American Journal of Psychiatry,
Год журнала:
2024,
Номер
181(1), С. 26 - 38
Опубликована: Янв. 1, 2024
Psychotropic
drug–related
weight
gain
(PDWG)
is
a
common
occurrence
and
highly
associated
with
non-initiation,
discontinuation,
dissatisfaction
psychiatric
drugs.
Moreover,
PDWG
intersects
the
elevated
risk
for
obesity
morbidity
that
has
been
amply
reported
in
population.
Evidence
indicates
differential
liability
exists
antipsychotics,
antidepressants,
anticonvulsants.
During
past
two
decades,
agents
within
these
classes
have
become
available
significantly
lower
or
no
as
such
should
be
prioritized.
Although
lithium
gain,
overall
extent
of
than
previously
estimated.
The
benefit
lifestyle
behavioral
modification
and/or
populations
established,
effectiveness
similar
to
general
Metformin
most
studied
pharmacological
treatment
prevention
PDWG,
promising
data
are
emerging
glucagon-like
peptide-1
(GLP-1)
receptor
agonists
(e.g.,
liraglutide,
exenatide,
semaglutide).
Most
pharmacologic
antidotes
supported
low-confidence
topiramate,
histamine-2
antagonists).
Future
vistas
include
large,
adequately
controlled
studies
GLP-1
possibly
GLP-1/glucose-dependent
insulinotropic
polypeptide
co-agonists
tirzepatide)
well
specific
dietary
modifications.
BMJ,
Год журнала:
2024,
Номер
unknown, С. e080340 - e080340
Опубликована: Окт. 22, 2024
Abstract
Objective
To
assess
whether
use
of
glucagon-like
peptide-1
(GLP-1)
receptor
agonists
before
upper
gastrointestinal
endoscopy
is
associated
with
increased
risk
pulmonary
aspiration
or
discontinuation
the
procedure
compared
sodium-glucose
cotransporter-2
(SGLT-2)
inhibitors.
Design
Cohort
study.
Setting
Two
deidentified
US
commercial
healthcare
databases.
Participants
43
365
adults
(≥18
years)
type
2
diabetes
who
used
a
GLP-1
agonist
SGLT-2
inhibitor
within
30
days
endoscopy.
Main
outcome
measures
The
primary
was
on
day
after
endoscopy,
defined
using
diagnostic
codes.
secondary
Risk
ratios
and
corresponding
95%
confidence
intervals
(CIs)
were
estimated
fine
stratification
weighting
based
propensity
score.
Results
After
weighting,
24
817
(mean
age
59.9
years;
63.6%
female)
18
537
an
(59.8
63.7%
female).
Among
users
inhibitors,
weighted
per
1000
people
was,
respectively,
4.15
4.26
for
9.79
4.91
Compared
use,
not
(pooled
ratio
0.98,
CI
0.73
to
1.31),
although
it
higher
(1.99,
1.56
2.53).
Conclusions
In
this
comparative
cohort
study,
no
during
observed
among
inhibitors
procedure;
however,
possibly
owing
retained
gastric
content.
absence
evidence
from
randomized
trials,
these
findings
could
inform
future
practice
recommendations
preprocedural
protocol
patients
requiring
Nutrients,
Год журнала:
2023,
Номер
16(1), С. 63 - 63
Опубликована: Дек. 25, 2023
Sarcopenia
is
an
age-related
clinical
complaint
characterized
by
the
progressive
deterioration
of
skeletal
muscle
mass
and
strength
over
time.
Type
2
diabetes
(T2D)
associated
with
faster
more
relevant
impairment.
Both
conditions
influence
each
other,
leading
to
negative
consequences
on
glycemic
control,
cardiovascular
risk,
general
health
status,
risk
falls,
frailty,
overall
quality
life,
mortality.
PubMed/Medline,
Scopus,
Web
Science,
Google
Scholar
were
searched
for
research
articles,
scientific
reports,
observational
studies,
trials,
narrative
systematic
reviews,
meta-analyses
review
evidence
pathophysiology
di-abetes-induced
sarcopenia,
its
relevance
in
terms
glucose
control
diabetes-related
outcomes,
diagnostic
therapeutic
challenges.
The
comprehensively
addresses
key
elements
definition
criteria
pathophysiological
correlation
be-tween
T2D,
related
a
critical
role
antihyperglycemic
treatment
health,
perspectives
specific
targeting
myokine
signaling
pathways
involved
regulation
metabolism
trophism.
Prompt
diagnosis
adequate
management,
including
lifestyle
inter-vention,
diet
programs,
micronutrient
supplementation,
physical
exercise,
pharmaco-logical
treatment,
are
needed
prevent
or
delay
T2D.
