Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/63968
Citations | ||
Scopus | Web of Science® | Altmetric |
---|---|---|
?
|
?
|
Type: | Journal article |
Title: | Metabolic changes following a 1-year diet and exercise intervention in patients with type 2 diabetes |
Author: | Albu, J. Heilbronn, L. Kelley, D. Smith, S. Azuma, K. Berk, E. Pi-Sunyer, F. Ravussin, E. |
Citation: | Diabetes, 2010; 59(March):627-633 |
Publisher: | Amer Diabetes Assoc |
Issue Date: | 2010 |
ISSN: | 0012-1797 1939-327X |
Statement of Responsibility: | Jeanine B. Albu, Leonie K. Heilbronn, David E. Kelley, Steven R. Smith, Koichiro Azuma, Evan S. Berk, F. Xavier Pi-Sunyer, Eric Ravussin, and the Look AHEAD Adipose Research Group |
Abstract: | Objective—To characterize the relationships among longterm improvements in peripheral insulin sensitivity (glucose disposal rate [GDR]), fasting glucose, and free fatty acids (FFAs) and concomitant changes in weight and adipose tissue mass and distribution induced by lifestyle intervention in obese individuals with type 2 diabetes. Research Design And Methods—We measured GDR, fasting glucose, and FFAs during a euglycemic clamp and adipose tissue mass and distribution, organ fat, and adipocyte size by dual-energy X-ray absorptiometry, CT scan, and adipose tissue biopsy in 26 men and 32 women in the Look-AHEAD trial before and after 1 year of diet and exercise aimed at weight loss. Results—Weight and fasting glucose decreased significantly (P _ 0.0001) and significantly more in men than in women (_12 vs. _8% and _16 vs. _7%, respectively; P _ 0.05), while FFAs during hyperinsulinemia decreased and GDR increased significantly (P _ 0.00001) and similarly in both sexes (_53 vs. _41% and 63 vs. 43%; P _ NS). Men achieved a more favorable fat distribution by losing more from upper compared with lower and from deeper compared with superficial adipose tissue depots (P _ 0.01). Decreases in weight and adipose tissue mass predicted improvements in GDR but not in fasting glucose or fasting FFAs; however, decreases in FFAs during hyperinsulinemia significantly determined GDR improvements. Hepatic fat was the only regional fat measure whose change contributed independently to changes in metabolic variables. Conclusions—Patients with type 2 diabetes undergoing a 1-year lifestyle intervention had significant improvements in GDR, fasting glucose, FFAs and adipose tissue distribution. However, changes in overall weight (adipose tissue mass) and hepatic fat were the most important determinants of metabolic improvements. |
Keywords: | Look AHEAD Adipose Research Group Adipose Tissue Humans Diabetes Mellitus, Type 2 Hyperinsulinism Insulin Resistance Obesity Body Weight Blood Glucose Fatty Acids, Nonesterified Hypoglycemic Agents Glucose Clamp Technique Treatment Outcome Exercise Life Style Sex Factors Body Composition Energy Metabolism Energy Intake Middle Aged Female Male Subcutaneous Fat |
Rights: | © 2010 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details. |
DOI: | 10.2337/db09-1239 |
Grant ID: | DK60412 U01 DK056990 |
Published version: | http://dx.doi.org/10.2337/db09-1239 |
Appears in Collections: | Aurora harvest Medicine publications |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
hdl_63968.pdf | Published version | 273.96 kB | Adobe PDF | View/Open |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.