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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A cross-sectional, population-based study was conducted on 1,647 Turkish adolescents to determine the prevalence of obesity, impaired fasting glucose (IFG) and type 2 diabetes mellitus (DM2), and to determine whether the recent increase in DM2 prevalence in some countries is applicable to this population. Information was gathered through a questionnaire. All children were screened with physical examination and fasting plasma glucose. 10.7% of adolescents were overweight (BMI 85-95th percentile) and 3.6% were obese (BMI > or =95th percentile). Mean BMI was 20.25 +/- 3.31 kg/m2 with maximum BMI 35.88 kg/m2. No child was diagnosed with DM2; 1.96% had IFG (110-126 mg/dl). No significant relationship was found between IFG and obesity, socio-economic status (SES) or family history of DM. The risk of obesity was increased among children with family history of DM or obesity, and among those who had low physical activity and were of high SES level. This analysis represents the population-based data upon which future studies will be based.
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PMID:Obesity and type 2 diabetes mellitus: a population-based study of adolescents. 1564 97

The medical community faces an emerging epidemic of type 2 diabetes mellitus (DM2) in children and adolescents with a disproportionate increase among certain ethnic groups. DM2 represents one arm of the metabolic syndrome and parallels an increasing prevalence of obesity. The metabolic syndrome includes insulin resistance, hyperlipidemia, and hypertension with a consequent risk of early cardiovascular disease. Thus, treatment of DM2 and the metabolic syndrome poses a challenge for pediatric endocrinologists and represents a huge public health issue. This review presents information about treatment of childhood DM2 with emphasis on indications for the use of insulin in management and normalization of blood glucose.
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PMID:The management of type 2 diabetes mellitus in children and adolescents. 1575

Prevalence of the Type 2 diabetes mellitus (DM2) has been rising in the whole word. It is assumed that before DM2 develops, patients undergo a stadium of impaired glucose tolerance (IGT) or they have impaired fasting glycaemia (IFG). The confirmed IFG or IGT represent strong predictors of DM2 manifestation and at the same time they are related with high cardiovascular risk, namely with IGT. Other significant risk factor (RF) of DM2 is the obesity and metabolic syndrome. Recent clinical studies have shown that some metabolic abnormalities, which precede development of DM2 can be positively influenced by the lifestyle changes, including improvement of the diet and increasing the physical activity. Such measures can prevent or at least to delay the development of type 2 diabetes mellitus and thus the development of cardiovascular diseases. Positive effect has also the administration of some drugs, already tested in clinical studies, namely glitasons, metromin, inhibitor of ACE, sartans and other.
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PMID:[Contemporary prospects of prevention of type 2 diabetes mellitus]. 1588 94

The aim of this study was to evaluate the prevalence of type 2 diabetes mellitus (DM2) and impaired glucose tolerance (IGT) in obese children and adolescents and to examine insulin resistance and insulin secretion. We studied 427 asymptomatic obese patients. DM2 and IGT were diagnosed by an oral glucose tolerance test. Insulin resistance and P-cell function were assessed by using homeostasis model assessment (HOMA), insulin/glucose index (I/GI), fasting insulin and insulin sensitivity index (ISI-composite). Thirty patients showed IGT (7%) and seven had DM2 (1.6%). The mean age was 10.7 +/- 3.5 years, the diabetic group being significantly older than the normal group (p < 0.01). The mean body mass index was 30 +/- 5.3 kg/m2 without significant differences between groups. beta-Cell function declined significantly in the patients with IGT and DM2, and insulin resistance increased significantly. Given the rather high prevalence of glucose metabolism impairment, children with obesity should undergo glucose tolerance testing for appropriate therapeutic intervention.
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PMID:Prevalence of type 2 diabetes mellitus and impaired glucose tolerance in obese Argentinean children and adolescents. 1592 Nov 79

In the past years, in Brazil and in developed countries, obesity has become a major public health problem. It was identified that besides DM2 and metabolic syndrome other clinical entities were associated with insulin resistance. In this review we describe some of these alterations emphasizing nonalcoholic fatty liver disease, but also including polycistic ovary disease, hyperuricemia, chronic renal failure, heart failure, cognitive decline and cancer.
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PMID:[Insulin resistance/hyperinsulinemia associated diseases not included in the metabolic syndrome]. 1676 2

Metabolic syndrome (MS) is a risk condition for the development of systemic atherosclerotic disease. Morbid obesity is a state of insulin resistance (IR) associated with visceral fat accumulation, which is involved in the development of MS. In severe obesity, conservative therapies promote an improvement of MS, but weight regain is frequent, whereas bariatric surgery promotes a more significant and sustained weight loss. Bariatric surgery is recommended for patients with unsatisfactory response to clinical treatment and with IMC > 40 kg/m(2) or > 35 in case of co-morbidities. In those cases, surgical risk must be acceptable and patients submitted to surgery must be informed about complications and postoperative care. Prevention, improvement and reversion of diabetes (DM2) (70 to 90% of cases) are seen in several bariatric surgery modalities. Disabsorptive are more efficient than restrictive procedures in terms of weight reduction and insulin sensitivity improvement, but chronic complications, such as malnutrition, are also more frequent. Vertical gastroplasty with jejunoileal derivation is a mixed surgery in which the restrictive component predominates. In this modality, reversion of DM2 is due to an increase in insulin sensitivity associated with improved beta cell function. Reversion of MS and its manifestations after bariatric surgery are associated with reduction of cardiovascular mortality and, thus, in severe obesity cases, MS can be considered a surgical condition.
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PMID:[Does bariatric surgery cure the metabolic syndrome?]. 1676 6

