open access

Vol 11, No 4 (2010): Practical Diabetology
Original articles (translated)
Published online: 2010-12-30
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Metabolic changes following a 1-year diet and exercise intervention in patients with type 2 diabetes

Jeanine B. Albu, Leonie K. Heilbronn, David E. Kelley, Steven R. Smith, Koichiro Azuma, Evan S. Berk, F. Xavier Pi-Sunyer, Eric Ravussin, the Look AHEAD Adipose Research Group
Diabetologia Praktyczna 2010;11(4):142-152.

open access

Vol 11, No 4 (2010): Practical Diabetology
Original articles (translated)
Published online: 2010-12-30

Abstract


OBJECTIVE. To characterize the relationships among long-term improvements in peripheral insulin sensitivity (glucose disposal rate, GDR), fasting glucose, and free fatty acids (FFA) 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.
(Diabet. Prakt. 2011; 11, 4: 142-152)

Abstract


OBJECTIVE. To characterize the relationships among long-term improvements in peripheral insulin sensitivity (glucose disposal rate, GDR), fasting glucose, and free fatty acids (FFA) 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.
(Diabet. Prakt. 2011; 11, 4: 142-152)
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About this article
Title

Metabolic changes following a 1-year diet and exercise intervention in patients with type 2 diabetes

Journal

Clinical Diabetology

Issue

Vol 11, No 4 (2010): Practical Diabetology

Pages

142-152

Published online

2010-12-30

Bibliographic record

Diabetologia Praktyczna 2010;11(4):142-152.

Authors

Jeanine B. Albu
Leonie K. Heilbronn
David E. Kelley
Steven R. Smith
Koichiro Azuma
Evan S. Berk
F. Xavier Pi-Sunyer
Eric Ravussin
the Look AHEAD Adipose Research Group

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