Five-year morbidity and mortality rates in a U.S. population with obesity with and without prediabetes

Impact of 3 G rice on plasma glucose, insulin, and gastrointestinal hormones in patients with obesity or type 2 diabetes: A non-randomized experimental study

OBJECTIVE

To evaluate the effects of a novel grain variety 3 G rice compared to traditional white rice on postprandial glycemia, insulinemia, and gastrointestinal hormones in individuals with obesity and type 2 diabetes (T2D).

METHODS

A non-randomized experimental study was conducted with 20 participants with obesity (without diabetes) and 20 patients with T2D. Each participant consumed meals containing 50 g of carbohydrates from either 3 G rice or white rice. Plasma glucose, insulin, and gastrointestinal hormone levels were measured at baseline and intervals up to 120 min post-consumption.

RESULTS

Among participants with obesity, plasma glucose levels were significantly lower at 90 and 120 after 3 G compared to white rice (0.52 ± 0.04 vs. 2.58 ± 0.37 mmol/L, p < 0.001 at 90 min and 0.06 ± 0.02 vs. 1.47 ± 0.26 mmol/L, p = 0.003 at 120 min). In contrast, plasma insulin levels were markedly higher following 3 G rice consumption at 90-120 min (p = 0.003). Gastrointestinal hormones were significantly elevated after 3 G rice intake compared to white rice, with GLP-1 levels showing sustained increases from 60 to 120 min (p = 0.019). In T2D patients, 3 G rice consumption led to a modest reduction in plasma glucose at 120 min (5.15 ± 0.49 mmol/L for white rice vs. 3.57 ± 0.35 mmol/L for 3 G rice, p = 0.0262) without significant effect on other parameters.

CONCLUSION

3 G rice significantly improved postprandial glycemic control and enhanced gastrointestinal hormone responses in individuals with obesity. These findings highlight the promise of 3 G rice as a dietary intervention for managing postprandial glycemia and insulin sensitivity.

What influences patient decisions when selecting an obesity treatment?

Objective

The objectives of this study were to understand patient preferences for obesity treatments, to describe how patients choose treatment options, and what factors influence their decisions.

Methods

This participatory action research used purposeful sampling to recruit 10 patients with complications of obesity. Photovoice was used as the qualitative research methodology. Recruitment took place in specialist clinics for metabolic dysfunction-associated steatotic liver disease, diabetes mellitus, hypertension, and chronic kidney disease. Two males and eight females aged 18-75 years, with a BMI greater than 35 kg/m2 were recruited. Participants watched a 60-min ​video explaining nutritional, pharmacological, and surgical therapies in equipoise. Data was collected using photographs with a disposal camera followed by one-to-one semi-structured interviews. Afterward, this analysis utilised reflective thematic analysis.

Results

Five main themes were identified that influenced patients' decisions when selecting an obesity treatment: 1] Accessibility issues, 2] Polypharmacy, 3] Fears around future health 4] Lack of Support 5] Information Mismanagement.

Conclusion

The themes identified in this study represent the patients' voices for those living with obesity complications and what influences their decisions on treatment options. The findings underscore the need for a holistic and patient-centred approach to the management of obesity and its associated complications. Patient-centred care including knowledge, health literacy, support, and participation is essential to providing effective care for patients with obesity to make decisions between treatment options.

Comorbidity of patients with noncommunicable diseases in general practice. Eurasian guidelines

Создание руководства поддержано Советом по терапевтическим наукам отделения клинической медицины Российской академии наук.

The impact of obesity on different glucose tolerance status with incident cardiovascular disease and mortality events over 15 years of follow-up: a pooled cohort analysis

BACKGROUND

The effect of obesity in different glucose tolerance statuses i.e. normoglycemia (NGT), pre-diabetes, and type 2 diabetes (T2DM) on cardiovascular disease (CVD) and mortality has been an area of ongoing debate and uncertainty. In the present study, we aimed to examine the impact of being obese, whether general or central separately, in comparison with non-obese in different glucose tolerance statuses on the above outcomes.

METHODS

The study population included 18,184 participants aged 30-60 years (9927 women) from three longitudinal studies, including Atherosclerosis Risk in Communities, Multi-Ethnic Study of Atherosclerosis, and Tehran Lipid and Glucose Study. Glucose tolerance status was defined as NGT (fasting plasma glucose < 5.55 mmol/L), pre-diabetes (5.55-7.00 mmol/L), and T2DM (≥ 7 mmol/L or taking any medication for diabetes). Moreover, general and central obesity were defined based on body mass index and waist circumference (WC), respectively. Multivariable stratified Cox regression analysis was used to estimate hazard ratios (HRs (95% CI)) for CVD and mortality events.

RESULTS

During a 16-year follow-up, 2733 CVD events, 1101 CV mortality, and 3678 all-cause mortality events were recorded. We observed that being generally obese in comparison with non-obese increased the risk of CV and all-cause mortality in all glucose tolerance statuses; while considering CVD events, only among individuals with T2DM, the presence of general obesity was associated with marginally significant higher risk [1.19 (0.98-1.43); p-value = 0.07]. Regarding central adiposity, multivariate analysis revealed that elevated WC in NGT participants is associated with incident CVD [1.27(1.12-1.46)] and all-cause mortality [1.13(1.00-1.28)]. Moreover, central adiposity increased the risk of CV mortality in pre-diabetes individuals [1.47 (1.11-1.95)].

CONCLUSION

Findings from this pooled prospective cohort studies provide evidence that general obesity shows an unfavorable association with CV and all-cause mortality among the general population irrespective of their glucose tolerance statusThe findings imply that it's important to take into account the requirement and magnitude of weight reduction in people who are obese when offering guidance.