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@#Introduction: Intervention approaches that integrate human coaching into technology are considered as a convenient, accessible and scalable method to reach a larger population at risk. The objective of this paper is to present the protocol for a randomised controlled trial that evaluates the efficacy of a lifestyle intervention programme via a mobile phone app (MyDiPP), which aims to prevent diabetes among adults at risk of developing diabetes. Methods: MyDiPP intervention is to be delivered for 12 months with multiple approaches (weight loss, dietary modification, physical activity, and quality of life). Eligible adults aged 18-65 years, overweight/obese (body mass index, BMI ≥ 23kg/m2), and at high risk of type 2 diabetes [American Diabetes Association (ADA) Diabetes Risk Score ≥5, or haemoglobin A1c (HbA1c) of 5.6-6.2%], will be randomly assigned to one of two study groups (intervention or usual care control groups) in a 1:1 ratio using simple randomisation. Results: Changes in weight and HbA1c level (primary outcomes), and changes in physical activity level, dietary intake, and quality of life (secondary outcomes) will be assessed at 6 and 12 months. Conclusion: This study protocol describes the first digital therapy for diabetes prevention in Malaysia, which will determine whether the effect of this intervention is larger than the effect of usual care in reducing body weight and HbA1c level, and improving dietary intake, physical activity, and quality of life of high-risk individuals. Results from this trial may be useful for preventing type 2 diabetes mellitus in Malaysia.
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Objective@#To evaluate the effect of online lifestyle intervention based on cognitive behavior adjustment on the female patients with infertility and central obesity. @*Methods@#From November 2019 to November 2020, the women with infertility and central obesity in the Reproductive Medicine Center of Zhejiang Provincial People's Hospital were recruited and divided into two groups. The intervention group received online lifestyle intervention based on cognitive behavior adjustment for twelve weeks, and the control group received routine health education. Body weight, waist circumference, fasting blood glucose, fasting insulin, insulin resistance index (HOMA-IR), body fat, the pregnancy rate and the abortion rate were compared between the two groups. @*Results@#There were 78 cases each in the intervention group and the control group, aged (31.15±4.87) years and (31.17±4.81) years, respectively. There were no significant differences between the two groups in age, body weight, body mass index, waist circumference, waist-hip ratio, fasting blood glucose, fasting insulin, HOMA-IR and body fat percentage before intervention (all P>0.05). After twelve-week intervention, the results of mixed effect model showed that the decrease of waist circumference, fasting insulin and body fat percentage in the intervention group were greater than those in the control group (all P<0.05). After six-month follow-up, there was no significant differences in the pregnancy rate (33.33% vs. 23.08%) and the abortion rate (7.69% vs. 16.67%) between the two groups (both P>0.05). @*Conclusion@#Online lifestyle intervention based on cognitive behavior adjustment helps to control central obesity and hyperinsulinemia.
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Nonobese non-alcoholic fatty liver disease (NAFLD) is a special clinical phenotype of NAFLD. The patients do not have the characteristics of obesity, so they are often overlooked by people. The reports of these patients in domestic and foreign literature are not completely consistent. This paper mainly discusses its etiology, risk factors, pathological characteristics, diagnosis and lifestyle intervention, so as to provide some help for the clinical diagnosis and treatment of adult patients with nonobese NAFLD.
