Search

Introduction: Diabesity, characterized by obesity-driven Type 2 diabetes mellitus (T2DM), arises from intricate genetic and environmental interplays that induce various metabolic disorders. The systemic lipid and glucose homeostasis is controlled by an intricate cross-talk of internal glucose/insulin and fatty acid molecules to maintain a steady state of internal environment. Methods: In this study, Caenorhabditis elegans were maintained to achieve glucose concentrations resembling the hyperglycemic conditions in diabetic patients to delve into the mechanistic foundations of diabesity. Various assays were conducted to measure intracellular triglyceride levels, lifespan, pharyngeal pumping rate, oxidative stress indicators, locomotor behavior, and dopamine signaling. Proteomic analysis was also performed to identify differentially regulated proteins and dysregulated KEGG pathways, and microscopy and immunofluorescence staining were employed to assess collagen production and anatomical integrity. Results: Worms raised on diets high in glucose and cholesterol exhibited notably increased intracellular triglyceride levels, a decrease in both mean and maximum lifespan, and reduced pharyngeal pumping. The diabesity condition induced oxidative stress, evident from heightened ROS levels and distinct FT-IR spectroscopy patterns revealing lipid and protein alterations. Furthermore, impaired dopamine signaling and diminished locomotors behavior in diabesity-afflicted worms correlated with reduced motility. Through proteomic analysis, differentially regulated proteins encompassing dysregulated KEGG pathways included insulin signaling, Alzheimer's disease, and nicotinic acetylcholine receptor signaling pathways were observed. Moreover, diabesity led to decreased collagen production, resulting in anatomical disruptions validated through microscopy and immunofluorescence staining. Discussion: This underscores the impact of diabesity on cellular components and structural integrity in C. elegans , providing insights into diabesity-associated mechanisms. [ABSTRACT FROM AUTHOR]

Summary Management of type 2 diabetes includes medications that can unintentionally increase obesity and insulin resistance. This unblinded, single‐centre, randomised controlled trial focused on rural Australian adults with type 2 diabetes (aged 18–75 and body mass index [BMI] >30 kg/m2), measuring the effectiveness of a tailored interdisciplinary obesity care approach compared with usual diabetes care. Led by a nurse practitioner with allied health support (dietitian ± psychologist and physiotherapist), the bariatric treatment involved reducing weight‐gaining medications, a 500‐calories/day deficit, an unsupervised exercise program emphasising movement/strength and psychotherapy, 3‐monthly to 24‐months with support phone calls at weeks 2, 4, 8 and 10. Outcomes from the 224 (113 intervention/111 control) participants were differences in biomedical and physical markers within‐ and between‐groups estimated using multivariate mixed‐effects linear regression between recruitment and 6‐monthly follow‐ups. Greater change occurred in intervention compared with control groups at 12 and 24 months in mean: body weight (−5.9 kg [95% confidence interval, CI: −8.53, −3.23] and −9.0 kg [95% CI: −13.2, −4.77]); BMI (−2.03 kg/m2 [95% CI: −2.92, −1.15] and −3.51 kg/m2 [95% CI: −4.93, −2.08]); and glycated haemoglobin (−0.26% [95% CI: −0.69%, 0.18%] and −0.63% [95% CI: −1.17%, 0.08%]). The control group showed a significant increase in mean leptin level, resulting in a between‐group difference (−27.1 [95% CI: −42.7, −11.5]). Lipids and blood pressure differences were inconclusive, while exploratory analysis showed greater decline in estimated glomerular filtration rate in the control group. The interdisciplinary obesity approach, compared with usual diabetes care, resulted in sustained weight loss and improved diabetes control over 2 years. Trial registration number: ACTRN12622000240741. [ABSTRACT FROM AUTHOR]

Objective. To investigate whether patients with diabesity (the combination of both conditions) have a higher mortality risk than isolated obesity or type 2 diabetes (T2D), particularly when waist-circumference (WC) is used as a criterion for obesity. Materials and methods. This longitudinal study included 4 514 Chilean participants from the Chilean National Health Survey 2009 and 2010. Participants were categorized into four groups based on WC and diagnosis of diabetes: a) normal, b) abdominal obesity-only, c) T2D-only, and d) diabesity. Cox proportional hazard models were performed to investigate the associations between diabesity and all-cause mortality. Analyses were also replicated using body mass index (BMI) categories. Results. After a median follow-up of 10.9 years, 445 (9.9%) participants died. In the fully-adjusted model, compared with participants with normal-conditions, those with diabesity had 1.37 (95%CI: 1.01,1.85) times higher allcause mortality risk. Conclusions. Individuals with diabesity had a higher mortality risk compared to their counterparts. The WC instead of BMI can be a more sensitive predictor of mortality risk in the Chilean population. [ABSTRACT FROM AUTHOR]

Background: The prevalence of type 2 diabetes mellitus (T2DM) has been steadily increasing over the past few decades, largely due to the rise in obesity rates. Bariatric surgery is a gastrointestinal surgical treatment focused on achieving weight loss in individuals with obesity. A more recent and growing body of literature has shown that improvements in glycemic control and insulin sensitivity and even the remission of T2DM can be seen in patients with obesity and T2DM (“diabesity”), before significant weight loss is achieved, justifying the modification of the terminology from bariatric to metabolic and bariatric surgery (BMS). Main Results: This narrative review provides an overview of the latest literature on BMS for diabesity, discussing key publications and exploring controversial and diverging hypotheses. Robust scientific evidence supporting the use of BMS as a treatment for diabesity has been garnered and new venues are being explored, suggesting the novel and complementary role of the latest generation of incretin-based pharmacotherapy. Conclusions: BMS has emerged as a valuable treatment option for patients with diabesity, offering significant improvements in glycemic control, weight loss, and overall health. The limitations of the currently available and reviewed literature include the flawed knowledge of the mechanisms of action and long-term effects of BMS for the treatment of diabesity. Further studies are also warranted to refine the patient selection criteria and optimal surgical techniques and to evaluate the impact of surgery on T2DM outcomes in diverse populations. Lastly, there is a scarcity of studies investigating the efficacy of BMS against incretin-based pharmacotherapy. The non-systematic, narrative nature of this review and its implicit subjective examination and critique of the body of literature are to be considered additional and intrinsic limitations.

