Anthropometric and cardiometabolic evolution during DIABEPIC 2 pilot study: type 2 diabetes remission program designed for cardiovascular prevention
Notice bibliographique
Résumé
Abstract Background The most studied strategies for type 2 diabetes (T2D) remission are bariatric surgery and continuous low-calorie diet. DIABÉPIC 2 pilot study demonstrated the feasibility of a T2D remission program based on nutritional and training interventions with known cardiovascular benefits. Thirteen of the 34 diabetics who completed the program were treatment-free at 6 months with an Hb1Ac < 6.5% (Remission group). In contrast, the other 21 diabetics did not reach the criteria of T2D remission (No remission group). Objective Evaluate exploratory cardiovascular (CV) risk reduction and the change in anthropometric and cardiometabolic values, for the whole sample and between the remission and no remission groups. Methods TD2 adults were recruited (Hb1Ac > 6.5% or on oral glucose-lowering agents). Interventions involved dietary education (ultra-processed food withdrawal, Mediterranean diet moderate in carbohydrates) and aerobic and strength training. Participants were also randomized (2:1) to an intermittent fasting protocol (figure 1). Bioimpedance analysis (Seca mBCA 514) and blood tests were performed prior to and at the end of the program. A multivariate repeated-measure ANOVA was used to assess group differences, regarding the change in all anthropometric and cardiometabolic markers presented. Exploratory one-way repeated-measures ANOVAs were used to compare pre-post differences. All effect sizes are reported using the partial Eta-squared. Results 34 participants (41.2% women, 63.6 ± 9.2 years old, T2D duration 7.4 ± 6.7 years, Hb1Ac 6.7 ± 0.7 %). The multivariate analysis showed a group effect (remission vs. no remission) only in the change in triglycerides (TG) (p=0.015, h2p = 0.171). The exploratory analysis in the whole sample (n=34), showed a significant improvement in all anthropometric values: weight -6.8 kg (-9.3 to -4.4, p<0.001), waist -7.5 cm (-9.4 to -5.5, p<0.001), visceral fat -1.3 liters (-1.8 to -0.9, p<0.001), fat mass -3.7% (-4.9 to -2.5, p<0.001), lean mass +3.7% (2.5 to 4.9, 0<0.001). For cardiometabolic parameters, there was a significant change in TG -0.3mmo/l (-0.5 to -0.1, p=0.002), alanine transaminase -7.5 U/L (-14.7 to -0.3, p=0.012), C-reactive protein-high sensibility -1.1 mg/L (-2.0 to -0.2, p=0.004), high-density lipoprotein cholesterol (HDL-C) +0.1 (-0.0 to 0.2, p=0.020), low-density lipoprotein cholesterol +0.2 (-0.0 to 0.4, p=0.036) and TG/HDL-C ratio -0.3 (-0.4 to -0.1, p=0.002), (figure 2 for complete results). Conclusion The difference in the evolution of anthropometric and cardiometabolic parameters between the remission and no remission groups was significant only for the TGs, underlining the magnitude of improvements even in the group that did not achieve T2D remission. In addition to the current T2D remission criteria, the CV risk reduction efficacy of selected interventions should be considered in program design. Larger clinical studies are needed to confirm these results. Figure 1. Interventions. Figure 2. Results.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».