Obese Diabetic Patients Research Articles

Aplicación de rayo láser frente a implantación de catgut en pacientes diabéticos con obesidad

ObjectiveTo compare the effect of laser beam application versus catgut implantation in reducing glucose, glycosylated hemoglobin A1c (HbA1c), and body mass index in obese diabetic patients. DesignWe conducted a clinical, comparative, longitudinal, prospective, and quantitative study. Locationclinic of the National School of Medicine and Homeopathy of the National Polytechnic Institute in Mexico City. ParticipantsThe initial assessment was conducted with 73 patients, resulting in a sample size of 40 patients (20 per group) with a diagnosis of type 2 diabetes mellitus and obesity grades I and II, males and females between 35 and 65 years of age, non-insulin dependent and with no clinical complication of their main comorbidity in the period from September 2019 to February 2020. Main measurementsWe performed simple random sampling to form two groups: group 1 laser, and group 2 catgut. Three elements were sampled (glucose, cholesterol, and triglycerides) for blood chemistry, and weight and height were measured for body mass index. Then acupoint treatment was applied in the formula: Yishu (ext), Pishu (V 20), Shenshu (V 23), and Zusanli (E 36) per group for 3 months, and weight and height were measured when the final blood sample was taken. ResultsVarious statistical tests were performed. No significant differences (p > .05) were found between group 1 laser and 2 catgut in any of the parametric Student's t-tests. In intra-group tests, at baseline and at the end of treatment there were significant differences only in HbA1c values in the overall group. ConclusionThe overall objective was to compare the effect of laser beam application versus catgut implantation to decrease 3 variables, of which there was a significant difference only in the HbA1c of group 2, thus fulfilling the null hypothesis.

Epidemiological study on short and long-term weight loss with improvement of metabolic control in obese diabetic patients with a standardized multidisciplinary weight loss program (DIAMEX Study).

Purpose of Study: Obesity in Mexico has risen since the 1980s affecting 30% of the adult population, and 15% of adults had diabetes in Mexico. The rise in the rates of obesity and diabetes is linked to an increased consumption of calorically dense foods and sedentary lifestyle. The present study (DIAMEX) was aimed to evaluate the effect of a VLCK diet as part of a commercial weight loss program (PnKDiaprokal®) in patients with Diabetes and Obesity. It is an epidemiological study on weight loss and improvement of metabolic control in obese diabetic patients with a standardized multidisciplinary program that includes diet, physical exercise, and emotional support.

EFFECT OF EXERCISE ON INSULIN RESISTANCE IN OBESE TYPE 2 DIABETES PATIENTS

ABSTRACT Introduction: Type 2 diabetes mellitus (T2DM), also known as non-insulin-dependent diabetes mellitus (NIDDM), accounts for more than 90% of the total number of diabetes mellitus cases and often occurs in middle-aged and elderly people. Objective: To investigate the effect of exercise intervention on insulin resistance in obese type 2 diabetes patients. Methods: Eighty-six obese diabetic patients were screened as experimental subjects in physical examinations and randomly divided into observation and control groups. Visceral fat volume, fasting blood glucose, and fasting insulin of all subjects were measured before and after completion of the 6-month experimental implementation. The insulin resistance was calculated for both groups and the values for each indicator were compared statistically between groups. Results: Control of body weight, body mass index, blood glucose, blood lipids and insulin resistance index were better in the observation group than in the control group, and the difference was statistically significant (P < 0.05). Conclusions: Basal intervention with quantitative exercise can significantly improve insulin resistance in obese type 2 diabetes patients and the effect is better than treatment with diet and conventional exercise. Level of evidence II; Therapeutic studies - investigation of treatment results.

The effect of different types of laparoscopic bariatric procedures on type 2 diabetic obese patients

The effect of different types of laparoscopic bariatric procedures on type 2 diabetic obese patients

Clinical significance of high mobility group box 1/toll-like receptor 4 in obese diabetic patients.