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OBJECTIVE@#To evaluate the effectiveness and possible mechanism of acupuncture treatment for negative emotion in patients with polycystic ovary syndrome (PCOS).@*METHODS@#A total of 40 PCOS patients were randomly divided into an observation group and a control group, 20 cases in each one. Both groups received lifestyle interventions (exercise and diet guidance) on the 5th day of menstruation. On the basis of above treatment, the patients in the observation group received acupuncture at Guanyuan (CV 4), Zhongwan (CV 12), Guilai (ST 29), Futu (ST 32), Liangqiu (ST 34), Sanyinjiao (SP 6), Zusanli (ST 36), Hegu (LI 4), Shenmen (HT 7), Baihui (GV 20) as the main acupoints, and connected the electroacupuncture (continuous wave, 2 Hz, 30 min), once every other day, 3 times a week. The treatment for 1 month was as one course and 4 courses were required totally in both groups. Before and after treatment, the body mass index (BMI), ferriman-gallway (F-G) score, self-rating anxiety scale (SAS) score, self-rating depression scale (SDS) score, PCOS health-related quality of life questionnaire (PCOSQ) score were observed, meanwhile, serum sex hormone, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen (E), progestin (P), prolactin (PRL), testosterone (T), sex hormone-binding globulin (SHBG) and free androgen index (FAI) levels, and serumβ-endorphin levels were detected.@*RESULTS@#Compared with before treatment, the BMI, F-G score, SAS score, SDS score and serum FAI level were decreased and the PCOSQ score and the levels of serum SHBG andβ-endorphin were increased in the observation group after treatment (all <0.05). Compared with before treatment, the SDS score was decreased in the control group after treatment (<0.05). Compared with the control group, the F-G score, SDS score, SAS score, and serum FAI level were lower, and the PCOSQ score and serumβ-endorphin level were higher in the observation group after treatment (all <0.05).@*CONCLUSION@#Applying acupuncture to the treatment of patients with PCOS can effectively relieve anxiety and depression, and the mechanism may be related to the regulation on the levels of serumβ-endorphin and androgen.
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Female , Humans , Acupuncture Points , Acupuncture Therapy , Anxiety , Therapeutics , Depression , Therapeutics , Emotions , Gonadal Steroid Hormones , Blood , Polycystic Ovary Syndrome , Psychology , Therapeutics , Quality of LifeABSTRACT
Background: The aim of the study was to investigate the effectiveness of Healthy Eating and Active Lifestyle Intervention Program (HEALIP) on physiological parameters among children with obesity.Methods: True experimental research design was adopted with 200 children between the age group of 12-18 years who met the inclusion criteria from four different schools in Chennai, Tamil Nadu, India. Samples were allocated into experimental group (n=100) and control group (n=100) by random sampling technique. Children were screened for weight, height, body mass index, and blood pressure were measured before as well as after the intervention. Healthy eating and active lifestyle intervention program were administered for the experimental group for 16 weeks, whereas the control group received routine practices. Post-test was conducted at the end of the 16th week for the both groups. Data were analysed using SPSS.Results: There was a difference in the pre-test systolic blood pressure (128.4'1.3) and post-test (118.6'0.7) and in the pre-test diastolic blood pressure (78.8'0.6) and post-test (72.8'0.6) mean value in the experimental group and found statistically significant at the level of p <0.001. It was also observed the significant difference between the experimental and control group.Conclusions: The finding of the study concluded that healthy eating and active lifestyle intervention program has proved the beneficial effect in maintaining the physiological parameters. Hence, it was concluded that there is a need to educate the children about the obesity and its complications. The study findings ensure that periodic monitoring of the basic physiological parameters among obese children will prevent the furthermore complications.
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Non-alcoholic fatty liver disease(NAFLD), the incidence of which grows rapidly, has become the main cause of abnormal liver enzymes in healthy individuals. By now, no clear consensus has been reached on the treatment due to the multi-factorial pathogenesis of NAFLD. It has been indicated by a lot of studies that there is a close association between the pathogenesis, treatment and prognosis of non-alcoholic fatty liver disease and type 2 diabetes. So some measures of type 2 diabetes, including lifestyle intervention, medication and bariatric surgery, have been gradually used for NAFLD patients. This article introduces and summarizes the above-mentioned treatment for nonalcoholic fatty liver disease.