Diabetes Obesity and Metabolism,
Год журнала:
2023,
Номер
25(8), С. 2362 - 2373
Опубликована: Июнь 5, 2023
Abstract
Aim
To
compare
different
types
of
metabolic
surgery
with
non‐surgical
therapy
for
the
treatment
type
2
diabetes
(T2D).
Methods
The
present
network
meta‐analysis
(NMA)
includes
randomized
clinical
trials
(duration
≥
52
weeks)
comparing
techniques
in
patients.
primary
endpoints
were
endpoint
HbA1c,
body
mass
index
(BMI)
and
remission.
secondary
included
fasting
plasma
glucose,
lipid
profile,
blood
pressure,
arterial
hypertension
dyslipidaemia
remission,
quality
life
surgical
adverse
events.
Indirect
comparisons
performed
by
NMA.
Mean
95%
confidence
intervals
continuous
variables,
Mantel–Haenzel
odds
ratio
categorial
calculated.
Results
procedure
laparoscopic
adjustable
gastric
banding,
Roux‐en‐Y
bypass
(RYGB),
sleeve
gastrectomy
(SG),
bilio‐pancreatic
diversion
(BPD),
greater
curvature
plication
(GCP),
one‐anastomosis
(OAGB)
Duodeno–Jejunal
bypass.
Thirty‐six
included.
Metabolic
bariatric
(MBS)
was
associated
a
significantly
higher
reduction
remission
BMI
compared
medical
therapy.
In
NMA,
significant
HbA1c
observed
OAGB
SG.
Complete
increased
all
procedures
comparison
therapy,
except
GCP.
addition,
only
BPD,
RYGB
BMI.
Conclusions
MBS
is
an
effective
option
T2D
patients
obesity.
Further
long‐term
appropriate
are
needed
assessing
risk–benefit
some
patient
cohorts,
such
as
those
less
than
35
kg/m
aged
older
65
years.
Journal of Clinical Medicine,
Год журнала:
2024,
Номер
13(16), С. 4674 - 4674
Опубликована: Авг. 9, 2024
Owing
to
their
potent
glucose-lowering
efficacy
and
substantial
weight
loss
effects,
glucagon-like
peptide-1
receptor
agonists
(GLP-1
RAs)
are
now
considered
part
of
the
frontline
therapeutic
options
treat
both
type
2
diabetes
mellitus
nondiabetic
overweight/obesity.
Stemming
from
successful
demonstration
cardiometabolic
modulation
reduction
major
adverse
cardiovascular
events
in
clinical
outcome
trials,
GLP-1
RAs
have
since
been
validated
as
agents
with
compelling
protective
properties.
Studies
spanning
bench
preclinical
large-scale
randomised
controlled
trials
consistently
corroborated
benefits
this
pharmacological
class.
Most
notably,
there
is
converging
evidence
that
they
exert
favourable
effects
on
atherosclerotic
ischaemic
endpoints,
data
indicating
may
do
so
by
directly
modifying
burden
composition
plaques.
This
narrative
review
examines
underlying
pharmacology
behind
RAs,
particular
focus
disease.
It
also
delves
into
mechanisms
underpin
putative
plaque-modifying
actions,
addresses
existing
knowledge
gaps
challenges
looks
future
developments
field,
including
use
combination
incretin
for
management.
Bariatric
surgery
(BS)
is
an
effective
intervention
for
obesity
and
related
metabolic
disorders,
significantly
improving
health
alleviating
hormonal
imbalances.
However,
it
induces
complex
endocrine
changes
that
can
lead
to
dysfunctions,
impacting
the
somatotropic,
gonadal,
thyroid,
pancreatic,
adrenal
axes.
This
review
highlights
dual
effects
of
BS
on
system.
A
comprehensive
peer-reviewed
studies
using
PRISMA
guidelines
was
conducted,
focusing
human
research
evaluating
pre
postoperative
parameters.
Studies
were
selected
their
relevance
quality
in
elucidating
consequences
BS.
restores
growth
hormone
secretion
improves
fertility
but
may
disrupt
insulin-like
factor-1
recovery
sex
balance,
leading
bone
loss
catabolic
states.
Postprandial
insulin
hypersecretion
result
hyperinsulinemic
hypoglycemia,
with
impaired
counter-regulatory
responses.
Secondary
hyperparathyroidism
reduced
density
highlight
additional
risks.
Changes
thyroid
levels
have
implications
both
hypothyroid
euthyroid
patients.
These
findings
underscore
interplay
between
improved
control
potential
dysfunctions.
The
current
evidence
predominantly
comprises
association
not
be
safe
clinical
decision-making,
highlighting
need
high-quality
establish
causality
refine
therapeutic
strategies.
Bridging
knowledge
gaps
mechanisms
underlying
these
crucial
optimizing
outcomes.
holistic
approach
integrating
preoperative
screening,
individualized
care,
targeted
therapies
essential
mitigate
complications
while
maximizing
benefits.
