Obese Diabetic Patients Research Articles

A DATA BASE STUDY OF DIET FOR OBESE DIABETES WITH SPECIAL REFERENCES TO DIABESITY

The goals of maintainable blood sugar level, weight loss and sustainable nutrition of an Obese Diabetic patient, attainable by using dietary therapy, are principles of the management of Diabesity. Diabesity is a syndrome complex, which compri ses Central obesity, Type 2 Diabetes Mellitus, Hypertension, Hyperlipidemia, Systemic inflammation and Prothrombotic state. Diet and Regimen have been considered to be the adoptable me asures of the very first step for the management of Diabetes and obesity . ‘Ayurveda’, the science of life, flamboyantly describes the Ahara Dravyas to the Obese Diabetic (Sthula Pramehi) patients and calls those Dravyas preventive and therapeutics for them. Different types of cereals, pulses, vegetables, oils, fruits, liquids and others have been revealed in this study as having logistic effects in the obese Diabetic patients, though the effects dep end on availability, economic condition, tolerance, desire, physical condition, level of digestion, and predominance of doshas of t he Dravyas and the patients. In the present study, effort was made to rule out the Ahara Dravyas as prescribed by the ancient health providers of the Ayur vedic classics. The study revealed the Ahara Dravyas along with their ancient Indian pharmacological p roperties. The outcome of the study is expected to be helpful for future scholars, dieticians and patients also. The study concludes that the Ahara Dravyas can be used in different forms in day to d ay meals of the Obese Diabetic patients, provided the guid elines given by the Physician and Dietician are properly followed.

Laparoscopic adjustable gastric banding reduces subcutaneous adipose tissue and blood inflammation in nondiabetic morbidly obese individuals.

Significant and sustained excess weight loss (EWL) appears to reduce the risk of obesity-related comorbidities (insulin resistance, hyperlipidemia, and inflammation), but this has been primarily shown in adult diabetic obese patients. We evaluated whether the EWL obtained 3 years after laparoscopic adjustable gastric banding (LAGB) improves the metabolic phenotype in nondiabetic morbidly obese (NDMO) individuals from south Italy. Serum and subcutaneous adipose tissue (SAT) samples from 20 obese individuals (median BMI=41.5 kg/m(2)) before (T0) and after LAGB (T1) and from 10 controls (median BMI=22.8 kg/m(2)) were taken. Serum leptin, adiponectin, C reactive protein (CRP), and main analyte levels were evaluated by routine methods or immunoassay. In SAT, adipocyte size was measured by hematoxylin/eosin staining, cluster of differentiation 68 (CD68) macrophage infiltration marker by immunohistochemistry, and adiponectin, adiponectin receptors 1 and 2, and interleukin 6 (IL6) messenger RNAs by qRT-PCR. The average EWL was 66.7 %, and CRP, triglycerides, hepatic markers, leptin levels, homeostasis model assessment, and the leptin/adiponectin ratio were lower (p<0.05) at T1 than at T0. The expression of small adipocytes and adiponectin was increased (p<0.05), and inflammation markers (CD68 and IL6) decreased (p<0.05) at T1 vs. T0. At linear regression multivariate analysis, over 90 % (R (2)=0.905) of EWL (dependent variable) was explained by CD68, adiponectinemia, triglyceridemia, CRP, and total protein levels. The EWL obtained 3 years after LAGB resulted in an improvement of lipid metabolism and a reduction of inflammation in NDMO patients, thereby decreasing the risk of obesity-associated diseases.

Amelioration of glycemic control by sleeve gastrectomy and gastric bypass in a lean animal model of type 2 diabetes: restoration of gut hormone profile.

