Type 2 Research

Reducing Inner Body Fat Is the Key to Metabolic Improvement After Weight Loss

Reducing visceral fat (the fat that surrounds the body’s vital organs) is responsible for metabolic improvements after weight loss, say Italian researchers. Reduction in subcutaneous fat (fat under the surface of the skin) is not, however.

“In 10 obese subjects, we determined visceral and subcutaneous abdominal fat volume by MRI [magnetic resonance imaging],” they write. “Subjects were then enrolled in a weight-reduction program based on dietary and lifestyle counseling, and MRI was repeated after each subject had achieved a weight loss equal to at least 5 percent of the original body weight.”

The researchers observed “a significant correlation between the amount of visceral fat lost and the improvement in insulin sensitivity.” No correlation, however, was observed between the amount or the percentage of subcutaneous fat lost.


Studies Confirm Byetta Efficacy and Safety

Allen B. King, MD, and colleagues undertook a study of the first 100 patients to take Byetta.

The patients’ charts were reviewed. Byetta was initiated at 5 mcg twice a day and increased to 10 mcg twice a day within four weeks in most cases. Patients were encouraged to reduce their intake of food and to increase activity.

Of the 68 who were still on Byetta at the 12-week mark, King noted that Byetta reduced A1C while allowing a reduction of diabetic medications.


In another Byetta study, German researchers studied the safety and effects of a once-weekly long-acting release formulation of Byetta over the course of 15 weeks in people with type 2.

Forty-five participants were enrolled in a randomized, double-blind, placebo-controlled study. Once-weekly doses of either 0.8 mg or 2.0 mg of long-acting release formulation Byetta or placebo were administered for 15 weeks.

“Exenatide [long-acting release] 0.8 mg and 2.0 mg treatment resulted in reductions from baseline A1C and fasting plasma glucose [42.7 mg/dl and 39 mg/dl, respectively] compared to corresponding increases . . . with placebo,” write the researchers. “With [Byetta] the proportion of patients achieving an A1C [of 7% or less] was 33 percent and 86 percent with 0.8 mg and 2.0 mg long-acting release formulation and 0 percent with placebo.

The researchers note that mild nausea was the most frequent adverse event during treatment with Byetta long-acting release.

No severe hypoglycemia was observed.


Type 2s Should Keep an Eye on Those AGEs

Chinese researchers say that advanced glycation end products (AGEs) play a role in HDL dysfunction in people with type 2. AGEs have been previously implicated in oxidative stress; therefore, the researchers say that increased AGEs may be associated with HDL (“good cholesterol”) dysfunction.

“The association between serum AGEs and the impaired antioxidative activity of HDL suggests that HDL dysfunction in diabetes may be partly due to the increased oxidative stress induced by AGEs,” the researchers conclude. “Whether the reduced antioxidative activity of HDL is due to consumption of HDL-associated antioxidative enzymes and the roles of AGEs involved are under investigation.”


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