusion, we report the first evidence of a humoral immune deficit, possibly due to an immunoglobulin class switch defect, in obesity and T2D during exacerbated S. aureus infection which may contribute to the increased infection risk following arthroplasty in patients with T2D and obesity.

Obesity or diabetes: which is more hazardous to the health of the offspring?

Objective: To examine impact on perinatal outcome of untreated gestational diabetes (GDM) and non-diabetics stratified by body mass index (BMI).Research design and methods: This is a secondary analysis of our investigation of the consequences of not treating GDM. We evaluated 555 untreated GDMs matched to 1100 non-diabetics. BMI was determined using subjects’ recalled pre-pregnancy weight. A primary composite variable consisted of stillbirth, neonatal macrosomia/large-for-gestational-age (LGA), neonatal hypoglycemia, erythrocytosis and hyperbilirubinemia. Secondary outcomes included shoulder dystocia, respiratory complications, cesarean delivery and pregnancy-related hypertension.Results: Untreated subjects in the normal weight category had an ∼2-fold increase for composite outcome and LGA and a 7-fold increase in metabolic complications. The overweight untreated group showed composite outcome, LGA and metabolic complications 2–3-fold higher and induction of labor 5-fold higher. For obese untreated GDMs, significantly higher rates of composite outcome, LGA and metabolic complications, induction of labor and cesarean delivery were 10-, 3-, 5-, 4- and 9-fold, respectively. Perinatal outcome for normal weight untreated GDM was similar to obese non-diabetics.Conclusions: Maternal obesity and GDM independently affect adverse pregnancy outcome. The combination has a greater impact than each one alone. However, glycemic level contributes a greater portion to the adverse pregnancy equation.

A comparative study of epicardial fat thickness and its association with abdominal visceral fat thickness in obese and nonobese type 2 diabetes subjects

Context:The concept of visceral fat and its role in various metabolic disorders is well-known. Epicardial fat (EF) is also visceral fat, and very few studies are done, especially in the Indian subcontinent.Aims:To study and establish the relationship of EF thickness (EFT) and abdominal visceral fat thickness (VAT) in obese and nonobese type 2 diabetics and to evaluate the usefulness of EFT as a marker of visceral adiposity.Settings and Designs:This cross-sectional study was carried out in the Department of Medicine, JSS Hospital, Mysore, India, between October 2012 and October 2014.Materials and Methods:A total of 68 patients were studied. Patients underwent transthoracic echocardiography and ultrasound abdomen. EFT and VAT were measured.Statistical Analysis:SPSS version 17.0 (SPSS Inc., Chicago, IL, USA) was used. T-test used for comparing quantitative variables. Correlation analysis was done using Pearson correlation test. P ≤ 0.05 was considered statistically significant. Kruskal-Wallis and Mann-Whitney test were used for analysis.Results:The mean value of EFT was 5.92 mm, 7.43 mm, 12.97 mm, 11.27 mm, and 13.8 mm for nonobese, obesity Grade I, II, III, and morbid, respectively (P < 0.0001). The mean EFT between nonobese and obese diabetics was 5.92 mm and 10.2 mm, respectively (P < 0.0001). The mean VAT between nonobese and obese diabetics was 16.58 mm and 38.53 mm, respectively. EFT was significantly correlating with VAT in obese diabetics.Conclusion:EFT and VAT were significantly correlated among obese diabetics while not significantly correlated among nonobese diabetics, suggesting obesity is an independent risk factor for visceral adipose tissue deposition both in abdomen as well as in epicardial surface.

Evaluation of BMI and Lipids Profile in Type 2 Diabetic Subjects with Low and Raised Levels of Thyroid Hormone in Calabar, Nigeria