In obese diabetic patients, bariatric surgery has been shown to induce remission of type 2 diabetes. Along with weight loss itself, changes in gut hormone profiles after surgery play an important role in the amelioration of glycemic control. However, the potential of gastrointestinal surgery regarding diabetes remission in non-severely obese diabetic patients has yet to be defined. In the present experimental study, we explored the effect of established bariatric procedures with and without duodenal exclusion on glycemic control and gut hormone profile in a lean animal model of type 2 diabetes. Forty 12- to 14-week-old non-obese diabetic Goto-Kakizaki (GK) rats were randomly assigned to four groups: control group (GKC), sham surgery (GKSS), sleeve gastrectomy (GKSG), and gastric bypass (GKGB). Age-matched Wistar rats served as a non-diabetic control group (WIC). Glycemic control and plasma lipids were assessed at the beginning of the observation period and 4 weeks after surgery. Fasting and mixed meal-induced plasma levels of ghrelin, glucagon-like peptide-17-36 (GLP-1), and peptide tyrosine-tyrosine (PYY) were measured. In GK rats, glycemic control improved after sleeve gastrectomy (SG) and gastric bypass (GB). Mixed meal-induced gut hormone profiles in Wistar rats (WIC) were significantly different from those of sham-operated or control group GK rats. After SG and GB, GK rats showed a similar postprandial decrease in ghrelin as observed in non-diabetic WIC. Following both surgical procedures, a significant meal-induced increase in PYY and GLP-1 could be demonstrated. SG and GB induce a similar improvement in overall glycemic control in lean diabetic rodents. Meal-induced profiles of ghrelin, GLP-1, and PYY in GK rats are significantly modified by SG and GB and become similar to those of non-diabetic Wistar rats. Our data do not support the hypothesis that duodenal exclusion and early contact of food with the ileal mucosa alone explain changes in gut hormone profile in GK rats after gastrointestinal surgery.

Preservation of the pyloric ring in surgery for pancreatic head cancer; PD vs PPPD vs SSPPD

Background: Limited vascular access could be encountered in an obese or re-transplant patient. Aims: An en bloc SPK composite graft transplant in an obese diabetic patient under hemodialysis was described. Patients & methods: At the back-table, SMA and SA of the pancreas graft were reconstructed with a long artery graft. The smaller left renal artery is anastomosed to thelonger common limb of the arterial Y graft and the shorter portal vein is to the longer graft left renal vein. This en bloc composite graft allowed to facilitate “real” SPK transplant using single common graft artery and vein for anastomosis to one recipient arterial and venous site. The en bloc pancreas and kidney composite graft was implanted by suturing the graft left renal vein to IVC and graft common iliac artery the recipient distal aorta. Results: The operative time was 7 hours with cold ischemic time of 6 hours and 25 min. and warm ischemic time of 47 min. The patient was discharged on postoperative day 20, with a serum creatinine level of 1.4 ng/ ml and a blood glucose level of 121 mg/dL. He has not had any rejection episodes or postoperative complications in the following 12 months after the en bloc SPK transplant. Conclusion: En bloc pancreas and kidney composite graft might be an option for patients with limited vascular access. This technique (1) facilitates “real” simultaneous pancreas and kidney (SPK) transplant with only single common artery and vein for implanting the composite graft; (2) minimizes dissection of vessels and conserves recipient vessels.

AB0744 There is NO Relationship between Glucagon like Peptide-1 and Inflammation in Psoriasis and Psoriatic Arthritis

BackgroundSeveral studies have found a higher prevalence of type 2 diabetes mellitus in patients with psoriasis and psoriatic arthritis (PsA). Interestingly, a complete remission of psoriasis has been observed following...

Cardiovascular risk in obese diabetic patients is significantly reduced one year after gastric bypass compared to one year of diabetes support and education.