Background: The prevalence of type 2 diabetes mellitus (T2DM) has been steadily increasing over the past few decades, largely due to the rise in obesity rates. Bariatric surgery is a gastrointestinal surgical treatment focused on achieving weight loss in individuals with obesity. A more recent and growing body of literature has shown that improvements in glycemic control and insulin sensitivity and even the remission of T2DM can be seen in patients with obesity and T2DM ("diabesity"), before significant weight loss is achieved, justifying the modification of the terminology from bariatric to metabolic and bariatric surgery (BMS). Main Results: This narrative review provides an overview of the latest literature on BMS for diabesity, discussing key publications and exploring controversial and diverging hypotheses. Robust scientific evidence supporting the use of BMS as a treatment for diabesity has been garnered and new venues are being explored, suggesting the novel and complementary role of the latest generation of incretin-based pharmacotherapy. Conclusions: BMS has emerged as a valuable treatment option for patients with diabesity, offering significant improvements in glycemic control, weight loss, and overall health. The limitations of the currently available and reviewed literature include the flawed knowledge of the mechanisms of action and long-term effects of BMS for the treatment of diabesity. Further studies are also warranted to refine the patient selection criteria and optimal surgical techniques and to evaluate the impact of surgery on T2DM outcomes in diverse populations. Lastly, there is a scarcity of studies investigating the efficacy of BMS against incretin-based pharmacotherapy. The non-systematic, narrative nature of this review and its implicit subjective examination and critique of the body of literature are to be considered additional and intrinsic limitations. [ABSTRACT FROM AUTHOR]

Spinophilin is an F-actin binding and protein phosphatase 1 (PP1) targeting protein that acts as a scaffold of PP1 to its substrates. Spinophilin knockout (Spino−/−) mice have decreased fat mass, increased lean mass, and improved glucose tolerance, with no difference in feeding behaviors. Although spinophilin is enriched in neurons, its roles in nonneuronal tissues, such as β cells of the pancreatic islets, are unclear. We have corroborated and expanded upon previous studies to determine that Spino−/− mice have decreased weight gain and improved glucose tolerance in two different models of obesity. We have identified multiple putative spinophilin-interacting proteins isolated from intact pancreas and observed increased interactions of spinophilin with exocrine, ribosomal, and cytoskeletal protein classes that normally act to mediate peptide hormone production, processing, and/or release in Leprdb/db and/or high-fat diet-fed (HFF) models of obesity. In addition, we have found that spinophilin interacts with proteins from similar classes in isolated islets, suggesting a role for spinophilin in the pancreatic islet. Consistent with a pancreatic β cell type-specific role for spinophilin, using our recently described conditional spinophilin knockout mice, we found that loss of spinophilin specifically in pancreatic β cells improved glucose tolerance without impacting body weight in chow-fed mice. Our data further support the role of spinophilin in mediating pathophysiological changes in body weight and whole body metabolism associated with obesity. Our data provide the first evidence that pancreatic spinophilin protein interactions are modulated by obesity and that loss of spinophilin specifically in pancreatic β cells impacts whole body glucose tolerance. NEW & NOTEWORTHY: To our knowledge, these data are the first to demonstrate that obesity impacts spinophilin protein interactions in the pancreas and identify spinophilin specifically in pancreatic β cells as a modulator of whole body glucose tolerance. [ABSTRACT FROM AUTHOR]

Multiple modifications of metabolic syndrome diagnostic criteria have been made—NCEP: ATP III (from 2001, modified in 2004), IDF (2005), IDF Consortium (2009), or Polish Scientific Society Consortium standards (2022) are now frequently in use. Hepatosteatosis and hepatofibrosis are commonly mentioned aspects of metabolic syndrome that greatly increase the likelihood of developing complications. The objective of the study was to assess different diagnostic criteria for metabolic syndrome based on the prevalence of liver steatosis and fibrosis. A retrospective analysis was conducted on the medical data of 2102 patients. Out of all the single criteria, meeting the obesity criterion based on waist circumference showed the highest increase in the risk of hepatosteatosis (by 64–69%, depending on the definition used)—hypertriglyceridemia increased the risk of hepatofibrosis by 71%. Regardless of the specific criteria used, patients with metabolic syndrome had a 34–36% increased likelihood of developing hepatosteatosis—the probability of hepatofibrosis varied between 42% and 47% for the criteria established in 2004, 2005, and 2009, while the Polish 2022 criteria were not statistically significant (p = 0.818). It seems appropriate to establish consistent metabolic syndrome diagnostic criteria—the 2009 IDF guidelines are the most effective in assessing hepatosteatosis and fibrosis risk. [ABSTRACT FROM AUTHOR]

IntroductionDiabesity, characterized by obesity-driven Type 2 diabetes mellitus (T2DM), arises from intricate genetic and environmental interplays that induce various metabolic disorders. The systemic lipid and glucose homeostasis is controlled by an intricate cross-talk of internal glucose/insulin and fatty acid molecules to maintain a steady state of internal environment.MethodsIn this study, Caenorhabditis elegans were maintained to achieve glucose concentrations resembling the hyperglycemic conditions in diabetic patients to delve into the mechanistic foundations of diabesity. Various assays were conducted to measure intracellular triglyceride levels, lifespan, pharyngeal pumping rate, oxidative stress indicators, locomotor behavior, and dopamine signaling. Proteomic analysis was also performed to identify differentially regulated proteins and dysregulated KEGG pathways, and microscopy and immunofluorescence staining were employed to assess collagen production and anatomical integrity.ResultsWorms raised on diets high in glucose and cholesterol exhibited notably increased intracellular triglyceride levels, a decrease in both mean and maximum lifespan, and reduced pharyngeal pumping. The diabesity condition induced oxidative stress, evident from heightened ROS levels and distinct FT-IR spectroscopy patterns revealing lipid and protein alterations. Furthermore, impaired dopamine signaling and diminished locomotors behavior in diabesity-afflicted worms correlated with reduced motility. Through proteomic analysis, differentially regulated proteins encompassing dysregulated KEGG pathways included insulin signaling, Alzheimer’s disease, and nicotinic acetylcholine receptor signaling pathways were observed. Moreover, diabesity led to decreased collagen production, resulting in anatomical disruptions validated through microscopy and immunofluorescence staining.DiscussionThis underscores the impact of diabesity on cellular components and structural integrity in C. elegans, providing insights into diabesity-associated mechanisms.