Relationship between lipid levels and BMI was investigated in euthyroid, hyperthyroid, hypothyroid, general Type 2 diabetics, and non-diabetic control subjects. FT4, T4, T3 and TSH did not differ in obese and non-obese diabetics but were higher in diabetics than in non-diabetics (p = 0.015, 0.012, 0.0164 respectively). Levels of FT4 correlated with TC, LDL-C, VLDL-C, TG and HDL-C (r = 0.179, p = 0.034; r = 0.183, p = 0.033; r = 0.183 p = 0,033; r = 0.176, p = 0.037; r = -0.210, p = 0.023 respectively). T3 levels correlated with TC (r = 0.210: p = 0.023), LDL-C (r = 0.193: p = 0.025), and VLDL-C (r = 0.244: p = 0.003) levels in diabetic subjects. FT4 and T4 levels correlated with BMI only in the non-diabetic subjects (p = 0.022, 0.025) respectively. TC and LDL-C levels correlated positively with BMI in non-diabetics (r = 0.265, p = 0.006; r = 0.249, p = 0.010), general diabetics (r = 0.247, p = 0.016; r = 0.291, p = 0.002), euthyroid (r = 0.274, p =0.017; r = 0.252, p = 0.022) and hyperthyroid (r = 0295, p = 0.008; r = 0.346, p = 0.002) diabetics respectively. There were negative correlations between BMI and HDL-C in the diabetics (r = -0.188, p = 0.018) and euthyroid (r = -0.273, p =0.018) groups. Atherogenic index correlated negatively with BMI in all 5 groups of subjects. The coexistence of both low and raised levels of thyroid hormones in the diabetic population altered the levels and interrelationship between lipids and BMI. Altered levels of FT4 observed in Type 2 diabetics emanated from diabetes not obesity. Atherogenic index is an efficient indicator of atherogenic risk irrespective of complications.

Tissue factor expression in obese type 2 diabetic subjects and its regulation by antidiabetic agents.

Objective. Increased coagulation activation may contribute to the high incidence of cardiovascular complications observed in obese and type 2 diabetes (T2D) subjects. Although tissue factor (TF), the primary initiator of coagulation is increased in obesity, its expression in adipose tissues and its association with metabolic parameters are unclear. We sought to compare TF expression in plasma and adipose tissues of obese subjects with and without T2D, its correlation with metabolic parameters, and regulation in response to antidiabetic drugs. Methods Subjects were recruited from diabetes clinics and adipose tissue was obtained by needle biopsy of lower subcutaneous abdominal depot. For the intervention study, subjects were randomized into treatment groups with rosiglitazone or metformin for 4 months. Results. Plasma TF antigen, activity, and adipose TF mRNA were greater in obese T2D subjects compared with obese nondiabetics. Plasma TF activity correlated with fasting insulin, glucose, and free fatty acids, (FFAs), and adipose TF mRNA correlated with plasma FFA. Plasma TF activity was reduced by metformin and increased with rosiglitazone treatment. Conclusions. Specific diabetes-related metabolic parameters, but not obesity per se, are correlated with TF expression. Regulation of TF activity by different classes of antidiabetic drugs may relate to protective or adverse cardiovascular outcomes.

English

Diabetes is a group of metabolic diseases characterized by high blood glucose levels while obesity is accumulation of excess body fat. Diabetes and obesity currently threaten the health, wellbeing and economic welfare of humanity OBJECTIVE: To study serum lipid profiles in Obese type 2 diabetics in comparison with Obese non-diabetic subjects. MATERIALS AND METHODS: The study was conducted in the Department of Biochemistry in collaboration with Department of Medicine, Sri Aurobindo Medical College & Post Graduate Institute, Indore. In this study a total of 200 subjects included, out of which 100 type 2 diabetic patients with obesity (BMI ≥30 kg/m²) taken as cases and 100 obese patients without diabetes mellitus are taken as controls as per the criteria of study design and their serum lipid profile was analyzed & computed. RESULTS: Majority of the study population were males in both cases and controls. No significant differences were observed between different age categories between cases and controls. In cases the mean TC levels, TG levels, LDLc levels, VLDLc levels found to be 225.95±24.51mg%, 175.35±24.45 mg%, 170.77±18.86 mg%, 35.03±4.89 mg% and it was found to be higher than controls. However, the mean HDLc value and the HDLc /LDLc ratio was found to be 37.03±7.84 mg% and 0.44±0.25 which was higher than those reported in the cases. A significant difference (P<0.0001) was found between cases and control population when the serum TC, TG, HDLc values, LDLc values, VLDLc values, HDLc /LDLc ratio were compared between them. CONCLUSION: Dyslipidemia is more in obese diabetics than obese non diabetics and it can be prevented with proper monitoring and therapy to avoid associated comorbidity of diabetes mellitus.