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One thousand and forty-six patients with type 2 diabetes mellitus (T2DM) aged >18 years from 11 community health service centers in Beijing Chaoyang district were enrolled in the study. The body weight, height, fasting plasma glucose level and glycosylated hemoglobin A1c (HbAlc) were measured. A door-to-door questionnaire survey on the use of oral antidiabetic drugs and insulin was conducted between January to December 2017. Of 1 046 T2DM patients, 182 (17.4%) received lifestyle intervention, 257 (24.6%) used single oral antidiabetic drug (OAD), 326 (31.2%) with combined OAD, and 281(26.9%) with insulin and OAD. The average HbA1c in T2DM patients with lifestyle intervention, single OAD drug, combined OAD, and insulin and OAD were (8.1±2.3)%, (7.6±2.0)%, (7.8±2.0)%, and (8.7±2.1)%, respectively (F=18.35, P<0.01). Proportions of the T2DM patients with HbAlc lower than 7.0% were 45.1%, 55.6%, 43.6% and 36.8% in groups, respectively (χ2=55.55, P<0.01). Patients with single or combined OAD aged 18-<45 years had a worse HbA1c control than those aged 45-<65 years and≥65 years. It was found that 59.4%, 52.6%and 30.8%of the patients receiving one OAD, two OADs and three or more OADs achieved glucose control target. The proportion of drug use was 62.6% for α-glucosidase inhibitors, 50.8% for metfomain, 32.5% for insulin, 18.2% for sulfonylureas, 4.9% for glinides, 3.2% for thiazolidinediones and 3.1% for dipeptidyl peptidase-Ⅳs. Among the combined treatment regimens, metfomain+a-glucosidase inhibitors was the most frequently used as compared with α-glucosidase inhibitors+sulfonylureas and metfomain+sulfonylureas. The survey showed that the target-reaching rate of HbA1c was 44.9%, and α-glucosidase inhibitors were frequently used for patients with T2DM in community health service centers in Beijing Chaoyang district south medical alliance.
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One thousand and forty-six patients with type 2 diabetes mellitus (T2DM) aged ＞18 years from 11 community health service centers in Beijing Chaoyang district were enrolled in the study.The body weight,height,fasting plasma glucose level and glycosylated hemoglobin A 1c (HbAlc) were measured.A door-to-door questionnaire survey on the use of oral antidiabetic drugs and insulin was conducted between January to December 2017.Of 1 046 T2DM patients,182 (17.4％) received lifestyle intervention,257 (24.6％) used single oral antidiabetic drug (OAD),326 (31.2％) with combined OAD,and 281(26.9％) with insulin and OAD.The average HbA1c in T2DM patients with lifestyle intervention,single OAD drug,combined OAD,and insulin and OAD were (8.1±2.3) ％,(7.6±2.0) ％,(7.8±2.0) ％,and (8.7±2.1) ％,respectively (F=18.35,P＜0.01).Proportions of the T2DM patients with HbAlc lower than 7.0％ were 45.1％,55.6％,43.6％ and 36.8％ in groups,respectively (x2=55.55,P＜0.01).Patients with single or combined OAD aged 18-＜45 years had a worse HbA1c control than those aged 45-＜65 years and≥65 years.It was found that 59.4％,52.6％and 30.8％of the patients receiving one OAD,two OADs and three or more OADs achieved glucose control target.The proportion of drug use was 62.6％ for α-glucosidase inhibitors,50.8％ for metfomain,32.5％ for insulin,18.2％ for sulfonylureas,4.9％ for glinides,3.2％ for thiazolidinediones and 3.1％ for dipeptidyl peptidase-Ⅳs.Among the combined treatment regimens,meffomain+a-glucosidase inhibitors was the most frequently used as compared with α-glucosidase inhibitors + sulfonylureas and metfomain + sulfonylureas.The survey showed that the target-reaching rate of HbA1c was 44.9％,and α-glucosidase inhibitors were frequently used for patients with T2DM in community health service centers in Beijing Chaoyang district south medical alliance.