Overweight and obesity are conditions associated with serious comorbidities, such as diabetes and cardiovascular disease. Prevalence of excessive fat accumulation is increasing worldwide, and thus the need for efficient and sustainable weight loss regimes has become a major issue in clinical practice. Despite the important advances in the development of anti-obesity medications (AOM), their side effects, cost, and accessibility, are limiting factors for their routine use. Conversely, the studies of medicinal plants for weight management holds strong promise as a growing area of research. This review consolidates the representative evidence about the beneficial impacts of Morus alba on weight management and associated metabolic parameters, encompassing: inhibition of digestive enzymes, and thus contribution to the energy deficit required for weight loss, improvements in glucose and lipid metabolism, and attenuation of adiposity. Findings from in vitro, in vivo, and clinical investigations reviewed in the paper, demonstrate that white mulberry extracts have the potency to supplement efficiently and safely a healthy weight management approach.

The increasing prevalence of ‘diabesity’, a combination of type 2 diabetes and obesity, poses a significant global health challenge. Unhealthy lifestyle factors, including poor diet, sedentary behaviour, and high stress levels, combined with genetic and epigenetic factors, contribute to the diabesity epidemic. Diabesity leads to various significant complications such as cardiovascular diseases, stroke, and certain cancers. Incretin-based therapies, such as GLP-1 receptor agonists and dual hormone therapies, have shown promising results in improving glycaemic control and inducing weight loss. However, these therapies also come with certain disadvantages, including potential withdrawal effects. This review aims to provide insights into the cross-interactions of insulin, glucagon, and GLP-1, revealing the complex hormonal dynamics during fasting and postprandial states, impacting glucose homeostasis, energy expenditure, and other metabolic functions. Understanding these hormonal interactions may offer novel hypotheses in the development of ‘anti-diabesity’ treatment strategies. The article also explores the question of the antagonism of insulin and glucagon, providing insights into the potential synergy and hormonal overlaps between these hormones.

Several hallmarks of metabolic syndrome, such as dysregulation in the glucose and lipid metabolism, endothelial dysfunction, insulin resistance, low-to-medium systemic inflammation, and intestinal microbiota dysbiosis, represent a pathological bridge between metabolic syndrome and diabesity, cardiovascular, and neurodegenerative disorders. This review aims to highlight some therapeutic strategies against metabolic syndrome involving integrative approaches to improve lifestyle and daily diet. The beneficial effects of foods containing antioxidant polyphenols, intestinal microbiota control, and physical activity were also considered. We comprehensively examined a large body of published articles involving basic, animal, and human studie, as well as recent guidelines. As a result, dietary polyphenols from natural plant-based antioxidants and adherence to the Mediterranean diet, along with physical exercise, are promising complementary therapies to delay or prevent the onset of metabolic syndrome and counteract diabesity and cardiovascular diseases, as well as to protect against neurodegenerative disorders and cognitive decline. Modulation of the intestinal microbiota reduces the risks associated with MS, improves diabetes and cardiovascular diseases (CVD), and exerts neuroprotective action. Despite several studies, the estimation of dietary polyphenol intake is inconclusive and requires further evidence. Lifestyle interventions involving physical activity and reduced calorie intake can improve metabolic outcomes. [ABSTRACT FROM AUTHOR]

Obesity is the modern world's current epidemic, with substantial health and economic impact. This study aimed to provide a narrative overview of the past, currently available, and future treatment options that offer therapeutic and preventive advantages for obesity management. Historically, rimonabant, and lorcaserin, were approved and used for managing non-syndromic obesity. Currently, orlistat, naltrexone/bupropion, glucagon-like peptide-1 receptor agonist (GLP-1 RA), and a few promising therapeutic agents are under investigation, including retatrutide, cagrilintide and orforglipron, which show promising weight reduction effects. We have developed a search string of the Medical Subject Headings (MeSH), including the terms GLP-1 RAs, obesity, and weight loss. This string was then used to perform a systematic literature search in the database including PubMed, EMBASE, MEDLINE, and Scopus up to January 31st, 2024. Managing obesity often requires medical interventions, particularly in cases of severe obesity or obesity-related comorbidities. Thus, it is important to approach obesity management holistically, considering individual needs and circumstances. In our opinion, consulting with healthcare professionals is crucial to developing a personalized plan that addresses both weight loss and overall health improvement. [ABSTRACT FROM AUTHOR]

"Diabetes" is a metabolic disorder where the body either produces little insulin or becomes progressively resistant to its action which consequently results in high blood sugar. The excessive accumulation of body fat referred to as obese results from a long-lasting imbalance between food intake and energy outlay. It is a complex condition affecting nearly all persons of diverse ages and socioeconomic groups with serious psychological problems. The prevalence of diabetes and obesity in India was 10% and 13%, respectively. This study was conducted to determine prevalence of Diabesity in rural field practice area of tertiary health care centre. A Cross sectional study was conducted for a period of six month (July 2023 to December 2023) in rural field practice area of tertiary health care centre. 192 patients of rural field practice area of tertiary health care centre. Appropriate statistical test is used. In the present study all the participants were in the age group of 18-60 years. 9.89% patients were having FBS more than 125mg/dL are classified as Diabetics and 10.41% of the patients were obese having BMI more than 25 Kg/m2. 5.2% patients were having Diabesity means having both Diabetes and Obesity. The association of diabesity with other NCDs has increased multimorbidity, Preventive services, including lifestyle changes at an early age are necessary. Rather than focusing on individual conditions, an approach to multimorbidity is required. Further studies are warranted to investigate the trends in diabesity [ABSTRACT FROM AUTHOR]