High mobility group box 1 (HMGB1) is an alarmin that may link to obesity and type 2 diabetes mellitus (T2DM). The present study analyzed the correlation between HMGB1/ Toll-like receptor 4 (TLR4) and certain biochemical parameters in obese (OB) diabetic patients. 40 normal glucose tolerant subjects (NGT) and 40 patients with newly diagnosed T2DM were enrolled. All patients were further divided into non-obese NGT (NGT-NOB), obese NGT (NGT-OB), non-obese T2DM (T2DM-NOB) and obese T2DM (T2DM-OB) groups according to body mass index (BMI).The levels of HMGB1 in serum were quantified using ELISA, whereas the mRNA expression levels of TLR4 in peripheral blood mononuclear cells were assessed using reverse transcription-quantitative PCR. The results suggested that the levels of HMGB1 and TLR4 were higher in NGT-OB and T2DM-NOB groups compared with those in NGT-NOB group. Similarly, the levels of these two markers were higher in T2DM-OB group compared with those in NGT-OB group. Correlation analysis indicated that the levels of HMGB1 and TLR4 were positively correlated with triglyceride (TG), fasting plasma glucose (FPG) levels and BMI, whereas a negative correlation between HMGB1 and high density lipoprotein (HDL) was noted. Linear regression analysis suggested that HMGB1 was associated with FPG and TG levels, whereas TLR4 was strongly associated with TG levels and BMI. The results demonstrated that the expression levels of HMGB1 and TLR4 in patients with T2DM or obesity were increased, which were associated with glycolipid metabolism disorders. Therefore, the HMGB1/TLR4 may serve a role in inflammatory process associated with obesity and T2DM.

Association of Vitamin D Deficiency, Dyslipidemia, and Obesity with the Incidence of Coronary Artery Diseases in Type 2 Diabetic Saudi Patients.

Diabetes mellitus type 2 (T2DM) is a chronic metabolic disease associated with vascular complications. We aimed to evaluate the relationship of vitamin D deficiency, dyslipidemia, and obesity with the incidence of coronary artery disease in type 2 diabetes mellitus. The study included 200 Saudi adult subjects, aged 40 - 60 years, of both genders, attending King Abdulaziz Specialist Hospital in Taif city. Subjects were divided into four groups; 50 subjects each: Control group, type 2 diabetic, type 2 diabetic with coronary artery disease, and type 2 diabetic obese patients having body mass index (BMI) ≥ 30 kg/m2. Serum vitamin D (25-OH-D), fasting blood glucose (FBG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), and glycosylated hemoglobin (HbA1c) levels were estimated. Serum vitamin D and HDL-C in the three diabetic patient groups were significantly decreased (p < 0.001) compared to the control group. Among patient groups, the levels in the diabetic coronary and diabetic obese patients were significantly decreased as compared to the diabetic patient group (p < 0.001). FBG levels, HbA1c%, TC, TG, LDL-C levels, and BMI in all diabetic patient groups were significantly higher (p < 0.001) in comparison to control. Significant negative correlations were observed between serum vitamin D and FBG, HbA1c%, TC, TG, LDL-C levels, and BMI whereas positive correlations with HDL-C in all diabetic patient groups. The deficiency status of 25-OH-D is associated with dyslipidemia in type 2 Saudi diabetic patients, specifically those complicated with obesity and coronary artery diseases.

Subclinical Impairment of Left Ventricular Function assessed by Speckle Tracking in Type 2 Diabetic Obese and Non-Obese Patients: Case Control Study.

Objectives:Type 2 diabetes mellitus (DM) and obesity are an independent risk factor for cardiovascular diseases, so early prediction of LV dysfunction carries better prognosis. So our aim was to assess the subclinical LV dysfunction in type 2 diabetic obese and non-obese patients using two-dimensional speckle tracking echocardiography (2DSTE).Materials and Methods:We studied 93 patients, including two groups of 31 each with type 2 diabetes mellitus (T2DM), divided by body mass index (BMI), and 31 non-diabetic non-obese controls. All these subjects underwent two-dimensional Echo (2DE) imaging with analysis of conventional parameters of systolic and diastolic function, as well as speckle tracking echocardiography s (STE) analysis of LV global and regional longitudinal strain.Results:We reported significant inter-group differences in parameters of diastolic function, but no significant differences in ejection fraction or fractional shortening. Nevertheless, we found significant differences in strain, which we interpreted as evidence of subclinical systolic dysfunction.Conclusion:2DSTE is better than basic echocardiographic measurements in assessment of subclinical LV dysfunction in type 2 diabetic obese and non-obese patients which can be used to predict cardiomyopathic changes in the earlier course of type 2 DM and start earlier treatment with better prognosis.