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Objective To investigate the status of self‐management of blood pressure (BP) among elderly hypertensive patients living in new rural communities of Shanghai. Methods We enrolled a total of 2 241 hypertensive patients over 60 years old who participated in the National Key Research and Development Project "Cohort study on hypertension" of the 13th Five‐Year Plan in Langxia, Shanghai from May to July 2018. Questionnaires, physical examinations, and laboratory tests were conducted. We collected participants' demographic information, cardiovascular history, and self‐management behaviors related to hypertension. The status of self‐management of BP among participants with hypertension was analyzed. Pearson's chi‐squared test was used to explore the differences between males and females. Results Participants'mean age was (70.0±6.8) years, and males accounted for 38.8% of all participants. The systolic and diastolic BP levels of participants were (147.8±15.4) mmHg (1 mmHg=0.133 kPa) and (82.8±9.8) mmHg, respectively. The systolic blood pressure level of women was higher than that of men, and the diastolic blood pressure level of men was higher; the difference was statistically significant (all P<0.05). The awareness, treatment, and control rate of hypertension were 79.0%, 78.0%, and 25.6%, respectively. Males had a significantly higher control rate than females (P<0.05). The status of self‐management of blood pressure was as follows: (1) As to lifestyle, 84.4% of participants lacked exercise, and 69.2% were overweight or obese. The prevalence of smoking and drinking was higher in males (40.7% and 46.2%, respectively), and the proportion of females (12.4%) with anxiety and/or depression was higher than that of males (P all<0.001). (2) Concerning BP‐monitoring, only 10.1% of participants measured BP every week, 22.9% had BP measurement instruments at home, and 4.6% recorded their BP levels. There was no significant difference in self‐blood pressure monitoring behavior between men and women. (3) Regarding adherence to medication treatment, 97.6% took antihypertensive drugs regularly, and 21.6% were on combination therapy. The proportion of men taking combined drugs was higher than that of women, but there was no significant difference. Conclusions The rates of awareness, treatment, and control of hypertension in elderly hypertensive patients in new rural communities of Shanghai were above the national average. However, the status of self‐management of BP was still not satisfactory. More attention should be paid to healthy lifestyle, home BP monitoring, and effective pharmaceutical treatment strategies for hypertension.
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Background: Lifestyle interventions consisting of diet, exercise, psychosocial support and stress management are a clinically effective alternative to the management of cardiovascular diseases that can be feasibly measured and monitored during treatment using various biological markers. Methodology: A thorough Pubmed search was conducted looking for the results of articles that treated cardiovascular disease patients of both sexes and all ages with lifestyle modification in which the effectiveness of lifestyle modification was measured by various biomarkers. Results: The final review was conducted on 11 journal articles that were found examining exercise, diet, psychosocial support and stress management in cardiovascular disease patients and showing a positive benefit of such an intervention and the effects on biomarkers as an alternative to traditional pharmacological treatment. The affected biomarkers found were percent diameter coronary artery stenosis, blood pressure, cholesterol, body weight and fat, heart rate, HbA1c, exercise capacity, C reactive protein, triglycerides and BMI. Conclusion: Lifestyle modification consisting of exercise, low fat, high complex carbohydrate diet, psychosocial support and stress management is clinically efficacious in the treatment of cardiovascular disease as seen by the various changes in biological measures.
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Lifestyle intervention is basic and background treatment for people with type 2 diabetes.Effective lifestyle intervention contributes to better glucose control and delay of diabetic complications.Dietary and exercise interventions as well as lifestyle advice are major components of lifestyle intervention.Dietary intervention focuses on restriction of total caloric intake and balanced nutritional composition,while exercise intervention focuses on exercise mode,frequency,intensity,timing,and duration.This review introduced several lifestyle intervention measures including exercise and dietary interventions as well as lifestyle advice,and discussed their effects on glucose control in people with type 2 diabetes.