Diabesity is a modern term that describes the coexistence of adverse health effects of diabetes mellitus and obesity and indicates a causal pathophysiological relationship between the two phenomena. The progression of diabesity leads to a deterioration of multiple organs and systems. Effective intervention for patients with diabesity must include optimal obesity therapy to prevent secondary complications. Metabolic surgery is the most effective and sustainable therapy for severe obesity and the elimination or prevention of many associated diseases, including type 2 diabetes mellitus, hypertension, sleep apnea, heart disease, and certain cancers. This review provides an up-to-date overview of surgical interventions for obesity, particularly the development of metabolic surgery. It evaluates different scoring systems for evidence-based selection of metabolic surgery based on disease severity. We reviewed different predictive scoring systems for better evidence-based selection of the best metabolic surgery for patients with diabesity. We found that medication type, fasting insulin level, and C-peptide influence the outcomes of different types of metabolic surgery and heterogeneous remission rates. There are different predictive scoring systems for evidence-based selection of the best metabolic surgery, either sleeve or mini-bypass, that will ensure the highest chance of diabetes remission. Using the metabolic score calculator is a useful tool to help medical specialists determine the optimal treatment strategy for a particular patient. More research is needed before we can agree on the ideal bariatric procedure that offers the highest chance of remission with the lowest incidence of hypoglycemia. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a devastating chronic metabolic disease. Since the majority of type 2 diabetes mellitus patients are overweight or obese, a novel term—diabesity—has emerged. The gut–brain axis plays a critical function in maintaining glucose and energy homeostasis and involves a variety of peptides. Amylin is a neuroendocrine anorexigenic polypeptide hormone, which is co-secreted with insulin from β-cells of the pancreas in response to food consumption. Aside from its effect on glucose homeostasis, amylin inhibits homeostatic and hedonic feeding, induces satiety, and decreases body weight. In this narrative review, we summarized the current evidence and ongoing studies on the mechanism of action, clinical pharmacology, and applications of amylin and its analogs, pramlintide and cagrilintide, in the field of diabetology, endocrinology, and metabolism disorders, such as obesity. [ABSTRACT FROM AUTHOR]

Background: Diabesity is a term used to emphasize the dual epidemic and the combined detrimental effects of diabetes and obesity. We aimed to investigate the associations of diabesity with the incidence and resolution of nonalcoholic fatty liver disease (NAFLD). Methods: This prospective cohort study included 5549 participants with a median follow‐up of 4.3 years (2010–2015). Diabesity was defined as six categories by the combinations of glucose tolerance status (normal glucose tolerance [NGT], prediabetes, and diabetes) diagnosed by fasting and oral glucose tolerance test 2‐h glucose and hemoglobin A1c and general or abdominal obesity status. We examined the odds ratios (ORs) for the incidence and resolution of NAFLD associated with diabesity categories, respectively. Results: For NAFLD incidence, compared with the diabesity category of NGT with nonobesity, the categories of either glucose intolerance or general obesity were associated with higher risks of NAFLD, of which the categories with obesity, regardless of glucose intolerance status, exhibited greater risks (ORs ranged from 3.19 to 4.49) than the categories of nonobesity. For NAFLD resolution, the categories of prediabetes or diabetes with obesity were associated with decreased likelihoods of a resolution of NAFLD (ORs ranged from 0.40 to 0.58). These association patterns were consistent across various definitions of diabesity by glucose tolerance status diagnosed by different combinations of glycemic parameters and general or abdominal obesity. Conclusions: The diabesity association pattern with NAFLD incidence was mainly determined by obesity, while that with NAFLD resolution was driven by the combined phenotype of glucose intolerance and obesity. [ABSTRACT FROM AUTHOR]

Background: Diabesity, the intersection of obesity and diabetes, presents a global health crisis with profound implications. Addressing diabesity requires multifaceted strategies, with diet playing a pivotal role. Over the last 15 years, clinical studies have intensified their exploration of various dietary approaches in diabesity management. This literature review aims to synthesize findings from clinical studies conducted in the last 15 years, shedding light on the efficacy, mechanisms, and nuances of different diet types in diabesity management with special focus on the Mediterranean diet (MD). Methods: Thorough research of academic databases yielded a collection of relevant clinical studies. These studies encompassed a range of dietary strategies, including the MD, low-carbohydrate diets, plant-based diets, high-protein diets, low-fat regimens, and intermittent fasting. Key findings, methodologies, and outcomes were thoroughly extracted and analyzed. Results: The last 15 years have witnessed considerable improvements in recognizing the role of human nutritional habits in diabesity management. The MD appears to be the most well-recognized diet, exerting favorable effects against both obesity and diabetes. Low-carbohydrate diets were found to enhance glycemic regulation and decrease insulin resistance. Plant-based diets demonstrated potential benefits in weight management and cardiometabolic health. High-protein, low-fat dietary models exhibited positive effects on satiety and body weight decline. Intermittent fasting regimens also exerted metabolic improvements and body weight decline. Personalization emerged as a crucial factor in dietary recommendations. Conclusions: Clinical studies from the last 15 years underscore the intricate relationship between diet types and diabesity management. The above results contribute to an increasing body of evidence, emphasizing the need for tailored dietary approaches and especially the MD. Healthcare providers can utilize this knowledge to offer personalized dietary recommendations for individuals with diabesity, potentially curbing the rise of these twin epidemics and improving the well-being of affected populations. [ABSTRACT FROM AUTHOR]

Diabesity is showing rising prevalence. Current treatment modalities include pharmacological and non-pharmacological approaches, yet associated with various drawbacks. Recently, gut microbial dysbiosis is documented as a crucial factor in the pathogenesis of diabesity. Targeting gut microbiome using modulators shows promising therapeutic strategy for diabesity management. In this line, nanonutraceuticals represent new class of gut microbial modulators. The present article explores the potential of nanonutraceuticals including nanoprobiotics, nanoprebiotics, and plant-derived nanovesicles that are fabricated on the ecofriendly food based scaffold with gut microbial modulatory potential for diabesity management. A number of compelling evidences from different studies support Bifidobacterium, Enterococcus, and Bacteroides genera and Lactobacillus plantarum and Akkermansia muciniphila species significant in diabesity management. The probable mechanisms reported for gut microbial dysbiosis–induced diabesity are mentioned. The review findings suggest gut microbiome as significant therapeutic target for diabesity management. Moreover, ecofriendly nanonutraceuticals developed using natural products including food-grade materials are efficient modulators of gut microbiome and indicate next-generation diabesity therapeutics. Clinical studies are imperative as further exploration may provide new dimensions to the future research. [ABSTRACT FROM AUTHOR]

