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• W2003758101 abstract "This study was designed to determine: (1) the effectiveness and safety of protein-sparing fast and gastric bypass surgery for achieving weight reduction in obese patients with type II diabetes mellitus (non-insulin-dependent diabetes mellitus); (2) the effects of these interventions on glycemic control; (3) the effects of weight loss on insulin secretion and action; and (4) the effects of treatment on atherosclerotic risk factors. Six patients consumed only a protein supplement (1.4 g/kg ideal body weight) for up to six months until a final weight below 120 percent of ideal body weight was achieved or weight loss ceased. Six patients underwent gastric bypass surgery. Both groups of patients were studied before and after treatment white consuming a balanced weight-maintaining diet. Both protein-sparing fast and gastric bypass surgery were safe and successful in the short term in producing weight loss. Both treatments improved glycemic control. Mean fasting plasma glucose values fell from 287 to 168 mg/dl (p < 0.01). Mean total glycosylated hemoglobin values declined from 11.9 to 8.2 percent (p < 0.01) (normal reference interval 5.85 to 8.85 percent). Patients who achieved a final weight below 125 percent of ideal body weight had significantly better post-treatment fasting plasma glucose values (130 versus 196 mg/dl, p < 0.05) and total glycosylated hemoglobin values (6.8 versus 9.0, p < 0.02) than those whose weight remained above 125 percent of ideal. In diet-treated patients, improved glycemic control occurred with caloric restriction alone prior to significant weight loss. Improved glycemic control was accompanied by decreased insulin resistance. Mean steady-state plasma glucose values fell from 377 to 208 mg/dl (p < 0.008), and mean fasting insulin values fell from 31.0 to 17.0 μU/ml (p < 0.004). Acute-phase insulin release, which was markedly impaired before treatment, did not improve even in patients who had post-treatment fasting plasma glucose values below 130 mg/dl. Significant improvements in atherosclerotic risk factors occurred. Mean high-density lipoprotein cholesterol values increased from 33.8 to 40.5 mg/dl (0.006 < p < 0.008), and factor VIII coagulant activity decreased from 194 to 140 percent (p < 0.005). Serum fibrlnogen also decreased (393 to 347 mg/dl, p = 0.08), although the decrease did not reach clinical significance. These results further emphasize the value of weight reduction in management of obese patients with type II diabetes mellitus and suggest that protein-supplemented fast and gastric bypass are safe and effective in the short term." @default.
• W2003758101 created "2016-06-24" @default.
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• W2003758101 date "1984-07-01" @default.
• W2003758101 modified "2023-09-28" @default.
• W2003758101 title "Effects of caloric restriction and weight loss on glycemic control, insulin release and resistance, and atherosclerotic risk in obese patients with type II diabetes mellitus" @default.
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• W2003758101 doi "https://doi.org/10.1016/0002-9343(84)90429-7" @default.
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