The ambulatory blood pressure monitoring among obese and nonobese diabetes mellitus patients.

Obesity and diabetes mellitus are two major factors related with the risk of metabolic syndrome and cardiovascular diseases. Co-existing hypertension with diabetes mellitus and obesity has poor prognosis for cardiovascular diseases. Ambulatory blood pressure monitoring (ABPM) correlates more closely to target organ damage than clinic blood pressure. The objective of the study is to assess and compare ABPM pattern among obese and nonobese diabetes mellitus patients. A cross-sectional study was conducted among fifty obese and fifty nonobese diabetic patients who were classified based on their body mass index as per the WHO criterion. The clinical blood pressure measurements were measured on each subject using a digital sphygmomanometer, and 24 h ABPM was done and ABPM parameters such as dipping pattern, 24 h systolic blood pressure (SBP), diastolic blood pressure (DBP), Mean SBP, mean DBP, diurnal variability of SBP, DBP, Mean arterial pressure, pulse pressure, SD systole (Standard Deviation systole), SD diastole, white coat hypertension was derived and compared between the two groups. Around 37 (74%) obese and 18 (36%) nonobese showed non dipping pattern in SBP and 28 (66.7%) of obese and 14 (33.3%) of nonobese showed a nondipping pattern in DBP and was found to be statistically significant (P &lt; 0.001). On comparison between normotensive obese and normotensive nonobese, it was found that SBP non dipping pattern18 (67%) versus 9 (29%) and DBP nondipping pattern 12 (45%) versus 5 (16%) was statistically significant with P = 0.004, 0.016, respectively. Obese diabetes mellitus subjects had altered ABPM parameters and increased prevalence of nondipping status. In addition, obese diabetic patients who did not give prior history of hypertension were also found to have higher nondipping SBP and DBP patterns.

Prediction of Diabetic Obese Patients using Fuzzy KNN Classifier based on Expectation Maximization, PCA and SMOTE Algorithms

Diabetes is a long-term disease. Inappropriate blood sugar level control in diabetic patients can lead to serious issues like kidney and heart diseases. Obesity is widely regarded as a major risk factor for type 2 diabetes. In this research, a model proposed to predict diabetic obese patients based on Expectation Maximization, PCA, and SMOTE Algorithms in the preprocessing and feature extraction phases, and using Fuzzy KNN classifier in the prediction phase. The model applied on real dataset and the accuracy of prediction results reflects the positive effect of the preprocessing techniques. The accuracy of the proposed model is 95.97% and outperforms other model applied on the same dataset.

Comparison of Canola and Soybean Oils on Serum Lipid and Glucose Profiles and Anthropometric Parameters in overweight and Obese Type 2 Diabetes Mellitus Patients: A Randomized Clinical Trial

No earlier human study compared influences of canola and soybean oils on patients with type 2 diabetes (T2D). Current study aimed to investigate effects of canola and soya oils on blood and anthropometric parameters in overweight and obese Iranian diabetic (II) patients. A total of sixty-six T2D subjects were randomly allocated to three groups. Canola oil (CO; n 23, received 30g canola oil); Soya oil (SO; n 19, received 30g soya oil) and control group (n 24, their usual intake of dietary oils) for 8 weeks. Lipid and glycemic profiles as well as anthropometric indicators were evaluated before and after the intervention. Repeated-measures ANOVA was used to evaluate time×group interactions for the outcome variables followed by a t test (significance level, p < 0.05). After 8 weeks, serum total cholesterol (-21.3 and -36.4v. -2.2 mg/dl; P=0·007), low density lipoprotein (-6.6 and -15.9v. +3.0 mg/dl; P=0·013), fasting blood sugar (-39.6 and -30.5v. +11.7 mg/dl; P<0.001) significantly decreased and high density lipoprotein (+3.0 and +3.5v. +2.4 mg/dl; P=0.038) significantly increased in CO and SO groups compared with controls. Changes in lipid profiles were more considerable in the soybean oil group than the canola oil group. The mean changes of waist circumference (WC; −4.1 v. -1.4 and -1.3 cm; P=0·031) and weight (−3.1 v. -0.3 and +0.5 kg; P=0·048) significantly decreased in canola group comparing to the two other groups. Current study showed that daily consumption of canola and soybean oil for 8 weeks improved serum levels of fasting blood sugar, total cholesterol, low density lipoprotein and high density lipoprotein in T2D patients. Changes were more considerable in those consumed soybean oil. Canola oil decreased central obesity indices (waist circumference and weight) in T2D patients. Further studies are needed to shed light on this issue.