Summary: Background: Long-term exposure to PM2.5 is known to increase the risks for diabetes and obesity, but its effects on their coexistence, termed diabesity, remain uncertain. This study aimed to investigate the associations of long-term exposure to PM2.5 and its chemical constituents with the risks for diabesity, diabetes, and obesity. Methods: This cross-sectional study used the baseline data of a multi-center cohort, consisting of three provincially representative cohorts comprising a total of 134,403 participants from the eastern (Fujian Province), central (Hubei Province), and western (Yunnan Province) regions of China. Obesity and diabetes, and diabesity were identified by a body mass index (BMI) ≥28 kg/m2 and fasting plasma glucose (FPG) ≥126 mg/dL. The average concentrations of PM2.5 and five chemical constituents (NO3−, SO42−, NH4+, organic matter, and black carbon) over participants’ residence during the past three years were estimated using machine learning models. Logistic regression models with double robust estimators, Bayesian kernel machine regression, and weighted quantile sum regression were employed to estimate independent and joint effects of PM2.5 chemical constituents on the risks for diabesity, diabetes, and obesity, as well as the differences from the effects on obesity. Stratified analyses were performed to examine effect modification of sociodemographic and lifestyle factors. Findings: There were 129,244 participants with a mean age of 54.1 ± 13.8 years included in the study. Each interquartile range increase in PM2.5 concentration (8.53 μg/m3) was associated with an increased risk for diabesity (OR = 1.23 [1.17, 1.30]), diabetes only (OR = 1.16 [1.13, 1.19]), and obesity only (OR = 1.03 [1.00, 1.05]). Long-term exposure to each PM2.5 chemical constituent was associated with an increased risk for diabesity, where organic matter exposure, with maximum weight (48%), was associated with a higher risk for diabesity (OR = 1.21 [1.16, 1.27]). Among those with obesity, black carbon contributed most (68%) to the joint effect of PM2.5 chemical constituents on diabesity (OR = 1.16 [1.11, 1.22]). Physical activity reduced adverse effects of PM2.5 on diabesity. Also, additive rather than multiplicative effects of obesity on the PM2.5-diabetes association were observed. Interpretation: Long-term exposure to PM2.5 and its chemical constituents was associated with an increased risk for diabesity, stronger than associations for diabetes and obesity alone. The main constituents associated with diabesity and obesity were black carbon and organic matter. Funding: National Natural Science Foundation of China (42271433, 723B2017), National Key R&D Program of China (2023YFC3604702), Fundamental Research Funds for the Central Universities (2042023kfyq04, 2042024kf1024), the Science and Technology Major Project of Tibetan Autonomous Region of China (XZ202201ZD0001G), Science and technology project of Tibet Autonomous Region（XZ202303ZY0007G), Key R&D Project of Sichuan Province (2023YFS0251), Renmin Hospital of Wuhan University (JCRCYG-2022-003), Jiangxi Provincial 03 Special Foundation and 5G Program (20224ABC03A05), Wuhan University Specific Fund for Major School-level Internationalization Initiatives (WHU-GJZDZX-PT07).

Multiple modifications of metabolic syndrome diagnostic criteria have been made—NCEP: ATP III (from 2001, modified in 2004), IDF (2005), IDF Consortium (2009), or Polish Scientific Society Consortium standards (2022) are now frequently in use. Hepatosteatosis and hepatofibrosis are commonly mentioned aspects of metabolic syndrome that greatly increase the likelihood of developing complications. The objective of the study was to assess different diagnostic criteria for metabolic syndrome based on the prevalence of liver steatosis and fibrosis. A retrospective analysis was conducted on the medical data of 2102 patients. Out of all the single criteria, meeting the obesity criterion based on waist circumference showed the highest increase in the risk of hepatosteatosis (by 64–69%, depending on the definition used)—hypertriglyceridemia increased the risk of hepatofibrosis by 71%. Regardless of the specific criteria used, patients with metabolic syndrome had a 34–36% increased likelihood of developing hepatosteatosis—the probability of hepatofibrosis varied between 42% and 47% for the criteria established in 2004, 2005, and 2009, while the Polish 2022 criteria were not statistically significant (p = 0.818). It seems appropriate to establish consistent metabolic syndrome diagnostic criteria—the 2009 IDF guidelines are the most effective in assessing hepatosteatosis and fibrosis risk.

Diabesity is the concurrence of both diabetes and obesity, and it has become a modern epidemic. It is linked by numerous common pathophysiological mechanisms which can be targeted to combat its harms. The available treatments for diabesity include the medications that are also causing several adverse side effects. The increasing healthcare costs, both direct and indirect, for diabesity management continue to rise, underscoring the urgency to find efficient and cost-effective treatment methods. These circumstances have prompted a shift in research towards exploring natural dietary alternatives for treatment. Among these dietary substitutes, citrus fruits rich in polyphenols have caught the attention of researchers. This review narrates the major interconnection of diabesity and brings out the various mechanisms in which citrus polyphenols can be used for its management. Citrus polyphenols fight against diabesity by targeting adipokines, reactive oxygen species, leptin deficiency, metabolic endotoxemia, peroxisomes proliferator activating receptors, insulin signaling, starch hydrolyzing enzymes, and human islet amyloid polypeptide. The studies on the role of citrus polyphenols in the treatment of diabesity have shown clearly that addressing various physiological systems which can interact with citrus polyphenols can help to manage diabesity and related health concerns.

Diabetes and obesity have been recognized as confirmed risk factors for the occurrence of liver fibrosis. Despite the long-standing acknowledgment of "diabesity", the simultaneous existence of diabetes and obesity, scholarly literature has shown limited attention to this topic. The aim of this pilot study was to assess the prevalence of liver fibrosis among individuals with diabetes (specifically those who are obese) in order to identify the key factors associated with hepatofibrosis and determine the most important associations and differences between patients with and without liver fibrosis. The research included a total of 164 participants (48.17% had comorbid obesity). Liver elastography (Fibroscan) was performed on these individuals in addition to laboratory tests. Liver fibrosis was found in 34.76% of type 2 diabetes patients; male gender almost doubled the risk of hepatofibrosis (RR 1.81) and diabesity nearly tripled this risk (RR 2.81; however, in degree III of obesity, the risk was elevated to 3.65 times higher). Anisocytosis, thrombocytopenia, or elevated liver enzymes raised the incidence of liver fibrosis by 1.78 to 2.47 times. In these individuals, liver stiffness was negatively correlated with MCV, platelet count, and albumin concentration; GGTP activity and HbA1c percentage were positively correlated. The regression analysis results suggest that the concentration of albumin and the activity of GGTP are likely to have a substantial influence on the future management of liver fibrosis in patients with diabesity. The findings of this study can serve as the basis for subsequent investigations and actions focused on identifying potential therapeutic and diagnostic avenues. [ABSTRACT FROM AUTHOR]