Roux-en-Y gastric bypass (RYGB) reduces most of the obesity-related comorbidities known to increase the cardiovascular risk in obese subjects. The Framingham risk score (FRS) is designed to be independent of body weight and estimates the 10-year risk for coronary heart disease (CHD), myocardial infarction, stroke, cardiovascular disease (CVD), death from CHD, and death from CVD. Our aim was to evaluate the effectiveness of RYGB on improving the FRS when compared to a matched control group who underwent diabetes support and education program (DSE). In a prospective cohort study, we evaluated preoperatively and at 12 months, 61 morbidly obese subjects with diabetes. Thirty underwent laparoscopic RYGB, and 31 received 1 year of DSE, consisting of educational sessions on diet, nutrition, and exercise. Groups were matched for gender, age, weight, blood pressure, and cholesterol and triglyceride levels. Strict gender-specific FRS was used to assess the cardiovascular risk. Excess weight-loss percentages (%EWL) were 55.6 ± 15.1 in the RYGB group and 1.2 ± 10.8 in the DSE group (P < 0.001). The two groups were matched for baseline FRS. RYGB patients experienced a significant decrease in all FRS, whereas control subjects did not show a significant decrease for the 10-year risk for CHD, CVD and death from CVD. The between-group differences for changes from baseline to 12 months in all FRS were significant. The 10-year risk reductions for CHD, MI, stroke, CVD, death from CHD, and death from CVD in the RYGB group relative to the DSE group were, respectively, 42, 48, 30, 39, 50, and 50%. No correlations between reduction in FRS and %EWL were found after RYGB. A significant improvement in the 10 year estimated cardiovascular risk is observed in patients undergoing RYGB, but not in those who were offered usual medical therapy plus DSE. However, the effects of RYGB on FRS are independent of weight loss.

Depressive symptoms in obese diabetes patients. Pilot study

Depressive symptoms in obese diabetes patients. Pilot study

T Cell–Derived IL-22 Amplifies IL-1β–Driven Inflammation in Human Adipose Tissue: Relevance to Obesity and Type 2 Diabetes

Proinflammatory cytokines are critically involved in the alteration of adipose tissue biology leading to deterioration of glucose homeostasis in obesity. Here we show a pronounced proinflammatory signature of adipose tissue macrophages in type 2 diabetic obese patients, mainly driven by increased NLRP3-dependent interleukin (IL)-1β production. IL-1β release increased with glycemic deterioration and decreased after gastric bypass surgery. A specific enrichment of IL-17- and IL-22-producing CD4(+) T cells was found in adipose tissue of type 2 diabetic obese patients. Coculture experiments identified the effect of macrophage-derived IL-1β to promote IL-22 and IL-17 production by human adipose tissue CD4(+) T cells. Reciprocally, adipose tissue macrophages express IL-17 and IL-22 receptors, making them sensitive to IL-17 and IL-22. IL-22 increased IL-1β release by inducing pro-IL-1β transcription through activation of C-Jun pathways in macrophages. In sum, these human data identified IL-1β and the T-cell cytokine IL-22 as key players of a paracrine inflammatory pathway previously unidentified in adipose tissue, with a pathological relevance to obesity-induced type 2 diabetes. These results provide an additional rationale for targeting IL-1β in obesity-linked type 2 diabetes and may have important implications for the conception of novel combined anti-IL-1β and anti-IL-22 immunotherapy in human obesity.

High vitamin D deficiency rate in metabolic inpatients: is bariatric surgery planning found guilty?

High rates of vitamin D insufficiency are usually found in obese patients, even before any malabsorptive bariatric surgery. It is not clear whether they lack vitamin D because of different food intake, different solar exposure, or different storage pathways or bioavailability in adipose tissue. To better understand vitamin D deficiency, we studied different categories of inpatients. We collected clinical and biological data from 457 consecutive inpatients during a year: 217 nonobese diabetic patients, 159 obese nonsurgical diabetic patients, 46 obese surgical nondiabetic patients, and 35 obese surgical diabetic patients. Statistically significant differences between two mean 25-hydroxyvitamin D (25(OH)D) levels were defined at the 5 % level using a Z-test. Vitamin D deficiency was found in 69 % of the patients, while 24 % had a normal level and 7 % an optimal level. A significant difference was found between obese (25(OH)D = 40.3 nmol/l) and nonobese patients (25(OH)D = 46.8 nmol/l). Patients undergoing bariatric surgery were not different from the other obese patients. No significant difference in 25(OH) vitamin D level could be demonstrated between obese patients before bariatric surgery and obese patients with no obesity surgery project. No difference was found between our Parisian obese population and a Spanish obese population, which benefits from a better solar exposure. Both findings suggest that obesity itself is the link with vitamin D deficiency, independently from behavioral differences.