T Regulatory Cell Adoptive Therapy for Tolerance Induction in Autoimmunity and Transplantation

T Regulatory Cell Adoptive Therapy for Tolerance Induction in Autoimmunity and Transplantation

Ectopic fat storage in the pancreas using 1H-MRS: importance of diabetic status and modulation with bariatric surgery-induced weight loss.

Recent literature suggests that ectopic fat deposition in the pancreas may contribute to endocrine and exocrine organ dysfunction, such as type 2 diabetes (T2D), pancreatitis or pancreatic cancer. The aim of this study was to determine factors associated with pancreatic triglyceride content (PTGC), and to investigate the impact of bariatric surgery on ectopic fat pads, pancreatic fat (PTGC) and hepatic fat (HTGC). In all, 45 subjects (13 lean, 13 obese nondiabetics and 19 T2D, matched for age and gender) underwent 1H-magnetic resonance spectroscopy, computed tomography of the visceral abdominal fat, metabolic and lipidomic analysis, including insulin-resistance homeostasis model assessment (HOMA-IR), insulin-secretion homeostasis model assessment (HOMA-B) and plasma fatty-acid composition. Twenty obese subjects were reassessed 6 months after the bariatric surgery. PTGC was significantly higher in type 2 diabetic subjects (23.8±3.2%) compared with obese (14.0±3.3; P=0.03) and lean subjects (7.5±0.9%; P=0.0002). PTGC remained significantly associated with T2D after adjusting for age and sex (β=0.47; P=0.004) or even after adjusting for waist circumference, triglycerides and HOMA-IR (β=0.32; P=0.04). T2D, C18:1n-9 (oleic acid), uric acid, triglycerides and plasminogen activator inhibitor-1 were the five more important parameters involved in PTGC prediction (explained 80% of PTGC variance). Bariatric surgery induced a huge reduction of both HTGC (-51.2±7.9%) and PTGC (-43.8±7.0%) reaching lean levels, whereas body mass index remained greatly elevated. An improvement of insulin resistance HOMA-IR and no change in HOMA-B were observed after bariatric surgery. The PTGC or HTGC losses were not correlated, suggesting tissue-specific mobilization of these ectopic fat stores. Pancreatic fat increased with T2D and drastically decreased after the bariatric surgery. This suggests that decreased PTGC may contribute to improved beta cell function seen after the bariatric surgery. Further, long-term interventional studies are warranted to examine this hypothesis and to determine the degree to which ectopic fat mobilization may mediate the improvement in endocrine and exocrine pancreatic functions.

Extremes of body mass index and mortality among Asian peritoneal dialysis patients.

Extremes of body mass index and mortality among Asian peritoneal dialysis patients.

Cardiovagal Modulation and Efficacy of Aerobic Exercise Training in Obese Individuals

Type 2 diabetes (T2D) is associated with poor exercise tolerance and peak aerobic capacity (V˙O2peak) even when compared to obese nondiabetic peers. Exercise training studies have demonstrated improvements in V˙O2peak among patients with T2D, yet there is a large amount of variability in this response. Recent evidence suggests that cardiac autonomic modulation may be an important factor when considering improvements in aerobic capacity. This study aimed to determine the effects of a 16-wk aerobic exercise program on V˙O2peak in obese individuals, with and without T2D, who were classified as having either high or low cardiovagal modulation (HCVM or LCVM) at baseline. Obese individuals (38 women and 19 men; body mass index = 36.1 kg·m(-2)) were studied in the fasted state. ECG recordings were obtained while seated for 3 min, before and after 4 months of exercise training (4 d·wk(-1), 65% V˙O(2peak)). The ECG recording was analyzed for HR variability in the spectral domain. Groups were split on a marker of CVM (normalized high frequency (HFnu)) at the 50th percentile, as either HCVM or LCVM. V˙O(2peak) only increased with exercise training among those classified as having HCVM, regardless of diabetes status (T2D: HCVM = 20.3-22.5 mL·kg(-1)min(-1), LCVM = 24.3-25.0 mL·kg(-1)min(-1); obese nondiabetics: HCVM = 24.5-26.3 mL·kg(-1)min(-1), LCVM = 23.1-23.7 mL·kg(-1)min(-1)) (P < 0.05). No change in V˙O(2peak) was observed for the LCVM group. Changes in weight do not explain the change in V˙O(2peak) among the HCVM group. Glucose tolerance only improved among the LCVM group with T2D. Obese individuals, with or without T2D, when classified as having relatively HCVM before exercise training, have a greater propensity to improve V˙O(2peak) after a 16-wk aerobic training program.