Could the increase in oxidative stress be the reason for the increased polyamine levels in diabetic obese and non-diabetic obese patients?

Could the increase in oxidative stress be the reason for the increased polyamine levels in diabetic obese and non-diabetic obese patients?

Role bariatrické chirurgie u pacientů s diabetes mellitus 1. typu

Bariatric surgery procedures are recognized as the most successful method of treating diabetes in obese patients with type 2 diabetes mellitus. Despite the fact that the number of obese type 1 diabetics has been constantly increasing in the last decade, bariatric surgery in these patients is still waiting to be widely used and standardized. Bariatric surgery has been proposed as an effective treatment for these patients, although data are scarce, based on case reports and retrospective studies. The article summarizes the current knowledge about the use of bariatric surgery in type 1 diabetics with obesity an cites some of the previous studies. Bariatric surgery is not yet routinely recommended in patients with type 1 diabetes mellitus.

“The obesity paradox” in patients with atrial fibrillation according to the results of the REKUR-AF study

Introduction: to evaluate the effect of excess body weight (EBW) and obesity on the survival of patients with atrial fibrillation (AF) in the REKUR-AF study.&#x0D; Materials and methods: A subanalysis of patients with AF included in the REKUR-AF (382 people) study was performed. Survival rates were analyzed in three patient groups: patients with normal body mass index (BMI), EBW and obesity. Then the nature and significance of the influence of the studied factor on the prognosis in patients with AF were assessed.&#x0D; Results and discussion: Patients with AF and normal BMI were significantly older than those with obesity and EBW (p&lt;0.001 and p=0.021, respectively). Among obese patients, hypertension was significantly (p=0.0015) more common (93.9%) compared to the group of patients with a normal BMI level (80.5%). The frequency of type 2 diabetes in obese patients prevailed over the same indicator in the groups of people with normal BMI and EBW (p=0.007 and p=0.020, respectively).&#x0D; The analysis of the survival rate of patients with AF depending on the BMI level showed that this factor had a significant impact (p=0.013) on the prognosis. The group of individuals with a normal BMI level had a significantly lower survival rate than the cohort of patients with EBW (p=0.011) and OB (p=0.025). The final model for Cox regression analysis (χ2=53.06, p&lt;0.001) included the following factors: age, form of AF, BMI, presence/absence of type 2 diabetes, presence/absence of previous hospitalizations, presence/absence of hypertension, and presence/absence of oral anticoagulant (OAC) intake.&#x0D; Conclusion: The obtained results do not make it possible to unambiguously interpret obesity as a predictor of a positive outcome in this category of individuals.