Opposite alterations in FGF21 and FGF19 levels and disturbed expression of the receptor machinery for endocrine FGFs in obese patients.

Fibroblast growth factor (FGF)-21, and possibly FGF19, protect against type 2 diabetes mellitus (T2DM) and obesity in rodents. We investigated the circulating levels of FGF21 and FGF19 in obese patients with varying degrees of abnormal glucose homeostasis, and we determined gene expression for FGF receptors (FGFR1-4) and the co-receptor β-Klotho, in liver and adipose tissues. We analyzed 35 lean healthy (71% men) and 61 obese patients (49% men, median body mass index (BMI): 40.5 kg m(-2), interquartile range: 34.7-46.2). Among obese patients, 36 were normoglycemic, 15 showed impaired glucose tolerance and 10 had T2DM. Biopsies from liver and visceral and subcutaneous fat from a subset of obese patients and controls were analyzed. FGF19 and FGF21 levels were measured using enzyme-linked immunosorbent assay, and tissue mRNA and protein levels by reverse transcription-polymerase chain reaction and immunoblotting. FGF21 serum levels were significantly increased in obese patients compared with controls (P<0.001), whereas FGF19 levels were decreased (P < 0.001). FGF21 levels were positively correlated with homeostasis model assessment of insulin resistance (P = 0.0002, r = 0.37) and insulin (P = 0.001, r = 0.32), whereas FGF19 levels were negatively correlated (P = 0.007, r = -0.27; P=0.003, r = -0.28; respectively). After adjusting for BMI, the correlations of FGF21 and FGF19 levels with indicators of abnormal glucose homeostasis were not significant. In obese patients, the hepatic expression of FGF21 was increased. (P = 0.04). β-Klotho transcript levels in visceral fat (P = 0.002) and β-Klotho protein levels in subcutaneous (P = 0.03) and visceral fat (P = 0.04) were significantly reduced in obese patients, whereas hepatic levels for β-Klotho (P = 0.03), FGFR1 (P = 0.04) and FGFR3 (P = 0.001) transcripts were significantly increased. Obesity is characterized by reciprocal alterations in FGF19 (decrease) and FGF21 (increase) levels. Although worsened in diabetic obese patients, obesity itself appears as the predominant determinant of the abnormalities in FGF21 and FGF19 levels. Opposite changes in β-Klotho expression in fat and liver indicate potential tissue-specific alterations in the responsiveness to endocrine FGFs in obesity.

Increased Calcaneal Spur Frequency in Patients with Obesity and Type-2 Diabetes Mellitus

Objective: Obesity is a risk factor for calcaneal spur (CS) formation. Diabetes mellitus may contribute to the risk of CS due to the decreased ability of tissue repair and peripheral neuropathy. Thus, we aimed to determine the frequency of CS in asymptomatic obese subjects with and without type 2 diabetes mellitus (T2DM). Also, we tried to find the related factors of CS in patients with T2DM. Material and Methods: Ninety-three obese patients with type-2 diabetes mellitus (T2DM) and 42 obese control subjects without glucose metabolism disturbances were enrolled in the study. A questionnaire was made about the duration of T2DM, age, and occupations of the participants. Physical, laboratory, and x-ray examinations of all cases were made. SPSS 15.0 was used for statistical analyses. Results: Patients with T2DM and control groups were similar in mean age and body mass index (BMI) (p=0.196, p=0.073, respectively). The existence of CS in the T2 diabetic group was significantly higher than in the control group (p=0.023). T2 diabetic patients with CS had significantly higher neuropathy existence, mean age, and BMI than T2 diabetic patients without CS (p=0.001, p=0.016, p=0.043, respectively). There was a positive correlation between the existence of CS and peripheral neuropathy and age (p=0.025, p=0.001, respectively). Conclusion: Increased ratio of CS in obese T2 diabetic patients may be important because of the relation between CS existence and complications of diabetes mellitus. Clinicians should pay more attention to increased frequency of CS in patients with T2DM, to avoid diabetic foot complications and other malformations.

