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[疾病防治] Prediabetes: Being a 'night owl' may lead to weight gain

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发表于 2023-3-9 12:54 PM | 显示全部楼层 |阅读模式


Prediabetes: Being a 'night owl' may lead to weight gain

https://www.medicalnewstoday.com ... s%20revealed%20that,gain%20among%20people%20with%20prediabetes.
 楼主| 发表于 2023-3-9 01:05 PM | 显示全部楼层
New research has revealed that having a preference for evening activities, going to bed late, and not getting enough sleep may lead to weight gain among people with prediabetes.

Prediabetes affects around 84 millionTrusted Source people in the United States.

That is, 1 in 3 U.S. individuals are living with the condition, and 90 percent of them are not aware that they have it.

In prediabetes, blood sugar levels are higher than what is considered normal, but not high enough to warrant a diagnosis of type 2 diabetes.

Prediabetes is a serious condition in its own right, putting people at risk of not only type 2 diabetes, but also stroke and heart disease.

Insufficient sleep or a disrupted sleep pattern are also known risk factors for obesity and diabetes. Previous research has suggested that being a “night owl,” or having a preference for activities in the evening and going to bed late, raises the risk of being overweight, as well as having type 2 diabetes and dying prematurely.

So, researchers led by Dr. Sirimon Reutrakul, an associate professor of endocrinology, diabetes, and metabolism in the University of Illinois at Chicago College of Medicine, set out to examine whether being a night owl influenced body mass index (BMI) among people with prediabetes.

BMITrusted Source is a measure of body fat in relation to a person’s height and weight.

Thunyarat Anothaisintawee is the first author of the paper, which was published in the journal Frontiers in Endocrinology.

Sleep patterns, BMI, and prediabetes
Dr. Reutrakul and colleagues examined 2,133 people with prediabetes who were 64 years old, on average.

Using a questionnaire, the scientists assessed the participants’ “eveningness” and “morningness” — that is, their preference for going to bed late and waking up early, respectively.

The scientists also assessed social jetlag, or the difference in sleep timing and duration between weekdays and weekends, in the participants.

Higher levels of social jetlag were found to correlate with a higher BMI. In people older than 60, eveningness was associated with a higher BMI as well. However, this effect was due to not having enough sleep, not to social jet lag.

“In patients with prediabetes,” explain the study authors, “more evening preference was directly associated with higher BMI and indirectly through insufficient sleep duration.”

“These data could inform further interventional studies to reduce BMI in this high-risk group,” add Anothaisintawee and colleagues. Dr. Reutrakul also comments on the significance of the findings.

“Diabetes is such a widespread disease with such an impact on quality of life,” she says, “that identifying new lifestyle factors that might play into its development can help us advise patients with an early stage of the disease on things they can do to turn it around and prevent prediabetes from becoming full-blown diabetes.”

“Timing and duration of sleep are potentially modifiable […] People can have more regular bedtimes and aim to have more sleep, which may help reduce BMI and the potential development of diabetes in this high-risk group.”

Dr. Sirimon Reutrakul

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 楼主| 发表于 2023-3-9 01:11 PM | 显示全部楼层


nightowl.png
A preference for late-night activities may cause people to gain weight.
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 楼主| 发表于 2023-3-9 02:06 PM | 显示全部楼层
People With Pre-Diabetes Who Drop Substantial Weight May Ward Off Type 2 Diabetes

Release Date: July 16, 2013
People with pre-diabetes who lose roughly 10 percent of their body weight within six months of diagnosis dramatically reduce their risk of developing type 2 diabetes over the next three years, according to results of research led by Johns Hopkins scientists.

The findings, investigators say, offer patients and physicians a guide to how short-term behavior change may affect long-term health.

“We have known for some time that the greater the weight loss, the lower your risk of diabetes,” says study leader Nisa Maruthur, M.D., M.H.S., an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine. “Now we understand that we can see much of the benefit of losing that weight in those first six months when people are adjusting to a new way to eating and exercising. Substantial weight loss in the short term clearly should go a long way toward preventing diabetes.”

Preventing pre-diabetes from becoming full-blown diabetes is critical, Maruthur says. Uncontrolled diabetes — marked by excess sugar in the blood — can lead to eye, kidney and nerve damage, as well as cardiovascular disease. The new research suggests that if people with pre-diabetes don’t lose enough weight in those first months, physicians may want to consider more aggressive treatment, such as adding a medication to push blood sugar levels lower.

A report on the research is published online today in the Journal of General Internal Medicine.

Maruthur and her colleagues based their conclusions on analysis of data from the Diabetes Prevention Program (DPP), the largest diabetes prevention study in the United States. Overweight, hyperglycemic people were recruited between 1996 and 1999 and followed for an average of 3.2 years. More than 3,000 participants at 27 academic medical centers were assigned at random either to receive an intense lifestyle intervention, doses of the diabetes drug metformin designed to reduce blood glucose (sugar) levels, or a placebo. Maruthur and her colleagues searched the study information for links among short-term weight loss, reduction of blood glucose levels and impact on the longer-term risk of developing diabetes.

Patients with pre-diabetes have blood sugar levels higher than normal but not yet high enough to be classified as type 2 diabetes. Although not all people with pre-diabetes develop full-blown type 2 disease, without intervention the risk of getting it within 10 years is substantially increased and damage to health may already have begun.
The good news, Maruthur says, is that studies like hers show that the progression from pre-diabetes to type 2 diabetes is not inevitable and lifestyle changes can bring blood sugar levels back to normal.

Participants in the lifestyle arm of the DPP were advised about better eating habits, directed to exercise 150 minutes a week, and given one-on-one counseling for the first six months and group counseling thereafter. Researchers found that those in the lifestyle intervention arm who lost 10 percent or more of their body weight had an 85 percent reduction in risk of developing diabetes within three years. Even more moderate weight loss showed positive effects. Those who lost 5 to 7 percent of their body weight reduced their risk of developing diabetes by 54 percent three years later.

Those who were given metformin, a drug that prevents the liver from producing too much glucose, did not lose significant amounts of weight on average. But those whose blood sugar levels were significantly lowered in six months of taking the medication saw their future risk of developing diabetes fall as well.

The lowest risk, Maruthur says, occurred in patients who lost weight and also lowered the amount of glucose in their blood, as measured by a blood test taken after fasting.

“I’m usually thrilled if a patient loses 3 to 5 percent of his or her body weight after six months, but based on this new knowledge, if patients aren’t losing more weight and if their glucose remains elevated, it might be time to escalate treatment by prescribing metformin,” she says.

Maruthur says few doctors use metformin in patients with pre-diabetes, but given what her new study shows, it might make sense for them to consider prescribing the drug to patients who are unable or unwilling to lose substantial weight in the short term.

When blood tests indicate pre-diabetes, doctors like Maruthur often discuss with their patients the changes they can make to hopefully stave off type 2 diabetes. “Right now, the doctor and patient discuss this and may not discuss it again until the next appointment, which may be six months away or even longer,” she says. “This routine isn’t getting us anywhere.”

She says doctors don’t effectively provide behavior modification programs, in part because insurance rarely covers them. The new research suggests just how valuable — and potentially cost-effective — such interventions could be, she says.

Maruthur’s work is supported by a grant from the National Institutes of Health’s National Center for Research Resources (1KL2RR025006-01).

Other Johns Hopkins researchers involved in the study include Frederick L. Brancati, M.D., M.H.S., and Jeanne M. Clark, M.D., M.P.H
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 楼主| 发表于 2023-3-9 02:09 PM | 显示全部楼层
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