AACE2021-A-1048: Effect of Dietary Intake of Branched Chain Amino Acids on Type 2 Diabetic Patients Control

BCAAs up regulate glucose transporters and activate insulin secretion has been widely demonstrated. However, several researchers have suggested that excessive intake of amino acids could lead to inhibition of insulin signalling. BCAAs may induce insulin resistance through m TOR activation. insulin resistance may be linked with high intake of BCAAs, Controversies remain on whether an increase in plasma BCAA levels is a cause or consequence of insulin resistance. The aim of the study is to measure the effect of consumption of BCCAs on lipid profile and glucose level in type 2 obese diabetic patients. Participants enrolled in the study 280 patients (139 male,141 female) with type 2 diabetes for more than 5 years Attending Endocrinology out patient clinic. Written consent was obtained from all participants Anthropometric measurement (height, weight, waist circumference, body mass index Dietary assessment participants had to complete food frequency questionnaire (24 hour recall)for 5 days and analysis for branched chain amino acid intake was performed using food composition table, life style ,socio-demographic level, laboratory investigations including, fasting glucose, HbA1c, cholesterol, triglyceride, LDL, HDL. Mean Age 38.24±4.28 ,male 49.6%, female 50.4%, diabetes duration 8.86±2.26 years, BMI; 29.89 ±3.02, protein intake 77.75±14.76 g, Leucine 4.75±1.01g, valine 4.04±0.89 g, Isoleucine 4.09±0.92 g, fasting glucose 206.60 ±51.01mg A1C 9.33±1.18, cholesterol 238.79±40.37 mg/dl, triglycerides 103.47±14.01mg/dl LDL178.20 ±43.32 mg/dl/ HDL 44.03±9.55mg/dl. All of our patients took higher load for age and ideal weight of (leucine,valine, and isoleucine is likely to be 0.04,0.017-0.02 ,and 0.019 g /kg respective) mainly from plant source protein Regarding correlation with A1C (Valine p 0.01,r 0.02/isoliosine p 0.08 r 0.156) Regarding correlation with LDL (liosine p 0.07 r 0.156). High BCCAs intake mainly from plant source is associated with dyslipidaemia and poor glycaemic control .proper dietary counselling is important in diabetic.

Sensitivity of DiaRem Scoring System in Predicting Type Two Diabetes Mellitus Resolution After Bariatric Surgery in Qassim Region.

Introduction: Type two diabetes mellitus (T2DM) remission has been observed as an additional benefit of bariatric surgery for morbidly obese diabetic patients. There are many scoring systems for identifying factors that predict diabetes remission; however, there is as yet no universally applicable scoring system.Aim: This study aims to test the sensitivity of the DiaRem scoring system for predicting the resolution of T2DM in morbidly obese patients who underwent bariatric surgery at King Fahad Specialist Hospital in Buraydah, Saudi Arabia.Methods: This was a non-randomized controlled trial conducted at King Fahd Specialist Hospital in Buraydah, Saudi Arabia. Visiting patients at first screening were enrolled based on eligibility criteria. Data were collected according to the given parameters such as gender, age, body mass index (BMI), duration of diabetes mellitus (DM), medications (insulin, oral antihyperglycemic agents, number of tablets if used, or no medications use), presence of comorbidities, such as hypertension and dyslipidemia, HbA1c level (before surgery and at third, sixth, and 12th months after surgery), and fasting blood glucose (FBG) level (before and after surgery).Results: A total of 96 diabetic patients were enrolled (35 males vs 61 females) with a mean age of 46.5 years. Laparoscopic sleeve gastrectomy was the most commonly performed surgery. The most common associated comorbidities were hypertension (50%) and hypothyroidism (14.6%). Results of the DiaRem scoring system showed 0-2 points in 15.6% patients, 3-7 points in 39.6% patients, 8-12 in 26% patients, 13-17 in 9.4% patients, and 18-22 in 9.4% patients. The lowest DiaRem score was associated with a higher value of BMI, shorter DM duration, and lower mean values of HbA1c and FBG post-surgery.Conclusion: Consistent with the literature, our results indicated that those with an increased BMI, shorter duration of DM, and lower values of HbA1c post-FBG had a greater chance of diabetes remission postoperatively.

Increased Serum Pentraxin 3 Is Associated with Prediabetes and Type 2 Diabetes in Obese Patients with Nonalcoholic Fatty Liver Disease.

