Remission of type 2 diabetes depends on prompt comprehensive lifestyle changes upon diagnosis: How can this "Road to Damascus" experience be supported? / 中西医结合学报

Theoretically, a new diagnosis of type 2 diabetes mellitus (T2DM) requires a dramatic change in an individual's way of life. Weight loss and physical activity can lead to remission of diabetes, which has been associated with a lower risk of developing complications. Today, the importance of a healthy lifestyle is further highlighted by data showing that obesity and diabetes increase the risk of severe complications from coronavirus disease 2019. However, remission rarely occurs in reality, probably due to the inability of people with T2DM to adhere to the intensive lifestyle interventions that are necessary. The complexity of contributing factors may explain why making these changes is so challenging and underscore the fact that there is no magical solution for T2DM. Instead, hard work from both patients and health care providers is needed for the conversion to be achieved. This article calls for more research on the underlying reasons why adhering to a healthy way of life is so difficult for people with diabetes and obesity. Clearly defining these barriers would facilitate the planning of effective policies to promote the adoption of appropriate lifestyle changes early in the course of the disease.

Type 2 diabetes remission: How does it work?

@#Type 2 diabetes mellitus (Type 2 DM) is a chronic disease which rise is closely linked to the obesity epidemic and which requires long-term medical attention to limit the development of its wideranged complications. Many of these complications arise from the combination of resistance to insulin action, inadequate insulin secretion, and excessive or inappropriate glucagon secretion. The increasing evidence of its remission state has been discussed in the literature. Here we report on a patient with metabolic syndrome who underwent a structured therapeutic lifestyle changes (TLC) therapy which eventually led to remission of Type 2 DM.

Effects of health education using therapeutic lifestyle changes method in a population with dyslipidemia / 中华健康管理学杂志

Objective This study evaluated the effects of health education promoting therapeutic lifestyle changes in a population with dyslipidemia. Methods Patients with dyslipidemia were randomly assigned to one of four groups: the current group (CG) received conventional health guidance, the educational course (EC) group attended six lectures as part of an educational course, the phone call (PC) group received twice-monthly follow-up by telephone,and the comprehensive group(EC+PC)attended both the educational course and received follow-up telephone calls. Total cholesterol (TC), total triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein (HDL-C), and the knowledge, attitude, and behavior (KAP) score for blood lipids were compared within each group and among groups. Results A total of 214 patients were enrolled and completed the study: 62 patients in CG,49 patients in EC,56 patients in PC,and 47 patients in EC+PC.There were significant differences in the EC,PC,and EC+PC groups after the 24-week intervention. For example, pre- and post-intervention values for each group were as follows:EC group:(5.74±0.69)mmol/L and(5.14±0.87)mmol/L for TC,35.22±1.67 and 42.96±5.72 for KAP;PC group:(5.63±0.58)mmol/L and(5.22±1.07)mmol/L for TC, 34.54.±0.97and 39.41±5.03 for KAP;EC+PC group:(5.60±0.48)mmol/L and(4.00±0.79)mmol/L for TC,35.44±1.80 and 45.05±3.19 for KAP, respectively (P<0.05). The CG group showed no significant differences before and after treatment:(5.66±0.54)vs.(5.32±1.28)mmol/L for TC,34.37±0.65 vs.35.28±4.02 for KAP(P>0.05).In a comparison among the four groups,the EC and PC groups showed greater improvements than the CG group.Moreover, the EC+PC group showed statistically significant differences in the results compared with the other three groups (P< 0.05). Conclusion An educational course combined with telephone follow-up calls was more effective than a single intervention in improving blood lipids and enhancing the health awareness of patients with dyslipidemia.This combined health education model not only improves the effectiveness of treatment to some degree,but also plays a role in its supervision and management.Furthermore,it may also assist in the implementation of continuous nursing services in medical institutions.

The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients / 가정의학회지

BACKGROUND: Hypertension is highly prevalent among patients who visit primary care clinics. Various factors and lifestyle behaviors are associated with effective blood pressure control. We aimed to identify factors and lifestyle modifications associated with blood pressure control among patients prescribed antihypertensive agents. METHODS: This survey was conducted at 15 hospital-based family practices in Korea from July 2008 to June 2010. We prospectively recruited and retrospectively assessed 1,453 patients prescribed candesartan. An initial evaluation of patients' lifestyles was performed using individual questions. Follow-up questionnaires were administered at 4, 8, and 12 weeks. We defined successful blood pressure control as blood pressure <140 mm Hg systolic and <90 mm Hg diastolic. RESULTS: Of the 1,453 patients, 1,139 patients with available data for initial and final blood pressures were included. In the univariate analysis of the change in performance index, weight gain (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.52 to 3.11; P<0.001), physical inactivity (OR, 1.195; 95% CI, 1.175 to 3.387; P=0.011), and increased salt intake (OR, 1.461; 95% CI, 1.029 to 2.075; P=0.034) were related to inadequate blood pressure control. Salt intake also showed a significant association. Multivariate ORs were calculated for age, sex, body mass index, education, income, alcohol consumption, smoking status, salt intake, comorbidity, and family history of hypertension. In the multivariate analysis, sex (OR, 3.55; 95% CI, 2.02 to 6.26; P<0.001), salt intake (OR, 0.64; 95% CI 0.43 to 0.97; P=0.034), and comorbidity (OR, 1.82; 95% CI, 1.23 to 2.69; P=0.003) were associated with successful blood pressure control. CONCLUSION: Weight gain, physical inactivity, and high salt intake were associated with inadequate blood pressure control.

Current Treatment of Postmenopausal Osteoporosis / 대한산부인과학회지

Osteoporosis is a silent disease which causes a serious morbidity such as fracture. Once osteoporosis risk has been established in postmenopausal women, dietary and lifestyle changes, such as exercise, discontinuing tobacco and alcohol use, are helpful in the prevention of osteoporosis. Fall prevention, calcium and vitamin D supplementation remain the foundation. When pharmacologic intervention is warranted, bisphosphonates and selective estrogen receptor modulator have shown the benefit in preventing bone loss and lowering fracture rates. Short term use of estrogen can be considered for the prevention and treatment of osteoporosis in the postmenopausal women with vasomotor symptoms. Calcitonin and parathyroid hormone are also options for the treatment of osteoporosis. Several new agents are in late-stage development and may offer another treatment alternatives.