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Globally, individuals with chronic diseases now consume over 80% of all healthcare resources. Set against this depressing projection is decades of epidemiologic work demonstrating that 80%-90% of cardiovascular disease can be prevented via lifestyle and dietary interventions. How can we reconcile such contrasting views toward the future of cardiovascular health in human populations? Herein, we review available sources of evidence that can be used to answer these challenging questions of how and why. In particular, we submit that analytical framework incorporating the 6P (prediction, precision, personalization, prevention, population, and policy)-3G (good food, good environment, and good behavior)-4I (interpretation, integration, implementation, and innovation) will allow us to focus resource towards the development of multi-level approaches for the betterment of population
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Objective To evaluate the effectiveness of intensive lifestyle intervention on rural residents with metabolic syndrome (MS) . Methods A total of 253 patients with MS selected from cross-sectional survey were divided into intensive lifestyle intervention and conventional management group incomplete randomly. Aimed to control weight, patients in the intervention group were treated with dietary control and exercise guidance. Besides, their compliances were assessed. In conventional management group, patients were disposed according to chronic disease management specification. Anthropometric measurements and biochemical markers detection were carried out in both groups at baseline and at the end of 6 months. Results These main anthropometric measurements and biochemical markers have no significant difference between the intervention group and conventional management group at the baseline (P>0.05) . After 6 months intensive lifestyle modification, the prevalence of MS did not significantly differ between the two groups: it was 67.14% in the intervention group and 60.95% in the conventional management group (P>0.05) .In the intervention group, the body weight, BMI and the waist circumference were decreased by 3.11 kg, 1.50 kg/m2, 4.29 cm, respectively, and 1.23 kg, 0.47 kg/m2, 1.22 cm in the conventional management group. The changes were significantly larger in the intervention group than in the conventional management group (P<0.01) .Uric acid, triglyceride were decreased by 14.30 μmol/L, 0.01 mmol/L, respectively, in the intervention group and in the conventional management group they were increased by 18.17 μmol/L and 0.41 mmol/L conversely. While the high density lipoprotein cholesterol was increased by 0.02 mmol/L, it was decreased by 0.10 mmol/L in the conventional management group (P<0.01) . Body weight and BMI decreased by 3.93kg and 1.40 kg/m2 in the high compliance group, compared to low compliance group, there was statistically difference with regard to this change between the two groups (P<0.05) . While the body fat% was decreased by 2.27%, and it was increased by 1.01% in the conventional management group (P<0.05) . Conclusion For rural residents, the beneficial effects of intensive lifestyle intervention are improving metabolic risk factors. The compliance is the main factor of the effects of intervention.
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Background & objectives: Several diabetes prevention programmes have demonstrated a reduction in incidence of diabetes in individuals with prediabetes through weight loss. Short-term yoga-based lifestyle intervention programmes have also been shown to be efficacious in weight loss. This study was undertaken to investigate if interleukin (IL)-6, vitamin D, neopterin, vaspin, and diabetes risk factors can be modified by a short-term yoga-based lifestyle intervention in overweight/obese subjects. Methods: In this pilot study, 34 overweight/obese [body mass index (BMI) ≥23 to <35 kg/m2 per Asian cut-off values] individuals were enrolled, and received directly supervised intervention for 10 days. Thereafter, they were advised to follow this yoga-based lifestyle at home for one month, and were reassessed for study variables at day 30. Results: There was a reduction from baseline to day 10 in weight (p<0.001), BMI (p<0.001), waist/hip-ratio (p<0.05), blood glucose (p<0.01), and a significant improvement in lipid profile. There was a decrease in median fasting insulin (p<0.05), homeostatic model assessment-insulin resistance (p<0.01), and IL-6 (p<0.05). A non-significant increase in 25-OH-vitamin D, and a decrease in neopterin and vaspin were observed. Twenty subjects returned for follow up assessments. At day 30, weight loss was sustained while systolic blood pressure also showed reduction (p<0.05). Changes in vitamin D levels were significantly and negatively correlated with changes in weight, BMI and fasting blood glucose, and positively with change in high density lipoprotein. Changes in body weight and BMI significantly and positively correlated with insulin. Changes in IL-6 levels positively and significantly correlated with change in neopterin levels. Interpretation & conclusions: the findings showed that IL-6, vitamin D, and diabetes risk factors were favourably modified by a short-term yoga-based lifestyle intervention in obesity. This study also highlighted the challenges in compliance associated with the follow up of subjects following an aggressive supervised intervention of 10 days.