Metabolic syndrome (MS) is a growing disorder affecting thousands of people worldwide, especially in industrialised countries, increasing mortality. Oxidative stress, hyperglycaemia, insulin resistance, inflammation, dysbiosis, abdominal obesity, atherogenic dyslipidaemia and hypertension are important factors linked to MS clusters of different pathologies, such as diabesity, cardiovascular diseases and neurological disorders. All biochemical changes observed in MS, such as dysregulation in the glucose and lipid metabolism, immune response, endothelial cell function and intestinal microbiota, promote pathological bridges between metabolic syndrome, diabesity and cardiovascular and neurodegenerative disorders. This review aims to summarise metabolic syndrome's involvement in diabesity and highlight the link between MS and cardiovascular and neurological diseases. A better understanding of MS could promote a novel strategic approach to reduce MS comorbidities. [ABSTRACT FROM AUTHOR]

Diabetes and obesity are highly prevalent in the world. Proteomics is a promising approach to better understanding enzymes, proteins, and signaling molecules involved in diabetes processes which help recognize the basis of the disease better and find suitable new treatments. This study aimed to summarize the molecular mechanisms from the beginning of insulin secretion in response to stimuli to the pathology of the insulin signaling pathway and, finally, the mechanisms of drugs/chemicals remedies that affect this process. The titles and subtitles of this process were determined, and then for each of them, the articles searched in PubMed and ScienceDirect were used. This review article starts the discussion with the molecular basis of insulin biosynthesis, secretion, insulin's mechanism of action, and molecular aspect of diabetes and diabesity (a new term showing the relation between diabetes and obesity) and ends with the drug and plant-derived intervention for hyperglycemia. [ABSTRACT FROM AUTHOR]

Yi Zhang,1,2 Yulin Zhang,3,&ast; Li Zhu,4,&ast; Zixiang Yu,5 Fangting Lu,1 Zhen Wang,1 Qiu Zhang1 1Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China; 2Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China; 3The Second Clinical Medical College, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China; 4Department of Endocrinology, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China; 5The First Clinical Medical College, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qiu Zhang, Department of Endocrinology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China, Email zhangqiu@ahmu.edu.cnIntroduction: Obesity in adults is a problem, particularly when paired with other metabolic abnormalities. Previous research have linked various screening approaches to diabetes, but additional evidence points to the relevance of combining diabetes screening methods with obesity and its effects. This research examined the impact of thyroid hormones (TSHs) and health risk factors (HRFs) in screening for obesity and diabetes in Chinese populations, and whether age can modulate this association.Methods: From March to July 2022, the Hefei Community Health Service Center connected with the First Affiliated Hospital of Anhui Medical University was chosen, and the multi-stage cluster sample approach was utilized to test adults aged 21– 90 in each community. Latent category analysis (LCA) was performed to investigate the clustering patterns of HRFs. A one-way ANOVA was used to examine waist circumference (WC), biochemical markers, and general data. Furthermore, multivariate logistic regression analysis was utilized to investigate the relationship between health risk variables and WC.Results: A total of 750 individuals without a history of major problems who had a community health physical examination were chosen, with missing data greater than 5% excluded. Finally, 708 samples were included in the study with an effective rate of 94.4%. The average WC was (90.0± 10.33) cm, the prevalence in the >P75, P50~P75, P25~P50, and ≤P25 groups were 24.7%, 18.9%, 28.7% and 27.7%, respectively. The average TSH was (2.76± 2.0) μIU/mL. Male (β=1.91), HOMA-IR (β=0.06), TyG (β=2.41), SBP (β=0.08), TG (β=0.94) and UA (β=0.03) were more likely to have a higher prevalence of WC level. The analyses revealed significant correlations between HRFs, TSH, age, other metabolic indexes and WC (P < 0.05).Discussion: Our findings suggest that the quality of metabolic-related indicators used to successfully decrease diabetes in Chinese individuals with high HRFs levels should be prioritized. Comprehensive indicators might be a useful and practical way for measuring the metabolic evolution of diabetes level levels.Keywords: health risk factors, diabetes mellitus, metabolic indicators, TSH, WC, diabesity

Several hallmarks of metabolic syndrome, such as dysregulation in the glucose and lipid metabolism, endothelial dysfunction, insulin resistance, low-to-medium systemic inflammation, and intestinal microbiota dysbiosis, represent a pathological bridge between metabolic syndrome and diabesity, cardiovascular, and neurodegenerative disorders. This review aims to highlight some therapeutic strategies against metabolic syndrome involving integrative approaches to improve lifestyle and daily diet. The beneficial effects of foods containing antioxidant polyphenols, intestinal microbiota control, and physical activity were also considered. We comprehensively examined a large body of published articles involving basic, animal, and human studie, as well as recent guidelines. As a result, dietary polyphenols from natural plant-based antioxidants and adherence to the Mediterranean diet, along with physical exercise, are promising complementary therapies to delay or prevent the onset of metabolic syndrome and counteract diabesity and cardiovascular diseases, as well as to protect against neurodegenerative disorders and cognitive decline. Modulation of the intestinal microbiota reduces the risks associated with MS, improves diabetes and cardiovascular diseases (CVD), and exerts neuroprotective action. Despite several studies, the estimation of dietary polyphenol intake is inconclusive and requires further evidence. Lifestyle interventions involving physical activity and reduced calorie intake can improve metabolic outcomes.