Correlation of abdominal adiposity with components of metabolic syndrome, anthropometric parameters and Insulin resistance, in obese and non obese, diabetics and non diabetics: A cross sectional observational study. (Mysore Visceral Adiposity in Diabetes Study).

Objectives:To measure Visceral Fat (VF) and Subcutaneous Fat (SCF) by ultrasound, in obese and non-obese diabetics and obese and non-obese non diabetics, in a South Indian (Asian Indian) Population and correlate them with Body Mass Index (BMI), Waist Circumference (WC), components of metabolic syndrome and Insulin Resistance (IR)Research Design and Methods:This was a prospective observational study, 80 diabetics (40 obese and 40 non obese) and 80 non diabetics (40 obese and 40 non obese) a total of 160 subjects were enrolled, out of whom 153 completed the study. The subjects were evaluated with respect to BMI, WC, Blood Pressure (BP); Fasting Blood Sugar (FBS) Fasting Insulin levels (FIL), HbA1C and Lipid profile. The SCF and VF were measured by Ultrasonography.The results were statistically analyzed.Results:WC correlated significantly with VF in all the groups. Diabetics had more VF compared to non-diabetics. Insulin resistance was significant in all the groups; however diabetics had greater levels of IR, BMI, WC, VF and SCF had no correlation with IR and had no significant correlation with metabolic parameters.Conclusions:In this study population, WC was found to be a useful surrogate measure of VF conforming to its well established applicability in other populations. Contrary to other studies elsewhere, SCF and VF were found to be poor indicators of Insulin Resistance. BMI, WC, VF and SCF were not useful in the prediction of metabolic syndrome. Ultrasound was found to be an easier and economic method of measuring abdominal adiposity and actual measurement of abdominal fat was more informative than anthropometric measurements.

Quality of life of a patient with type 2 diabetes: a cross-sectional study in rural South India.

Background:With a high prevalence of diabetes in India, there is a need to study the impact of this disease on the quality of life (QoL) of the patients.Materials and Methods:This facility-based cross-sectional study assessed the QoL of patients attending the diabetic clinic using the World Health Organization (WHO) QoL BREF instrument in Tamil Nadu. The QoL was analyzed domain-wise and various socio-demographic factors affecting the QoL were studied.Results:The mean total score of the QoL scale was 58.05 (95% CI, 22.18–93.88). Domain-wise, 63% had good physical, 69% had good psychological, 27% had good social and 85% had good environmental QoL scores. Males, currently married and those with BMI more than 25 had a statistically significantly better QoL compared to their counterparts.Conclusions:Diabetes does impair the QoL of patients but not to a great extent. There is a need to specifically target and improve the QoL of women, widowed and separated, and non-obese diabetics who are at risk of a poor QoL. QoL assessment should be routinely practiced in diabetic clinics.

Strong correlations between circulating chemerin levels and lipoprotein subfractions in nondiabetic obese and nonobese subjects

Chemerin is a recently described adipokine expressed primarily in the white adipose tissue. Compared with lean subjects, circulating chemerin levels are significantly elevated in obese individuals and correlate positively with the prevalence of various cardiovascular risk factors including altered lipoprotein levels. To date, the impact of chemerin on lipoprotein subfractions and its role in atherosclerotic processes are still unclear. Fifty nondiabetic obese (NDO) patients and 38 lean controls matched in age and gender were enrolled. Chemerin level was measured by ELISA. Low-density lipoprotein (LDL) and high-density lipoprotein (HDL) subfractions were detected by nongradient polyacrylamide gel electrophoresis (Lipoprint). We detected significantly higher serum chemerin levels in NDO patients compared with healthy controls (590·1 ± 190·3 ng/ml vs 405 ± 127·1 ng/ml, P < 0·001). A significant positive correlation was found between chemerin and LDL cholesterol levels, while chemerin showed a significant negative correlation with the level of HDL cholesterol. Significant positive correlation was detected between chemerin and the ratio of small dense LDL, while chemerin correlated negatively with the mean LDL size. Also, a significant negative correlation was found between serum chemerin and the ratio of large HDL subfraction, while there were significant positive correlations between chemerin levels and intermediate and small HDL subfraction ratios, respectively. Chemerin may be involved in the regulation of lipoprotein metabolism in obese patients who do not show apparent abnormalities of glucose metabolism. Early changes in the distribution of the lipoprotein subfractions may contribute to the progression of atherosclerosis, leading to increased cardiovascular risk.