Abstract 218: Contributions of Microangiopathy to the Pathogenesis of Coronary Macroangiopathy of Nonobese Diabetes

Background: Visceral obesity and metabolic syndrome have been proposed as major coronary risk factors, however non-obese diabetes patients have also significant coronary atherosclerosis. Purpose: To elucidate the difference of prognosis between obese diabetes and non-obese diabetes. Methods: Up to December 2003, 606 patients who were initially treated with PCI, were recruited as cohort, and followed up for mean 10.3 years. Patients were divided into four groups according to diabetes and obesity. Endpoints are occurrence of new coronary lesions. Results: Non-obese diabetes had more frequently new coronary lesions than obese diabetic patients, indicating the incidence rate at 10 years was 56% and 31%, respectively (p=0.0017). At baseline, frequency of chronic kidney disease (CKD) was almost equal in these two groups, however, during follow-up, percentage of death associated with renal failure significantly increased up to 21.4% in non-obese diabetes, whereas 4.4% in obese diabetes. This increase is coincidence with occurrence of new coronary lesions, indicating diabetic microangiopathy is strong promoting factor in pathogenesis of coronary atherosclerosis in non-obese diabetes. Conclusion: In lean diabetes, microangiopathy especially nephropathy are frequently occurred, and this may contribute to progression of coronary atherosclerosis via the same mechanisms such as oxidative stress and glycation endproducts, or indirectly via secondary hypertension. these intriguing interaction of microangiopathy and macroangiopathy make unique coronary anatomy observed in diabetes.

Sa1011 Obesity Is Associated With Significantly Lower Long-Term Survival Among Patients With Acute Liver Failure Undergoing Liver Transplantation in the United States

Background: Over 2,000 cases of acute liver failure (ALF) are reported in the U.S. on an annual basis. Previous studies have demonstrated that the prevalence of obesity in patients with ALF is comparable to general U.S. population. However, obese patients that developed ALF had significantly poorer survival. The validity of these studies was limited by the fact that body mass index (BMI) data was missing in over 25% of ALF patients. Our study aims to evaluate the impact of obesity on post-liver transplantation (LT) survival among ALF patients in the U.S. Methods: Adult patients with ALF undergoing LT in the U.S. from 20032012 were evaluated using data from the United Network for Organ Sharing registry. Patient demographics and clinical characteristics (including the etiology of ALF) were evaluated using chi square testing for categorical variables and Student's t-test for continuous variables. Non-parametric methods were used for non-normally distributed variables. Analyses were stratified by obesity status (BMI > 30 kg/m2) and race/ethnicity. Overall long term post-LT survival was evaluated with KaplanMeier methods and multivariate Cox proportional hazards models (adjusted for age, sex, race/ethnicity, etiology of ALF, obesity, year of LT, MELD score, ascites and presence of diabetes). Results: A total of 2,924 patients with ALF underwent LT from 2003-2012. Overall, 31.8% of ALF patients undergoing LT were obese (mean BMI: 27.1 ± 6.1) and 9.2% (n=246) had diabetes. When stratified by race/ethnicity, blacks had the highest rates of obesity (44.0%, n=210), followed by non-Hispanic whites (30.4%, n= 556), Hispanics (30.3%, n=100), and Asians (17.5%, n=43), p<0.001. Compared to nonobese patients, there was a trend towards lower 5-year post-LT survival among obese ALF patients (73.4% vs. 76.0%, p=0.18). However, when compared with non-obese, non-diabetic patients, there was a stronger trend towards lower post-LT survival among obese diabetic ALF patients (66.9% vs. 77.3%, p=0.08). In the multivariate Cox proportional hazards model, obesity was independently associated with lower post-LT survival in ALF patients (HR 1.20, 95% CI 1.00-1.43, p<0.01) (Table). Presence of diabetes was also associated with significantly lower post-LT survival (HR 1.45, 95% CI 1.09-1.93, p=0.01). Conclusions: Among patients with ALF undergoing LT, obesity is associated with significantly lower post-LT survival. Concurrent diabetes among obese ALF patients may confer an additional survival disadvantage. Multivariate Cox Proportional Hazards Model

Cell-specific dysregulation of microRNA expression in obese white adipose tissue.