Background: Pentraxin 3 (PTX3) is an acute-phase protein, which resembles C-reactive protein in both structure and function, and belongs to the same family. PTX3 is associated with cardiovascular diseases, obesity, and metabolic syndrome (MetS). This study evaluated the relationship between serum PTX3 levels, prediabetes, newly diagnosed type 2 diabetes mellitus (T2DM), and other biochemical and clinical parameters in obese patients with nonalcoholic fatty liver disease (NAFLD). Methods: A total of 77 obese patients with NAFLD were included. Forty-seven of them were with normal glucose levels and 30 were with glycemic disorders, including prediabetes and newly diagnosed T2DM. Serum PTX3 was measured using ELISA method. Results: Higher PTX3 serum levels were found in patients with prediabetes and T2DM compared with those with normal blood glucose (2321.29 ± 926.63 vs. 1877.03 ± 895.45 pg/mL, P = 0.028). There were significant correlations between PTX3 and alanine aminotransferase (P = 0.018), gamma-glutamyl transferase (P = 0.005), and neuropathy disability score (P < 0.05). The presence of hypertension, dyslipidemia, insulin resistance, and MetS, as well as the number of components of the MetS did not affect PTX3 levels. Conclusions: PTX3 serum levels were higher in an obese subject with NAFLD with prediabetes and T2DM.

Effect of Treatment With Sodium-Glucose Cotransporter 2 Inhibitor on the Initiation of Continuous Positive Airway Pressure Therapy in Type 2 Diabetic Patients With Obstructive Sleep Apnea Syndrome

Background: Obese patients with type 2 diabetes mellitus often develop obstructive sleep apnea syndrome (OSAS). In this study, continuous positive airway pressure (CPAP) was initiated in Japanese patients with type 2 diabetes mellitus who developed OSAS during treatment with a sodium-glucose cotransporter 2 (SGLT2) inhibitor, and the effect of the SGLT2 inhibitor therapy on the patients was investigated. Methods: The study was conducted in outpatients with type 2 diabetes mellitus with serum hemoglobin A1c (HbA1c) values of ? 6.5% who developed OSAS. The patients were divided into two groups according to whether they were receiving treatment with an SGLT2 inhibitor or with other oral hypoglycemic agents: the SGLT2 inhibitor group (n = 9) and non-SGLT2 inhibitor group (n = 7). The patients in the former group were under treatment with one of the following three SGLT2 inhibitors: luseogliflozin (2.5 mg/day), dapagliflozin (5 mg/day) and empagliflozin (10 mg/day). The patients took the drugs once daily, before or after breakfast. The patients were initiated on CPAP therapy for OSAS, and their weight, body mass index (BMI), serum HbA1c level, lipid profile, liver function parameters, serum uric acid, and apnea-hypopnea index (AHI) measured before the initiation of CPAP therapy (baseline) were compared with the values measured 3 months after the start of CPAP therapy. Results: The AHI decreased significantly after 3 months of CPAP therapy, as compared to that at the baseline, in both the SGLT2 inhibitor and non-SGLT2 inhibitor groups. There was no significant change in the serum HbA1c value after 3 months of CPAP therapy as compared to that at the baseline in either group. The body weight and BMI increased significantly after 3 months of CPAP therapy in the SGLT2 inhibitor group, but not in the non-SGLT2 inhibitor group. Conclusion: The body weight and BMI increased significantly after 3 months of CPAP therapy initiated for OSAS in the type 2 diabetic patients who were receiving SGLT2 inhibitor therapy. Thus, when CPAP therapy is adopted for an obese diabetic patient with OSAS, it should be borne in mind that the body weight may increase if the patient is receiving SGLT2 inhibitor treatment. J Clin Med Res. 2021;13(10-11):497-501 doi: https://doi.org/10.14740/jocmr4626

Pleurotus tuber-regium inclusion in diet ameliorates dyslipidaemia in obese-type 2 diabetic rats

