Effect of a standard schema of self-monitoring blood glucose in patients with poorly controlled, non-insulin-treated type 2 diabetes mellitus: A controlled longitudinal study

The effect of self-monitoring of blood glucose (SMBG) on glycemic control with regard to non-insulintreated Type 2 diabetes mellitus (NIT-Type 2 DM) is still a controversial topic. Against this backdrop, we sought to compare the effect of a continuous short-term SMBG schema with as-usual treatment, based on changes in oral antidiabetic treatment in patients with poorly controlled Type 2 DM. We reviewed 492 NIT-Type 2 DM record charts, selecting 27 patients, with poor glycemic control, who were thought to self-monitor their blood glucose levels (SMBG group). We then compared them with 27 patients treated with modifying drugs or diets to achieve and maintain the glycemic target (Control Group). Haemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) were evaluated at baseline, after 3 and 6 months. HbA1c values decreased after 3 and 6 months in the SMBG group (P < 0.001 on both occasions) and in the control group (P < 0.05 and P < 0.01, respectively), but without a significant difference between the two groups when compared at the same time. The FPG progressively decreased in both groups, reaching a significant difference in the SMBG group after 3 months and in the control group after 6 months, and without a significant difference between the two groups. The SMBG schema used in our study could be adopted for target groups before proceeding to the next therapeutic enhancement drug step, representing a useful tool that can help diabetic patients in raising awareness of and treating their disease

From the Ketogenic Diet to the Mediterranean Diet: The Potential Dietary Therapy in Patients with Obesity after CoVID-19 Infection (Post CoVID Syndrome)

Purpose of review: This review primarily examines the evidence for areas of consensus and on-going uncertainty or controversy about diet and physical exercise approaches for in the post-CoVID. We propose an ideal dietary and physical activity approach that the patient with obesity should follow after CoVID-19 infection in order to reduce the clinical conditions associated with post-CoVID syndrome. Recent findings: The CoVID-19 disease pandemic, caused by the severe acute respiratory syndrome coronavirus-2, has spread all over the globe, infecting hundreds of millions of individuals and causing millions of death. It is also known to be is associated with several medical and psychological complications, especially in patients with obesity and weight-related disorders who in general pose a significant global public health problem, and in specific affected individuals are on a greater risk of developing poorer CoVID-19 clinical outcomes and experience a higher rate of mortality. Little is still known about the best nutritional approach to be adopted in this disease especially in the patients post-CoVID syndrome. Summary: To the best of our knowledge, no specific nutritional recommendations exist to manage in the patients post-CoVID syndrome. We report a presentation of nutritional therapeutic approach based on a ketogenic diet protocol followed by a transition to the Mediterranean diet in patients post-infection by CoVID, combined to a physical activity program to address conditions associated with post-CoVID syndrome

The Effect of Tirzepatide on Body Composition in People with Overweight and Obesity: A Systematic Review of Randomized, Controlled Studies

: Tirzepatide (TZP) is a new anti-obesity drug, and little is currently known about its effect on body composition (BC) in people with overweight or obesity. The aim of this study is to conduct a systematic review on the impact of TZP on BC compartments in this population during weight loss programs. Literature searches, study selection, method development, and quality appraisal were performed. The data were synthesized using a narrative approach, in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Of the 1379 papers retrieved, 6 randomized controlled trials met the inclusion criteria and were reviewed, revealing the following findings. Firstly, TZP was shown to result in a significant reduction in total fat mass (FM), visceral adipose tissue (VAT) and waist circumference (WC) between baseline and short as well as intermediate follow-ups. Compared to other anti-obesity medications (e.g., dulaglutide and semaglutide) taken over the same duration, TZP showed a superior decrease in body fat compartments (i.e., total FM, VAT and WC). Finally, the effect of TZP on fat-free mass (FFM) is still uncertain because the findings remain inconclusive. In conclusion, TZP appears to be an effective strategy for achieving significant improvements in body fat and its distribution, but additional investigations are still needed to determine the impact of TZP on lean mass in this population

Resting energy expenditure assessment in anorexia nervosa: comparison of indirect calorimetry, a multisensor monitor and the Müller equation.