Obesity is characterized by the excessive accumulation of dysfunctional white adipose tissue (WAT), leading to a strong perturbation of metabolic regulations. However, the molecular events underlying this process are not fully understood. MicroRNAs (miRNAs) are small noncoding RNAs acting as posttranscriptional regulators of gene expression in multiple tissues and organs. However, their expression and roles in WAT cell subtypes, which include not only adipocytes but also immune, endothelial, and mesenchymal stem cells as well as preadipocytes, have not been characterized. Design/Results: By applying differential miRNome analysis, we demonstrate that the expression of several miRNAs is dysregulated in epididymal WAT from ob/ob and high-fat diet-fed mice. Adipose tissue-specific down-regulation of miR-200a and miR-200b and the up-regulation of miR-342-3p, miR-335-5p, and miR-335-3p were observed. Importantly, a similarly altered expression of miR-200a and miR-200b was observed in obese diabetic patients. Furthermore, cell fractionation of mouse adipose tissue revealed that miRNAs are differentially expressed in adipocytes and in subpopulations from the stromal vascular fraction. Finally, integration of transcriptomic data showed that bioinformatically predicted miRNA target genes rarely showed anticorrelated expression with that of targeting miRNA, in contrast to experimentally validated target genes. Taken together, our data indicate that the dysregulated expression of miRNAs occurs in distinct cell types and is likely to affect cell-specific function(s) of obese WAT.

Roux-en-Y gastric bypass for lower esophageal submucosal cancer in an obese diabetic patient

laifi@ Obesity is becoming an epidemic health problem and has been identified as an independent risk factor for the development of gastroesophageal reflux disease and Barrett's esophagus, which increases the incidence of esophageal cancer (EsC) [1]. Routine esophagogastroduodenoscopy (EGD) before bariatric/metabolic surgery has a high diagnostic yield and it can alter or delay the surgical management in 4.9– 9.4% of cases [2,3]. We report a case of early EsC in an obese diabetic patient treated with laparoscopic Roux-en-Y gastric bypass (LRYGB).

Diabetes and obesity are significant risk factors for morning hypertension: From Ibaraki Hypertension Assessment Trial (I-HAT)

AimsAlthough morning hypertension (HT) has been identified as a major cardiovascular risk, susceptible populations remain unknown. This study aimed to clarify the relationship between morning HT and diabetes or obesity in a large-scale population. Main methodsClinic blood pressure (BP) and BP upon awakening were recorded in 2554 outpatients with HT who attended 101 clinics or hospitals for two weeks. Mean clinic and awakening BP>140/90 and >135/85mmHg, respectively, were considered as HT. The patients were classified according to values for clinic and home BP, into normal BP, white coat HT, masked HT, and sustained HT. Key findingsMorning BP (mmHg) significantly and progressively elevated in the order of normal glucose tolerance, impaired glucose tolerance and diabetes (134.1±12.2, 135.4±13.1 and 137.5±11.5; p<0.0001). The incidence of morning HT significantly increased and progressively in the same order (53.4%, 55.6%, 66.4%, p<0.0001). Morning BP was significantly higher among obese patients with diabetes than among non-obese and non-diabetic patients (138.8±10.5, 133.1±11.9, p<0.0001). In addition, the incidence of morning HT was significantly higher in obese diabetic patients than in non-obese and non-diabetic patients (73.0% vs. 49.9%, p<0.0001). SignificanceDiabetic or obese patients frequently have morning HT.