Resting metabolic rate in obese diabetic and obese non-diabetic subjects and its relation to glycaemic control

BackgroundBoth obesity and type II diabetes mellitus are associated with insulin resistance and abnormal metabolic reactions. This study was conducted to evaluate resting metabolic rate in obese diabetic patients and to assess its relation to glycaemic control.ResultsThis is a case control study conducted in Gabir AbuEliz centre in Khartoum, Sudan. A random sample of 40 obese diabetic patients (cases) and 40 obese non-diabetic subjects (controls) were interviewed and examined clinically to exclude presence of acute or chronic medical illness. Haemoglobin A1c was measured for each participant using the “NycoCard Haemoglobin A1c test” (Axis -Shield/ Norway). Fasting blood sugar was measured using one touch(R) glucometer (LifeScan Canada Ltd). The PowerLab 8/35 with a gas analyzer (AD Instruments, Castle Hill Australia) was used for measurement of VO2, VCO2 and Respiratory exchange ratio (RER). Resting metabolic rate was calculated using the Weir equation. VO2 (mean+/-SD) ml/min was significantly higher among cases (209.9+/-42.7) compared to the controls (192.4+/-28.1), (P = 0.034). Similarly, VCO2 (mean+/-SD) ml/min was higher among cases (191.4+/-35.0) than controls (178.3+/-22.5), (P = 0.05). Resting metabolic rate “RMR” (mean+/-SD) kcal/day was higher in obese diabetic patients (1480.7 +/- 274.2) than obese non-diabetic subjects (1362.4+/- 184.8), (P = 0.027). Participants with high glycated haemoglobin had higher RMR than those with normal glycated haemoglobin (P = 0.016).ConclusionIt is concluded that resting metabolic rate is significantly higher in obese diabetic patients compared to obese non-diabetics, especially in those with poor glycaemic control.

Prevalence of obesity among diabetics seen in a tertiary health care centre in south-south Nigeria

Background: Obesity is a leading determinant for diabetes mellitus. The objective of this study was to assess the prevalence of overweight/obesity among diabetic patients seen at a tertiary hospital in South-South Nigeria. Methods : A retrospective study of 244 diabetic patients seen between January 2010 and June 2012. Weight and height was obtained from hospital records and BMI calculated as weight (in kilograms) divided by height (in meters) squared. The presence of hypertension was also obtained at first clinic visit . Results: The prevalence of overweight and obesity was 48%. Female and male prevalence was 25.8% and 22.1% respectively. Obese diabetics also showed worse glycaemic control and higher blood pressure than non-obese diabetics. Conclusion: The prevalence of overweight and obesity among diabetics in this study is fairly high. It is worthwhile to target educational strategies and interventions to reduce obesity prevalence as a cardiovascular risk. Keywords : Obesity, prevalence, Diabetes

Laparoscopic sleeve gastrectomy in remission of obesity and associated co-morbidities

Background: There is a lot of discussion on bariatric surgery and its effect on weight loss as well as resolution of associated conditions such as diabetes, sleep apnea, and thyroid imbalance. Recent reports also indicate role of laparoscopic sleeve gastrectomy (LSG) in non-obese diabetics. Aims: This study was undertaken to assess medium-term effects of LSG on body weight and co-morbid factors such as diabetes, hypertension, and thyroid imbalance. Materials and Methods: A total of 42 obese subjects (19 males and 23 females; age: 23-65 years; body mass index [BMI]: 45 ± 5 kg/m¼) underwent evaluation of anthropometric/clinical parameters and blood sugar, hypertension and thyroid function tests before, 3 and 9-15 months after LSG. Results: Mean BMI decreased from 45 to 38 after 3 months and 30 at 9-15 months after surgery. Remission of type 2 diabetes mellitus and hypertension occurred in all patients except one. Sleep apnea and asthma was cured in all five patients. Out of the five patients with thyroid imbalance, all except one were off medication within 5 months. Conclusion: Our study showed that LSG is effective in producing a significant and sustained weight loss and improving diabetes mellitus, hypertension, and other co-morbid factors in obese patients.