Eddy Edson
Well-Known Member
- Relationship to Diabetes
- Type 2
Generally the best thing to do if you're diagnosed with "pre-diabetes", "at risk of diabetes" or whatever, is lose some weight. The common Internet advice to start stressing about carb intake is generally off the mark, except to the extent that doing so helps to reduce calorie intake.
Retrospective cohort study using data from the big US long-term Diabetes Prevention Program by researchers at the NIDDK: https://academic.oup.com/jcem/advance-article-abstract/doi/10.1210/clinem/dgac509/6692282
Diabetes risk reduction was directly related to the amount of weight loss
I think basically another confirmation the Roy Taylor/Newcastle twin-cycles work: weight loss improves liver insulin sensitivity and pancreas insulin production. So more robust and granular than the traditional "lose some weight" advice. Of cource, saying it doesn't make it easy to do.
Insulin secretion and sensitivity regulate glycemia, with inadequately compensated deficiencies leading to diabetes.
Objective
We investigated effects of weight loss, an intensive lifestyle intervention (ILS), and metformin on the relationship between insulin secretion and sensitivity using repository data from 2931 participants in the Diabetes Prevention Program clinical trial in adults at high risk of developing type 2 diabetes.
Methods
Insulin secretion and sensitivity were estimated from insulin and glucose concentrations in fasting and 30-minute post-load serum samples at baseline and 1, 2, and 3 years after randomization, during the active intervention phase. The non-linear relationship of secretion and sensitivity was evaluated by standardized major axis regression to account for variability in both variables. Insulin secretory demand and compensatory insulin secretion were characterized by distances along and away from the regression line, respectively.
Results
ILS and metformin decreased secretory demand while increasing compensatory insulin secretion, with greater effects of ILS. Improvements were directly related to weight loss; decreased weight significantly reduced secretory demand [b=-0.144 SD; 95% CI (-0.162, -0.125)/ 5 kg loss] and increased compensatory insulin secretion [b=0.287 SD, 95% CI (0.261, 0.314)/ 5 kg loss]. In time-dependent hazard models, increasing compensatory insulin secretion [HR=0.166 per baseline SD, 95% CI (0.133, 0.206)] and weight loss [HR=0.710 per 5 kg loss, 95% CI (0.613, 0.819)] predicted lower diabetes risk.
Conclusions
Diabetes risk reduction was directly related to the amount of weight loss, an effect mediated by lowered insulin secretory demand (due to increased insulin sensitivity) coupled with improved compensatory insulin secretion.
Retrospective cohort study using data from the big US long-term Diabetes Prevention Program by researchers at the NIDDK: https://academic.oup.com/jcem/advance-article-abstract/doi/10.1210/clinem/dgac509/6692282
Diabetes risk reduction was directly related to the amount of weight loss
I think basically another confirmation the Roy Taylor/Newcastle twin-cycles work: weight loss improves liver insulin sensitivity and pancreas insulin production. So more robust and granular than the traditional "lose some weight" advice. Of cource, saying it doesn't make it easy to do.
Abstract
ContextInsulin secretion and sensitivity regulate glycemia, with inadequately compensated deficiencies leading to diabetes.
Objective
We investigated effects of weight loss, an intensive lifestyle intervention (ILS), and metformin on the relationship between insulin secretion and sensitivity using repository data from 2931 participants in the Diabetes Prevention Program clinical trial in adults at high risk of developing type 2 diabetes.
Methods
Insulin secretion and sensitivity were estimated from insulin and glucose concentrations in fasting and 30-minute post-load serum samples at baseline and 1, 2, and 3 years after randomization, during the active intervention phase. The non-linear relationship of secretion and sensitivity was evaluated by standardized major axis regression to account for variability in both variables. Insulin secretory demand and compensatory insulin secretion were characterized by distances along and away from the regression line, respectively.
Results
ILS and metformin decreased secretory demand while increasing compensatory insulin secretion, with greater effects of ILS. Improvements were directly related to weight loss; decreased weight significantly reduced secretory demand [b=-0.144 SD; 95% CI (-0.162, -0.125)/ 5 kg loss] and increased compensatory insulin secretion [b=0.287 SD, 95% CI (0.261, 0.314)/ 5 kg loss]. In time-dependent hazard models, increasing compensatory insulin secretion [HR=0.166 per baseline SD, 95% CI (0.133, 0.206)] and weight loss [HR=0.710 per 5 kg loss, 95% CI (0.613, 0.819)] predicted lower diabetes risk.
Conclusions
Diabetes risk reduction was directly related to the amount of weight loss, an effect mediated by lowered insulin secretory demand (due to increased insulin sensitivity) coupled with improved compensatory insulin secretion.
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