Effects of metformin on the body composition in subjects with risk factors for type 2 diabetes.

OBJECTIVES: To measure the effect of metformin on the body composition, insulin resistance and sensitivity in subjects with risk factors for type 2 diabetes mellitus (type 2 DM). DESIGN: Placebo-controlled clinical trial. MATERIAL AND METHODS: Twenty-three subjects with risk factors for type 2 DM were randomly assigned to receive 850 mg of metformin or a placebo twice a day for 2 months. Before and after the treatment, the body mass index and waist/hip ratio were calculated, the body composition was measured through bioelectric impedance and the fasting levels of blood glucose, insulin, triglycerides and cholesterol were measured. The level of insulin resistance was calculated by the homeostatic model and the level of sensitivity by the quantitative insulin sensitivity check index method. The Wilcoxon rank test was used. RESULTS: Twenty-one subjects completed the study, 12 of the metformin group and nine of the placebo group. In the metformin group, there was a decrease in fat weight from 25.9 +/- 9.4 to 20.8 +/- 9.2 kg, p < 0.01, an increase in lean weight from 57.05 +/- 13.6 to 61.9 +/- 16.5 kg, p < 0.01, an increase in basal metabolism from 1735 +/- 413 to 1878 +/- 505 calories/day, p < 0.05 and an increase in body water, p < 0.05. There was no significant decrease in insulin resistance. In the placebo group, the blood glucose increased from 84.7 +/- 13 to 96.7 +/- 16 mg/dl, p < 0.05. There were no significant modifications in lipids. CONCLUSIONS: The administration of metformin for 2 months improves the parameters of body composition and insulin dynamics in subjects with risk factors for type 2 DM.

[Lifestyle and metabolic control in patients with type 2 diabetes mellitus. Construct validation of IMEVID questionnaire]. / Estilo de vida y control metabólico en pacientes con diabetes mellitus tipo 2. Validación por constructo del IMEVID.

OBJECTIVE: To evaluate construct validity of an instrument to measure lifestyle in patients with type 2 diabetes mellitus (IMEVID questionnaire) DESIGN: Comparative cross-sectional study. SETTING: Six family medicine units (primary care). PATIENTS: 412 adults with type 2 diabetes. MEASUREMENTS: The IMEVID was applied by self-administration and the following metabolic control parameters values were measured: body mass index (BMI), waist/hip index (WHI), hemoglobin A1C (HbA1C), total cholesterol (TC), triglycerides (TG), systolic blood pressure (SBP), diastolic blood pressure (DBP), and the average of fasting plasma glucose in the last three months (FG). The test hypothetic construct was that higher total scores in the IMEVID (better lifestyle) would be associated with lower values in the metabolic control parameters. Three groups of subjects were formed based on the total score: group one (quartile 75). Differences on these parameters between groups were researched. RESULTS: 389 subjects completed the study, 69,2% were women. Seven IMEVID domains had weak correlations at least with two of eight parameters (r between 0.22 and 0.16; P<.05). The total score had correlation with six of eight parameter (r between 0.18 and 0.10; P< or =.05). The group three subjects had lower levels of BMI, WHI, HbA1C, FG, TC and TGL than group one subjects (P<.05). CONCLUSIONS: IMEVID has construct validity to measure the lifestyle in subjects with DM2. Its total score discriminates outstanding clinical characteristics in these patients.

Estilo de vida y control metabólico en pacientes con diabetes mellitus tipo 2. Validación por constructo del IMEVID / Lifestyle and metabolic control in patients with type 2 diabetes mellitus. Construct validation of IMEVID questionnaire

Objetivo. Evaluar la validez de constructo de un instrumento para medir el estilo de vida en los pacientes con diabetes mellitus tipo 2 (cuestionario IMEVID).Diseño. Estudio observacional transversal comparativo. Emplazamiento. Seis unidades de medicina familiar (atención primaria).Participantes. Un total de 412 adultos con diabetes mellitus tipo 2.Mediciones principales. Se aplicó el IMEVID por autoadministración y se midió el índice de masa corporal (IMC), índice cintura/cadera (ICC), hemoglobina glucosilada (HbA1C), colesterol total (CT), triglicéridos (TG), presión arterial (PA) y glucemia en ayunas (GA). El constructo hipotético de prueba fue que las mayores calificaciones totales en el IMEVID (mejor estilo de vida) estarían asociadas a valores menores de estas variables clínicas. Se dividió a los sujetos en tres grupos según su calificación total: grupo uno ( cuartil 75) y se buscaron diferencias intergrupo en los valores de los parámetros medidos. Resultados. Completaron el estudio 389 sujetos, y un 69,2 por ciento eran mujeres. Siete dimensiones del IMEVID tuvieron correlaciones débiles al menos con dos de los ocho parámetros (r, -0,22 a 0,16; p 0,05). La calificación total se correlacionó con seis de ocho parámetros (r, -0,18 a 0,10; p 0,05). Los sujetos del grupo tres tuvieron valores menores de IMC, ICC, HbA1C, GA, CT y TGL que los del grupo 1 (p < 0,05).Conclusiones. El IMEVID tiene validez de constructo para medir el estilo de vida en los sujetos con diabetes tipo 2. Su calificación total discrimina las características clínicamente relevantes (AU)

[Validity and reliability of FANTASTIC an instrument for measuring the life style in Mexican patients with arterial hypertension]. / Validez y fiabilidad del instrumento "FANTASTIC" para medir el estilo de vida en pacientes mexicanos con hipertensión arterial.

OBJECTIVE: To evaluate the reliability and validity of the instrument "FANTASTIC", when being applied to a sample of Mexican patients with high blood pressure. DESIGN: Observational, prospective, longitudinal, descriptive. SETTING: Unit of Family Medicine No. 91 Instituto Mexicano del Seguro Social. PATIENTS: 103 patients with hypertension on treatment, adults, non diabetics that knew to read and to write. INTERVENTIONS: Was applied "FANTASTIC" instrument (that consists of 25 closed items on the lifestyle), translated to Spanish in versions of 3 and 5 answers, with an interval test-retest of 14 to 21 days. The average of the systolic arterial tension (SAT), diastolic (DAT) and half arterial tension (HAT) was calculated of the last 3 registrations of the clinical file, mass corporal index (MCI), waist/hip ratio (WHR), and fast glucaemia (FG) was measured. MEASUREMENT AND RESULTS: 66% was women. The correlation test-retest, in the version of five answer options was of 0.81 (p = 0.01) and among both versions of 0.91 (p = 0.01). They were not differences in the total qualification according to the sex. To more age, it was bigger qualification and smaller MCI and FG. Weak correlation was observed (not significant) among more total qualification and smaller DAT. There was negative correlation among more qualification in the nutrition domain and smaller MCI (p = 0.01), among more qualification in the domain of tobacco (smaller consumption) with smaller DAT (p = 0.05) and smaller HAT (p = 0.05). CONCLUSIONS: The consistency of the instrument is very good. Their content doesn't correlate specifically with the control indicators in hypertension.