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Introdução: Doenças crônicas não transmissíveis representam as principais morbidades da atualidade, dentre estas o diabetes mellitus (DM) tipo 2 e a depressão, as quais encontram-se frequentemente associadas. Ambas contribuem para complicações cardiovasculares e mortalidade. Há evidências de que intervenções comportamentais trazem benefícios cardiometabólicos e psicológicos. Objetivos: Para avaliar intervenção no estilo de vida, este estudo incluiu: 1) revisão sistemática e metanálise destinada a investigar os efeitos de intervenções no estilo de vida na melhora da depressão em indivíduos de risco ou com diabetes mellitus tipo 2; 2) comparação do efeito de duas intervenções no estilo de vida sobre o risco cardiometabólico e na retenção dos indivíduos ao programa; 3) análise do papel da depressão na resposta cardiometabólica às intervenções, mediada pela inflamação e; 4) avaliação do efeito residual 9 meses após término das intervenções quanto às respostas de variáveis clínicas, qualidade de vida (QV) e depressão. Métodos: Para revisão sistemática os principais bancos de dados bibliográficos foram pesquisados, sendo a meta-análise conduzida por modelos de efeito aleatório. O estudo longitudinal incluiu adultos pré-diabéticos, submetidos a 18 meses de intervenção tradicional (TRD) ou interdisciplinar com psicoeducação (INT) para mudanças em hábitos de vida, sendo os dados coletados (antropometria, pressão arterial, perfil bioquímico e marcadores de inflamação PCR, TNF-, adiponectina) no momento basal, 9 e 18 meses, bem como 9 meses após o término do acompanhamento (27 meses).
Introduction: Nowadays non-communicable chronic diseases, such as diabetes mellitus and depression, are major public health problems worldwide. These conditions are commonly associated and contribute to cardiovascular complications and mortality. Previous studies showed that motivational interviews may improve cardiometabolic and psychological aspects. Objectives: In order to assess lifestyle intervention this study includes: 1) Systematic review and meta-analysis to verify effect of lifestyle interventions on depression; 2) to compare effects of two lifestyle interventions in the cardiometabolic risk and in retention of at-risk individuals; 3) to analyze influence of depression in cardiometabolic response to interventions mediated by inflammation and, 4) to assess residual effect at 9 months after completion of interventions according to clinical variables, quality of life and depression. Methods: In the systematic review major bibliographic databases were searched. Meta-analysis was conducted by random-effects model. The effect of method, duration, and frequency of the interventions were determined via subgroup analyses. Our longitudinal study includes prediabetic adults, submitted to one of two lifestyle interventions (TRD:Traditional or INT:Interdisciplinary). Data were collected (anthropometry, blood pressure, biochemical profile and inflammation markers CRP, TNF-, adiponectin) at baseline, 9th and 18th month, as well as 9 months after completion of interventions (observational phase). Diet was evaluated by 24h recalls and physical activity by IPAQ.
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Humans , Clinical Trial , Heart Diseases/metabolism , Heart Diseases/prevention & control , Depression , /physiopathology , Life Style , Inflammation , Interdisciplinary Research , Risk FactorsABSTRACT
This randomized controlled trial study aimed to investigate the effects of a lifestyle intervention on metabolic syndrome (MetS) among middle-aged Koreans. A total of 243 middle-aged Koreans with MetS were randomly assigned to either of 2 types of lifestyle intervention for MetS and followed for 12 months. Health examinations and interventions were implemented at 16 regional branch facilities of a Korean medical institution from 2010, following the NCEP-ATP III criteria and recommendations. Lifestyle intervention (LI) group (n = 137) participated in a 12-week multi-component intervention including individual counseling, group sessions, and self-help materials. Basic usual intervention (BI) group (n = 106) was provided with one-page health information sheet on MetS and MetS management at baseline. Prevalence of MetS and each of MetS components, except for low HDL-cholesterol, in both groups were significantly reduced and maintained after the intervention. Notably, prevalence of hypertension and abdominal obesity continued to improve during the follow-up period. Between-group differences in results were not found. Both interventions were effective when they were accompanied with repeated check-ups and notification of MetS status. It is recommended to design clear guidelines for the notification of MetS after MetS screening and to encourage checking MetS status periodically for effective MetS management (KCT 0000446).
