BACKGROUND: Caloric restriction in obese diabetic patients quickly improves glucose control, independently from weight loss. However, the early effects of a very-low-calorie diet (VLCD) on insulin sensitivity and insulin secretion in morbidly obese patients with type 2 diabetes are still unclear. OBJECTIVE: The objective was to study the relative contributions of insulin sensitivity, insulin secretion, or both to improvement in glucose metabolism, after 1 wk of caloric restriction, in severely obese diabetic patients. DESIGN: Hyperglycemic clamps were performed in 14 severely obese (BMI, in kg/m(2): >40) patients with type 2 diabetes in good glucose control (glycated hemoglobin < 7.5%) before and after 7 d of a VLCD (400 kcal/d). RESULTS: The VLCD caused a 3.22 ± 0.56% weight loss (P < 0.001), 42.0% of which was fat loss, accompanied by decreases in fasting plasma glucose (P < 0.05) and triglycerides (P < 0.01). In parallel, the Disposition Index, which measures the body's capability to dispose of a glucose load, increased from 59.0 ± 6.3 to 75.5 ± 6.3 mL· min(-1) · m(-2) body surface area (P < 0.01), because of improvements in indexes of both first- and second-phase insulin secretion (P < 0.02), but with no changes in insulin sensitivity (P = 0.33). CONCLUSION: The marked improvement in metabolic profile, observed in severely obese patients with type 2 diabetes after a 7-d VLCD, was primarily due to the amelioration of β cell function, whereas no contribution of insulin sensitivity was shown. This trial was registered at www.clinicaltrials.gov as NCT01447524.
BACKGROUND: Caloric restriction in obese diabeticpatients quickly improves glucose control, independently from weight loss. However, the early effects of a very-low-calorie diet (VLCD) on insulin sensitivity and insulin secretion in morbidly obesepatients with type 2 diabetes are still unclear. OBJECTIVE: The objective was to study the relative contributions of insulin sensitivity, insulin secretion, or both to improvement in glucose metabolism, after 1 wk of caloric restriction, in severely obese diabeticpatients. DESIGN: Hyperglycemic clamps were performed in 14 severely obese (BMI, in kg/m(2): >40) patients with type 2 diabetes in good glucose control (glycated hemoglobin < 7.5%) before and after 7 d of a VLCD (400 kcal/d). RESULTS: The VLCD caused a 3.22 ± 0.56% weight loss (P < 0.001), 42.0% of which was fat loss, accompanied by decreases in fasting plasma glucose (P < 0.05) and triglycerides (P < 0.01). In parallel, the Disposition Index, which measures the body's capability to dispose of a glucose load, increased from 59.0 ± 6.3 to 75.5 ± 6.3 mL· min(-1) · m(-2) body surface area (P < 0.01), because of improvements in indexes of both first- and second-phase insulin secretion (P < 0.02), but with no changes in insulin sensitivity (P = 0.33). CONCLUSION: The marked improvement in metabolic profile, observed in severely obesepatients with type 2 diabetes after a 7-d VLCD, was primarily due to the amelioration of β cell function, whereas no contribution of insulin sensitivity was shown. This trial was registered at www.clinicaltrials.gov as NCT01447524.
Authors: Cyrus Jahansouz; Federico J Serrot; Brigitte I Frohnert; Rocio E Foncea; Robert B Dorman; Bridget Slusarek; Daniel B Leslie; David A Bernlohr; Sayeed Ikramuddin Journal: Obes Surg Date: 2015-12 Impact factor: 4.129
Authors: M Caprio; M Infante; E Moriconi; A Armani; A Fabbri; G Mantovani; S Mariani; C Lubrano; E Poggiogalle; S Migliaccio; L M Donini; S Basciani; A Cignarelli; E Conte; G Ceccarini; F Bogazzi; L Cimino; R A Condorelli; S La Vignera; A E Calogero; A Gambineri; L Vignozzi; F Prodam; G Aimaretti; G Linsalata; S Buralli; F Monzani; A Aversa; R Vettor; F Santini; P Vitti; L Gnessi; U Pagotto; F Giorgino; A Colao; A Lenzi Journal: J Endocrinol Invest Date: 2019-05-20 Impact factor: 4.256
Authors: J Sonya Haw; Karla I Galaviz; Audrey N Straus; Alysse J Kowalski; Matthew J Magee; Mary Beth Weber; Jingkai Wei; K M Venkat Narayan; Mohammed K Ali Journal: JAMA Intern Med Date: 2017-12-01 Impact factor: 21.873
Authors: Matheni Sathananthan; Meera Shah; Kim L Edens; Karen B Grothe; Francesca Piccinini; Luca P Farrugia; Francesco Micheletto; Chiara Dalla Man; Claudio Cobelli; Robert A Rizza; Michael Camilleri; Adrian Vella Journal: J Nutr Date: 2015-08-05 Impact factor: 4.798