The term intrauterine growth restriction (IUGR) is assigned to newborns with a birth weight and/or birth length below the 10th percentile for their gestational age and whose abdominal circumference is below the 2.5th percentile with pathologic restriction of fetal growth. IUGR is usually due to maternal, fetal, or placental factors. However, many IUGR cases have unknown underlying cause. Recent studies focus on new factors that can influence fetal development and birth outcome like the timing and the type of fetal nutrition, maternal psychosocial stress and personality variables, 11beta-hydroxysteroid dehydrogenase type 2 placental activity, the activity of the neuroendocrine system that mediates the effects of psychosocial stress, and the role of proinflammatory cytokines and of oxidative stress. Data have shown that IUGR is associated with a late life increased prevalence of metabolic syndrome, a condition associating obesity with hypertension, type 2 diabetes mellitus (DM2), and cardiovascular disease. Recent data demonstrated that the diabetes-associated mortality appears to be disproportionately concentrated among individuals of abnormal birth weight.
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PMID:Causes of intrauterine growth restriction and the postnatal development of the metabolic syndrome. 1730 40

The objective of this study was to compare plasma levels of adiponectin and leptin in lean (LN), obese (OB) and obese diabetic (OD) postmenopausal females (PMF). We recruited 26 PM women (group 1, mean age - 59,7+/-8,1 years, BMI - 36,6+/-1,8 kg/m(2)). All women had their last menstrual flow more than 2 year before the study (mean duration of PM period was 11,9+/-8,3 years). No woman had received hormones within 3 months of this study. All Women were diabetic patients (mean duration of DM2 was 9,5+/-5,5 years). Ten obese (group 2; mean BMI - 35,9+/-2,3 kg/m(2) and age - 58,1+/-4,7 years) and ten lean (group 3; mean BMI - 22,3+/-1,9 kg/m(2) and age - 56,5+/-5,6 years) PM women were recruited as controls for comparing adipocytokine levels. Adiponectin was significantly decreased and leptin is significantly elevated in OD PMF in comparison with group 1 and 2 (p<0,001 and p=0,003, respectively). There was a tendency for adiponectin levels to be lower in OD PMF as compared with OB individuals (p=0,053). OD PMF were more insulin resistant than OB and LN subjects (p<0,001). Hypoadiponectinemia in PMF may be explained by IR and obesity. Leptin levels in OD PMF are not significantly different from leptin levels of OB subjects, although they significantly differ from leptin levels of LN individuals.
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PMID:Plasma adipocytokine levels in obese and insulin resistant postmenopausal females with type 2 diabetes. 1732 29

Numerous population studies confirm the high prevalence of hypertension in type II diabetic (DM2) subjects and that intensive antihypertensive treatment is more beneficial to diabetic than to nondiabetic hypertensive subjects, yet not many of these are specific to Spain. To assess the degree of blood pressure (BP) control and the effects of antihypertensive drugs in the medical management of hypertension in diabetic patients in specialist care centres throughout Spain, we studied the socio-demographic, clinical and relevant laboratory parameters of 796 hypertensive patients with DM2 (mean age 66.09 (95% confidence interval (CI): 64.08-68.10). The percentage of diabetic patients responding positively to BP control measures was lower when compared to the nondiabetic population in both Spain and Europe. The degree of control was poorer for systolic than for diastolic BP, yet 40.6% of the patients were only on monotherapy. The fact that antihypertensive treatment was modified in only 40% of the poorly controlled patients was also highly significant and could be attributed to a nonstringent use of clinical guidelines. Among the other differences between well-controlled and poorly controlled patients, we found that well-controlled patients presented with lower levels of cholesterol and triglycerides, a lower prevalence of excess weight/obesity, and a greater prevalence of cardiovascular and/or cerebrovascular disease despite having a greater percentage of patients on antiplatelet therapy. Better application of therapeutic guidelines and the prevention and treatment of compounding factors could improve the response rate to BP control measures in poorly controlled patients.
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PMID:Blood pressure, antihypertensive treatment and factors associated with good blood pressure control in hypertensive diabetics: the Tarmidas study. 1746 Jul 9

The incidence of obesity, cardiometabolic syndrome (CMS), and type 2 diabetes mellitus (DM2), as well as their devastating cardiovascular consequences, keep rising with increasing human and economical costs. For a long time, insulin resistance has been the main player in the pathogenesis and treatment of DM2, but every day more knowledge is gained about the central role of beta-cell failure, not only in the appearance of hyperglycemia but also in the failure of the pharmacological therapy. beta-Cell failure implies impairment of glucosestimulated insulin secretion and loss of beta-cell mass. Hyperglycemia, elevated circulating fatty acids, inadequate local activation of renin angiotensin system, and chronic low grade inflammation are conditions that coexist in the CMS and DM2 that turn out to be deleterious for the beta-cell functioning and existance. Excessive oxidative stress secondary to increased production of reactive oxygen species and decreased availability of antioxidants is a possible common converging point of the multiple noxious stimuli. Activation of the NADPH oxidase complex secondary to angiotensin II stimulation is of interest, as its pharmacological blockade has beneficial effects. New knowledge about the intimate mechanisms of oxidative-stress induced beta-cell failure will provide new therapeutic targets against CMS and DM2.
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PMID:The expanding role of oxidative stress, renin angiotensin system, and beta-cell dysfunction in the cardiometabolic syndrome and Type 2 diabetes mellitus. 1750 16


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