The aim of this study was to compare the estimations provided by three different means of measuring the resting energy expenditure (REE) in anorexia nervosa (AN) patients. REE was measured, after 24 h of refeeding, using a portable multisensor body monitor [SenseWear Pro2 Armband (SWA)], FitMate™ method and the Müller equation for individuals with body mass index < 18.5, the latter being based on dual-energy X-ray absorptiometry assessment of body composition. The mean differences between REE values estimated by SWA and those provided by the Müller equation and the FitMate™ method were significantly different from zero in both cases. In contrast, the mean differences between FitMate™ method and Müller equation were weakly significantly different from zero, and a significant correlation was noted between these two methods. In conclusion, the SWA does not appear to be an alternative to FitMate™ and Müller equation methods for assessing REE in AN patients

Contribution of copy number variants (CNVs) to congenital, unexplained intellectual and developmental disabilities in Lebanese patients

International audienceBackground: Chromosomal microarray analysis (CMA) is currently the most widely adopted clinical test for patients with unexplained intellectual disability (ID), developmental delay (DD), and congenital anomalies. Its use has revealed the capacity to detect copy number variants (CNVs), as well as regions of homozygosity, that, based on their distribution on chromosomes, indicate uniparental disomy or parental consanguinity that is suggestive of an increased probability of recessive disease. Results: We screened 149 Lebanese probands with ID/DD and 99 healthy controls using the Affymetrix Cyto 2.7 M and SNP6.0 arrays. We report all identified CNVs, which we divided into groups. Pathogenic CNVs were identified in 12.1% of the patients. We review the genotype/phenotype correlation in a patient with a 1q44 microdeletion and refine the minimal critical regions responsible for the 10q26 and 16q monosomy syndromes. Several likely causative CNVs were also detected, including new homozygous microdeletions (9p23p24.1, 10q25.2, and 8p23.1) in 3 patients born to consanguineous parents, involving potential candidate genes. However, the clinical interpretation of several other CNVs remains uncertain, including a microdeletion affecting ATRNL1. This CNV of unknown significance was inherited from the patient's unaffected-mother; therefore, additional ethnically matched controls must be screened to obtain enough evidence for classification of this CNV. Conclusion: This study has provided supporting evidence that whole-genome analysis is a powerful method for uncovering chromosomal imbalances, regardless of consanguinity in the parents of patients and despite the challenge presented by analyzing some CNVs

Starvation symptoms in patients with anorexia nervosa: a longitudinal study

Objective. The aim of this study was to evaluate the change in starvation symptoms over time and their role as potential predictors of change in eating disorder and general psychopathology in patients with anorexia nervosa treated by means of intensive enhanced cognitive behavioral therapy (ICBT-E). Method. Ninety adult female patients with anorexia nervosa (63 restricting type and 27 binge-eating/purging type) were recruited. Body mass index (BMI), Eating Disorder Examination (EDE) interview, Eating Disorder Examination Questionnaire (EDE-Q), Brief Symptom Inventory (BSI) and Starvation Symptoms Inventory (SSI) scores were recorded at admission, at the end of treatment, and at 6-month follow-up. All tests, except for the EDE, were also administered after 4 weeks of treatment to assess the role of refeeding on these variables. Results. At baseline, starvation symptoms were correlated with measures of eating disorder and general psychopathology. The treatment was associated with a significant increase in BMI, improvement in eating disorder and general psychopathology, and a significant reduction in starvation symptoms. The change in SSI scores from baseline to 4 weeks predicted the improvement in EDE eating concern subscale and global BSI scores. Among patients who had restored their body weight by the end of treatment, dietary restraint and eating concern EDE-Q subscales, global EDE-Q and SSI scores showed greater improvement in the first 4 weeks than in the remaining 16&nbsp;weeks of treatment. Discussion. The findings underline the close relationship between improvements in both starvation symptoms and eating disorder and general psychopathology and indicate the important role of refeeding in ameliorating both

Development of an easy-to-use prediction equation for body fat percentage based on BMI in overweight and obese lebanese adults

An accurate estimation of body fat percentage (BF%) in patients who are overweight or obese is of clinical importance. In this study, we aimed to develop an easy-to-use BF% predictive equation based on body mass index (BMI) suitable for individuals in this population. A simplified prediction equation was developed and evaluated for validity using anthropometric measurements from 375 adults of both genders who were overweight or obese. Measurements were taken in the outpatient clinic of the Department of Nutrition and Dietetics at Beirut Arab University (Lebanon). A total of 238 participants were used for model building (training sample) and another 137 participants were used for evaluating validity (validation sample). The final predicted model included BMI and sex, with non-significant prediction bias in BF% of −0.017 ± 3.86% (p = 0.946, Cohen’s d = 0.004). Moreover, a Pearson’s correlation between measured and predicted BF% was strongly significant (r = 0.84, p, &lt;, 005). We are presenting a model that accurately predicted BF% in 61% of the validation sample with an absolute percent error less than 10% and non-significant prediction bias (−0.028 ± 4.67%). We suggest the following equations: BF% females = 0.624 × BMI + 21.835 and BF% males = 1.050 × BMI − 4.001 for accurate BF% estimation in patients who are overweight or obese in a clinical setting in Lebanon