Omental fat from obese and obese diabetic patients dys‐regulates vascular function by NF‐κB, PARP‐1 and interleukin 12‐dependent mechanism (1076.7)

Background: The abdominal adipose omental tissue in obese and obese diabetic patients is a major risk factor for cardiovascular diseases. Here we determined the role of interleukin 12 (IL‐12), NFκB and PARP‐1 in omental tissue‐induced vascular dysfunction in obese, obese type 2 diabetic (T2D) patients, and type 2 diabetic (db‐/db‐) mouse.Methods &amp;amp; results: Mesenteric resistance arteries (MRA) from C57/BL6 and IL‐12 receptor‐/‐ mice were mounted in a wire myograph and incubated with omental fat from obese, obese T2D patients, db‐/db‐ and db‐/db‐p50NFκB‐/‐, db‐/db‐PARP‐1‐/‐ and C57/BL6 mice treated with and without NFκB (DHMQ), PARP‐1 (ABT‐888) inhibitors and IL‐12 receptor antagonist. The endothelium‐dependent relaxation was not affected. However, we observe an increase in phenylephrine‐(PE) and thromboxane‐(U46619)‐induced contraction in MRA incubated with omental fat from obese, obese T2D patients and db‐/db‐ mice. The contraction was potent with omental fat from obese T2D than obese patients. Interestingly, ABT‐888, DHMQ, IL‐12 receptor antagonist and MRA from IL‐12 receptor‐/‐ significantly reduced the exacerbated PE and thromboxane‐induced contraction in MRA incubated with omental fat from obese, obese T2D patients or db‐/db‐. Importantly, PE and thromboxane‐induced contraction was significantly reduced when MRA from db‐/db‐p50NFκB‐/‐ or db‐/db‐PARP‐1‐/‐ double knockout mice were incubated with omental fat from obese, obese T2D patients and db‐/db‐ mice. These results were associated with augmented NFkB and PARP‐1 activity and IL‐12 content in omental fat from obese, obese T2D patients and db‐/db‐ mice compared to control. IL‐12 content was significantly reduced in omental fat incubated with NFkB and PARP‐1 inhibitors.Conclusion: The present study provide evidence that adipose omental tissue in obese, obese T2D patients and T2D mouse impairs vascular function by IL‐12, NFκB and PARP‐1‐dependent mechanisms

Metabolic Effects of Bariatric Surgery in Diabetic and Non-Diabetic Obese Patients: Preliminary Results

Metabolic Effects of Bariatric Surgery in Diabetic and Non-Diabetic Obese Patients: Preliminary Results

Impact of an integral health program for metabolic diseases (1028.7)

The modification of unhealthy behavior is one of the most important issues to control obesity and chronic diseases. The aim of this study was to evaluate the impact of a wellness integral program to control anthropometric, biochemical parameters and cardiorespiratory capacity in dislipidemic diabetic obese patients from Sinaloa. 41 adult obese dislipidemic diabetic participants were divided into 2 groups. One obese dislipidemic and the other obese diabetic‐dislipidemic. Those two groups were divided into 2 groups, one with pharmacological treatment and the other without. They all receive the integral program that included nutrition education physical activity skills and an hipocaloric‐hiperproteic diet for 4 weeks. All participants reduce weight, BMI and LDL‐C and TAG. Glucose concentrations was reduced in the diabetic dislipidemic obese group. All participants increased their cardio respiratory capacity due to the skill for physical activity that they received. HBP decreased in all participants. In integral program that include diet, education behavior and physical activity promotion successfully reduce all the parameters associated to obesity, dislipidemic syndrome and diabetes mellitus, therefore obese patient with metabolic disorders, must be treated using an integral program.

Comment on Dutia et al. Limited Recovery of β-Cell Function After Gastric Bypass Despite Clinical Diabetes Remission. Diabetes 2014;63:1214−1223

The article in this issue of Diabetes by Dutia et al. (1) shows that in obese diabetic patients returning to normal glucose tolerance (NGT) after gastric bypass β-cell function appears to recover if evaluated through oral glucose tolerance test (OGTT), but not if evaluated through isoglycemic glucose clamp. In fact, the plot indicating Δinsulin/Δglucose (insulin release [IR]) versus 1/homeostasis model assessment of insulin resistance (HOMA-IR) (insulin sensitivity [IS]) grows during OGTT, but stays flat or moves right, indicating …