Aims: The purpose of this review is to explore the interconnected pathways of the microbiota-gut-brain axis (MGBA), focusing on the roles of the vagus nerve and glucagon like peptide-1 in appetite control, and in the development of obesity and diabetes. Methods: Type 2 diabetes mellitus (T2DM) and obesity are metabolic disorders whose prevalence has significantly increased in recent decades and is expected to increase every year, to pandemic proportions. These two pathologies often coexist and have substantial public health implications. The term "diabesity" defines the pathophysiological connection between overweight and T2DM. The gut microbiota affects many aspects of the host. Beyond the regulation of intestinal functions and the activation of immune responses, the gut microbiota plays a role in central nervous system functions (i.e., mood, and psychiatric conditions associated with stress and memory) and is a central regulator of metabolism and appetite. Results: The MGBA involves pathways such as the autonomic and enteric nervous systems, the hypothalamic– pituitary–adrenal axis, the immune system, enteroendocrine cells, and microbial metabolites. Notably, the vagus nerve plays an essential role in eating behavior by modulating appetite and learning nutritional preferences. Conclusions: Because of its enteroendocrine cell-mediated interaction with the gut microbiota, the vagus nerve may provide a potential pathway through which gut microorganisms influence host feeding behavior and metabolic control of physiological and pathological conditions. [ABSTRACT FROM AUTHOR]

Obesity-induced skeletal muscle (SKM) inflexibility is closely linked to mitochondrial dysfunction. The present study aimed to evaluate the effects of melatonin on the red vastus lateralis (RVL) muscle in obese rat models at the molecular and morphological levels. Five-week-old male Zücker diabetic fatty (ZDF) rats and their age-matched lean littermates (ZL) were orally treated either with melatonin (10 mg/kg body weight (BW)/24 h) (M–ZDF and M–ZL) or non-treated (control) (C–ZDF and C–ZL) for 12 weeks. Western blot analysis showed that mitochondrial fission, fusion, and autophagy were altered in the C-ZDF group, accompanied by reduced SIRT1 levels. Furthermore, C-ZDF rats exhibited depleted ATP production and nitro-oxidative stress, as indicated by increased nitrites levels and reduced SOD activity. Western blotting of MyH isoforms demonstrated a significant decrease in both slow and fast oxidative fiber-specific markers expression in the C-ZDF group, concomitant with an increase in the fast glycolytic fiber markers. At the tissue level, marked fiber atrophy, less oxidative fibers, and excessive lipid deposition were noted in the C-ZDF group. Interestingly, melatonin treatment partially restored mitochondrial fission/fusion imbalance in the RVL muscle by enhancing the expression of fission (Fis1 and DRP1) markers and decreasing that of fusion (OPA1 and Mfn2) markers. It was also found to restore autophagy, as indicated by increased p62 protein level and LC3BII/I ratio. In addition, melatonin treatment increased SIRT1 protein level, mitochondrial ATP production, and SOD activity and decreased nitrites production. These effects were associated with enhanced oxidative phenotype, as evidenced by amplified oxidative fiber-specific markers expression, histochemical reaction for NADH enzyme, and muscular lipid content. In this study, we showed that melatonin might have potential therapeutic implications for obesity-induced SKM metabolic inflexibility among patients with obesity and T2DM. [ABSTRACT FROM AUTHOR]

Yi Zhang,1,2 Yanlei Wang,1,&ast; Shengwu Zhang,1,&ast; Yulin Zhang,3 Qiu Zhang1 On behalf of the China National Diabetic Chronic Complications Study Group1Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China; 2Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China; 3The Second Clinical Medical College, Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qiu Zhang, Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China, Email zhangqiu@ahmu.edu.cnBackground: Health risk factors (HRFs), including the adjustment of disturbed sleep patterns (including disorders and duration) and improvement of dietary intake, have become relatively novel and critical strategies to prevent the development of diabesity and treat diabetic complications.Objective: We aimed to explore 1) whether there was an association between diet styles (including healthy and unhealthy diets) and diabesity; 2) whether sleep patterns could moderate this relationship; and 3) whether there was a complex interaction association between sleep patterns, diet styles, and diabesity.Methods: The study was based on a national survey conducted by the China National Diabetic Chronic Complications Study Group, this study extracted data from some cities in Anhui Province and obtained basic and lifestyle information using a detailed questionnaire for analysis. The primary exposure was diet styles, and the outcomes were body mass index (BMI) and waist circumference (WC), while HbA1c and FBG and sleep patterns were moderators. Data were pooled using logistic regression and moderation analysis.Results: The overall response rate was 92.0%. This study ultimately included 1765 participants. The mean age was 57.10 ± 10.0 years. Sociographically, participants with lower educational levels were more likely to have lower levels of WC (χ2 = 2.73) and BMI (χ2 = 3.47), were female (t=6.54), were more likely to have lower educational levels (F=13.78) and were older (F=23.75), were more likely to have higher detection rates of sleep disorders and were more likely to have other HRFs (walking, SSBs, HbA1c and TG). Additionally, diet styles were also significantly associated with BMI and WC. In the moderation analysis, SES (socioeconomic status) also affected the correlation between healthy diet style, sleep disorders and WC (β=0.20), neither in BMI nor unhealthy diet style in BMI and WC; the combination effect between diet styles, sleep patterns and HbA1c was associated with WC and BMI.Conclusion: Complex associations and interactions were found between diet styles, sleep patterns, HbA1c, and diabesity. Therefore, it is necessary to understand the dietary pattern and other HRFS that cause diabesity, so as to strengthen further preventive measures. These results can provide some theoretical basis for the treatment of diabesity in the public health field.Keywords: diabesity, BMI, waist circumference, diet styles, diabetes

Objective: According to modern medicine sciences, new term “diabesity” is being coined to explain the interdependency and relationship of diabetes and obesity. Diabesity is diabetes occurring in the context of obesity. The terms such as Prameha and Sthoulya are used to explain the above conditions in Ayurveda. Both of these conditions have many etiological factors in common. The basic principles of management of all the diseases in Ayurveda include Aushadha (~medications), Aahara (~diet), and Vihaara (~lifestyle). It is observed that Pathya-Aahara-Vihaara (~balanced diet and lifestyle) can help in reversal of such diseases. Data Source: Combined Pathya-Aahara-Vihaara regimen as prescribed for both Prameha and Sthoulya can help in effective management of the condition. This includes the study of suggested Pathya-Aahara-Vihaara from almost all the Aahara Varga (~food groups) mentioned in Data Source and Review. Review Methods: Information regarding the etiological factors and Pathya-Aahara-Vihaara according to different Samhita ranging from Brihattrayee (Charaka Samhita, Sushruta Samhita, Ashtang Sangraha, Ashtang Hridaya) to Laghutrayee (Bhavaprakash, Sharangdhar Samhita, Madhav Nidana), Bhaishajya Ratnavali, and Yogaratnakar. In this article, we mainly focus on the Pathya-Aahara-Vihaara that Sthula Pramehi (~obese diabetic) or any person suffering from diabesity can follow to prevent control and revert the diseases. Conclusion: Diabesity can be correlated with conditions such as Prameha and Sthoulya according to Ayurveda, and there was similarity in etiological factors of both conditions. Combined Pathya-Aahara-Vihaara can help in managing the diabesity like condition.