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Adult , Female , Humans , Male , Middle Aged , Combined Modality Therapy , Directive Counseling/methods , Mass Screening/methods , Metabolic Syndrome/diagnosis , Patient Education as Topic/methods , Risk Reduction Behavior , Self-Help Groups , Treatment OutcomeABSTRACT
Objective To investigate the effect of intervention management of hypertension and related risk factors.Methods One hundred and twenty hypertension patients are intervened in terms of blood uric acid,unbalanced diet,overweight,obesity,smoking,excessive drinking,stress and lack of physical activity.And after the medication,comparative analysis is carried out after 1 years follow-up supervision.Results There were significant differences in terms of systolic blood pressure,diastolic blood pressure,waist circumference,body mass index(BMI),fasting blood glucose,total cholesterol,low density lipoprotein (LDL),triglyceride (TG),high density lipoprotein (HDL),blood uric acid and halophilic,stroke like adaptation and cognitive ability in hypertension before and after intervention (t =10.44,8.93,3.98,2.76,7.82,5.39,3.11,3.88,2.24,2.73,5.31,5.11,6.44,3.60,6.58 respectively ;P ＜ 0.01).There weren't significant differences regarding of smoking habit,unregularly life style and stress (P ＞ 0.05).Conclusion The intervention on blood pressure and related risk factors based on changing lifestyles is proved to be with high efficiency in University Communities.
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[Summary] There is a huge population of adults with pre-diabetes in China ,and the majority of whom are impaired glucose tolerance(IGT) patients. IGT is not only a risk factor for type 2 diabetes ,but is also closely related to diabetic microvascular and macrovascular complications. Preventing or delaying the development of diabetes by intervention on IGT has become imperative. When lifestyle intervention alone cannot achieve the ideal goal of diabetes prevention ,pharmacological intervention should be considered. This review will discuss thepathophysiology of IGT ,and the effectiveness ,safety and pharmacoeconomics of IGT pharmacological intervention.
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Obesity is a global health burden and its prevalence is increasing substantially due to changing lifestyle. Chronic adiposity is associated with metabolic imbalance leading to dyslipidaemia, diabetes, hypertension and cardiovascular diseases (CVD). Adipose tissue acts as an endocrine organ releasing several adipocytokines, and is associated with increased levels of tissue and circulating inflammatory biomolecules causing vascular inflammation and atherogenesis. Further, inflammation is also associated independently with obesity as well as CVD. Keeping this in view, it is possible that a reduction in weight may lead to a decrease in inflammation, resulting in CVD risk reduction, and better management of patients with CVD. Lifestyle intervention has been endorsed by several health authorities in prevention and management of chronic diseases. A yoga-based lifestyle intervention appears to be a promising option in reducing the risk for CVD as well as management of patients with CVD as it is simple to follow and cost-effective with high compliance. The efficacy of such lifestyle intervention programmes is multifaceted, and is achieved via reduction in weight, obesity-related inflammation and stress, thereby culminating into risk reduction towards several chronic diseases including CVD. In this review, the association between obesity-related inflammation and CVD, and the role of yoga-based lifestyle intervention in prevention and management of CVD are discussed.
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Ectoenzyme nucleotide pyrophosphate phosphodiesterase 1 (ENPP1) gene has been studied in relation to type 2 diabetes mellitus (T2DM) and insulin resistance (IR). We hypothesized that the difference in genotype may be one of the factors that affect the outcome of intervention. We genotyped 448 men with fasting glucose> or =5.6 mM/L, including 371 in subjects with K allele (KK) (69 control group [CG]; and 302 intervention group [IG]) and 77 in subjects with Q allele (KQ+QQ) (13 CG and 64 IG). The web-based intervention based on a lifestyle modification was delivered by e-mail once a month for 10 months. In the KK, IG demonstrated significantly decreased levels of fasting serum insulin (FSI) as compared to CG and homeostasis model of assessment of insulin resistance (HOMA-IR). In the KQ+QQ IG group, hemoglobin A1c (HbA1c), FSI and HOMA-IR were significantly decreased, and showed further reduction in the HOMA-IR than KQ+QQ CG. After analysis of covariance, K121Q did significantly influence the change of HbA1c in CG after appropriate adjustment. In a multivariate model, BMI change predicted HOMA-IR change (adjusted beta=0.801; P=0.022) in KK IG subjects with T2DM. ENPP1 K121Q did not influence the change in IR. However, individuals with T2DM carrying the K121 variant are very responsive to the effect of BMI reduction on HOMA-IR.