BackgroundPleurotus tuber-regium (P.T) is an edible mushroom with abundant polysaccharides that has been used in traditional medicine to treat diabetes mellitus. This study investigated the hypoglycaemic potential and ameliorative activity of Pleurotus tuber-regium incorporated diet on diabetes induced dyslipidaemia.Materials and methodsThirty five (35) adult male wistar rats were randomly assigned to seven groups; Normal control, diabetic control, obese control, obese diabetic control, 10% PT, 20% PT, and Drug control. Type II DM was induced by placing the animals on high fat diet for a period of 10 weeks and a single intraperitoneal injection of streptozotocin (50 mg/kg/BW). P. T was incorporated into the feed and given to the animals for two weeks daily after the confirmation of diabetes.ResultsTreatment of the obese diabetic rats with P. T supplemented diet caused a decrease in the blood glucose level compared to the control groups. Increased organo-somatic ratio of the kidney and heart were markedly (p < 0.05) reduced following treatment (20% P.T). Furthermore, cholesterol, triglycerides, LDL-C and VLDL-C levels were reduced due to treatment accompanied by increased HDL-C in the liver. Histological evaluation of the liver, kidney, heart, and pancreas of the P. T treated groups were comparable to normal.ConclusionIncorporation of P. tuber-regium in diets could be effective in reversing dyslipidaemia in obese diabetic patients.

Effect of Treatment With Sodium-Glucose Cotransporter 2 Inhibitor on the Initiation of Continuous Positive Airway Pressure Therapy in Type 2 Diabetic Patients With Obstructive Sleep Apnea Syndrome.

BackgroundObese patients with type 2 diabetes mellitus often develop obstructive sleep apnea syndrome (OSAS). In this study, continuous positive airway pressure (CPAP) was initiated in Japanese patients with type 2 diabetes mellitus who developed OSAS during treatment with a sodium-glucose cotransporter 2 (SGLT2) inhibitor, and the effect of the SGLT2 inhibitor therapy on the patients was investigated.MethodsThe study was conducted in outpatients with type 2 diabetes mellitus with serum hemoglobin A1c (HbA1c) values of ≥ 6.5% who developed OSAS. The patients were divided into two groups according to whether they were receiving treatment with an SGLT2 inhibitor or with other oral hypoglycemic agents: the SGLT2 inhibitor group (n = 9) and non-SGLT2 inhibitor group (n = 7). The patients in the former group were under treatment with one of the following three SGLT2 inhibitors: luseogliflozin (2.5 mg/day), dapagliflozin (5 mg/day) and empagliflozin (10 mg/day). The patients took the drugs once daily, before or after breakfast. The patients were initiated on CPAP therapy for OSAS, and their weight, body mass index (BMI), serum HbA1c level, lipid profile, liver function parameters, serum uric acid, and apnea-hypopnea index (AHI) measured before the initiation of CPAP therapy (baseline) were compared with the values measured 3 months after the start of CPAP therapy.ResultsThe AHI decreased significantly after 3 months of CPAP therapy, as compared to that at the baseline, in both the SGLT2 inhibitor and non-SGLT2 inhibitor groups. There was no significant change in the serum HbA1c value after 3 months of CPAP therapy as compared to that at the baseline in either group. The body weight and BMI increased significantly after 3 months of CPAP therapy in the SGLT2 inhibitor group, but not in the non-SGLT2 inhibitor group.ConclusionThe body weight and BMI increased significantly after 3 months of CPAP therapy initiated for OSAS in the type 2 diabetic patients who were receiving SGLT2 inhibitor therapy. Thus, when CPAP therapy is adopted for an obese diabetic patient with OSAS, it should be borne in mind that the body weight may increase if the patient is receiving SGLT2 inhibitor treatment.

The influence of gender and age on laparoscopic sleeve gastrectomy short-term outcomes in type 2 diabetic obese patients

Background: Bariatric surgery has come out as an effective treatment for morbid obesity due to its effects as stabilized weight loss and remission of obesity related comorbidities like type 2 diabetes. Postoperative weight loss is affected by many factors and predictors of weight loss after bariatric surgery are controversial.This study has been performed to evaluate the impact of gender and age on the short-term outcomes of laparoscopic sleeve gastrectomy (LSG) in type 2 diabetic(T2D) obese patients.&#x0D; &#x0D; Material and Methods: In this retrospective study, the records of morbidly obese patients with a body mass index(BMI)≥40 kg/m2, aged between 18-65 years old who underwent LSG and were followed-up for at least 6 months postoperatively were reviewed.Patients were subdivided into two groups according to age(≥50 y,