Obesity and type 2 diabetes thesis

Weight loss program for type 2 diabetes

Twin and adoption studies, with the ability to attribute familial similarity to genetic and environmental effects, support both genetic and environmental factors on childhood BMI, with the influence of environmental factors dissipating in adolescence [ 21 ] Other aspects of the family environment are also highly influential. While the intervention did not result in greater decreases in the combined prevalence of both overweight and obesity, there were significant reductions in other measures of adiposity and metabolic risk, including zBMI, waist circumference, and fasting insulin. Successful lifestyle intervention programs typically involve self-monitoring of weight, dietary intake, and activity; behavioral modification; frequent contact; and caloric balance through diet, with or without exercise. Table 1. Inaccurate perception about weight was associated with less physical activity and poorer dietary habits in the adolescents. Although mechanisms underlying this coupling e. Even in youth with T2D, early signs of microvascular and macrovascular health complications may be present. Parents are satisfied with receiving obesity interventions for their children via telehealth [ 51 ].

For example, short-term intervention studies suggest that dietary changes, which emphasize less fat and refined carbohydrates, make it easier to reduce total caloric intake in obese adults and overweight children 30 Metformin, an insulin sensitizer, was shown to significantly improve glycemic control in youth with T2D [ 92 ].

In cases of morbid obesity, inpatient and surgical approaches have been used but additional research is needed to demonstrate their safety and long-term effects.

Type 2 diabetes exercise plan

Although additional genes with important roles will undoubtedly be discovered, this low predictive power may reflect the importance of environmental factors, less frequent genetic variants with stronger effects, or gene-environment, gene-gene, and epigenetic interactions that are not readily identified through methods based on population genetics. However, recent research indicates that most youth with T2D do not attain optimal glycemic control, remain overweight, and often do not stay in medical treatment. Low SES neighborhoods often lack sidewalks and are unsafe, factors that are associated with higher rates of obesity [ 39 ]. Another study with Mexican-American children demonstrated early risk factors for metabolic syndrome, including high levels of body mass index, insulin, glucose, triglycerides, and systolic blood pressure, as well as lower HDL cholesterol [ 31 ]. Proximity of a person's home to fast food restaurants has been associated with increased obesity rates [ 26 ]. It is clear that poor glycemic control eventually results in serious health complications such as retinopathy, neuropathy, and nephropathy, and cardiovascular disease. There are also many barriers to a healthy diet for low SES and ethnic minority youth.

Research indicates that youth with T2D are likely to develop serious diabetes-related health complications relatively early in adulthood, contributing to decreased life expectancy. Parents are satisfied with receiving obesity interventions for their children via telehealth [ 51 ]. A few longitudinal studies of youth with T2D reported low follow-up rates.

exercise and type 2 diabetes pubmed

Other benefits of pharmacological treatment included smaller waist circumference, lower triglyceride levels, and high density lipoprotein-cholesterol; however, serious side effects were noted with medication use including increases in systolic and diastolic blood pressure, and higher pulse rates for sibutramine, and a high prevalence of gastrointestinal adverse effects for orlistat.

The intervention group experienced environmental changes in the school setting including changes to school breakfast and lunch menusincreased physical activity, and behavioral change by increasing health knowledge through interactive games and goal setting.

Weight loss in diabetes mellitus type 2

Being overweight in early childhood increases risk for later obesity. For example, recent rodent studies have demonstrated diabetogenic effects of reduced pancreatic expression of the Pdx1 gene 14 , Efficacious treatments are available for obese children, but a major issue is how to reach the population of overweight and obese children. One potential link could be sustained cell exposure to nutrient concentrations exceeding energy requirements. As physicians frequently prescribe glucose-lowering medications associated with weight gain, trade-offs between glycemic control and body weight with current therapeutic options need more consideration. To assess the impact of the other covariates, we estimated an unadjusted logistic regression model with BMI level as the only covariate ; the resulting ORs were 1. The evidence therefore indicates that environmental factors associated with urban and low-income neighborhoods increases the likelihood of low rates of physical activity among minority and low SES children. One should also keep in mind that the missing heritability could be an illusion of inferring additive genetic effects from epidemiological data Given the fact that youth with T2D are at high risk for development of diabetes-related health complications, identification of effective medical and behavioral treatment approaches remains a priority. Results showed that youth with poor glycemic control had parents who were less involved for social and proactive care of diabetes [ ]. Managing body weight by behavioral change and medications The dramatic increase in incidence and prevalence of obesity over the past 50 years, associated in part with major worldwide changes in caloric intake and dietary composition, has focused attention on lifestyle intervention to reverse or ameliorate caloric imbalance. E-mail: ude. Twin and adoption studies, with the ability to attribute familial similarity to genetic and environmental effects, support both genetic and environmental factors on childhood BMI, with the influence of environmental factors dissipating in adolescence [ 21 ] Other aspects of the family environment are also highly influential. However, most drug trials last only 6—12 months, and thus there are few long-term data that weight loss can be sustained.

A clear, mechanistic basis for this decompensation has remained elusive.

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Obesity and Type 2 Diabetes in Children: Epidemiology and Treatment