Background: A large number of epidemiologic studies across the world indicate a growing link between obesity and diabetes. The metropolitan city of Chennai in South India is experiencing an alarming increase in diabetes and obesity. Aim: The aim of this study was to determine the prevalence of and risk factors for diabetes and obesity together termed as “diabesity” among adults in urban Chennai. Materials and Methods: This was a community-based cross-sectional door-to-door study done as part of a large National Institute of Health and Care Research (NIHR)––a funded project aimed to understand patterns and determinants of health in South Asia. Of the 200 wards in Chennai, 34 wards were surveyed in the main project and two wards were selected randomly for this substudy. Five community enumeration blocks were selected using a systematic sampling technique. Participants aged ≥18 years were selected using a consecutive sampling method. Results: Of the 1138 participants studied, the prevalence of diabesity was found to be 34.3%(n = 390). Of the study participants, 74.8% had obesity (61.9%––generalized obesity; 68.5%––abdominal obesity) and 43.0% had diabetes. As age increased, the diabesity risk also increased gradually from 30 to 39 years (odds ratio [OR]: 3.6[95%, confidence interval [CI]: 1.4–8.9]) to 50–59 years (OR: 5.4[95%, CI: 2.2–13.2]), whereas there was a slight decrease in risk after 60 years (OR: 5.1[95%, CI: 2.1–12.3]). Females had nearly twice the risk of diabesity compared to men (OR: 1.8, P < 0.001), and physically inactive individuals had 1.7 times increased risk (P < 0.001). Conclusion: We report in this study that the prevalence of the dual metabolic defect (diabesity) is alarmingly high in urban Chennai. This study was an attempt to understand the epidemiology of diabesity.

Introduction: Although the independent effects of diabetes mellitus and obesity on total hip replacement (THR) outcomes have been widely studied, their combined effect remains uncharacterised. This study aimed to assess the influence of diabesity on primary THR operative outcomes. Materials and methods: A retrospective study was performed comparing the outcomes of patients with diabesity (diabetes mellitus and obesity [BMI ≥ 30]) with a control cohort after primary THR using an established arthroplasty database. Data were collected pre-operatively and 12 months post-operatively, including Oxford Hip Score (OHS), EuroQol 5-dimensions (EQ5D), post-operative satisfaction and complication rates. Results: 2323 THRs were analysed, of which 94 (4%) had diabesity. Diabesity was independently associated with significantly worse OHS improvement post-operatively (− 1.85 points, 95% CI − 2.93 to − 0.76, p = 0.001). This reduction in addition to the independent effect of obesity (− 0.69 points, 95% CI − 1.18 to − 0.21, p = 0.005) resulted in an overall 2.54 point OHS reduction for patients with diabesity. Diabesity was not associated with EQ5D score change or post-operative satisfaction. Diabesity was independently associated with a worse pre-operative EQ5D score (−0.08 points, 95% CI −0.12 to −0.03, p = 0.002). When combining the associated risk of obesity (Odds Ratio (OR) 1.71, 95% CI 1.15–2.54, p = 0.008) with the superadded effect of diabesity (OR 2.37, 95% CI 1.19–4.71, p = 0.014) the rate of superficial wound infection post-operatively was significantly increased (OR 4.05, 95% CI 1.38–11.95). Obesity was associated with a significantly increased risk of deep infection (OR 3.67, 95% CI 1.55–8.68, p = 0.003), but no additive effect of diabetes was found. Conclusions: Diabesity confers a superadded effect over established associations between THR outcomes and obesity and diabetes individually. Patients with diabesity experience worse improvement in hip-specific functional outcome, worse post-operative quality of life, and an increased risk of superficial and deep wound infection following THR. [ABSTRACT FROM AUTHOR]

Diabesity is a neologism that we use to describe Type 2 diabetes in the context of obesity. In this descriptive review, we aim to analyze the phenomenon of diabesity in the context of the Yucatecan Maya population, given the demographic importance of this ethnic group in Mexico and due to the high prevalence of diabetes and obesity observed. Firstly, we describe the phenotypic and genotypic traits associated with diabesity. We also discuss the role of the sociocultural factors that have impacted the dietary pattern of the Maya, the available evidence regarding the phenotypic characteristics acquired during the early stages of development, their possible repercussions on the metabolism and the presence of obesity and diabetes. Finally, we propose that the failure of insulin secretion and glucolipotoxicity are common factors and a possible unifying factor of diabesity within the Maya population. For this purpose, we draw upon primary sources of information, including original research articles, chapters from edited books about diabesity and sociohistorical essays on the Maya population. [ABSTRACT FROM AUTHOR]

To date, the 21st Century has witnessed key developments in the management of diabesity (a conflation of obesity and Type 2 Diabetes Mellitus [T2D]), including Glucagon Like Peptide 1 (GLP1) receptor agonist therapies, and recently the 'designer' GLP1 Poly-agonist Peptides (GLP1PPs). A PubMed search of published data on the GLP1PP class of therapies was conducted. The gut-brain axis forms complex multi-directional interlinks that include autonomic nervous signaling, components of the gut microbiota (including metabolic by-products and gram-negative cell wall components [e.g. endotoxinaemia]), and incretin hormones that are secreted from the gut in response to the ingestion of nutrients. The development of dual-incretin agonist therapies includes combinations of the GLP1 peptide with Glucose-dependent Insulinotropic Polypeptide (GIP), Glucagon (Gcg), Cholecystokinin (CCK), Peptide YY (PYY), and Glucagon-Like Peptide 2 (GLP2). Triple incretin agonist therapies are also under development. At the dawn of a new era in the therapeutic management of diabesity, the designer GLP1PP class holds great promise, with each novel combination building on a preexisting palimpsest of clinical data and insights. Future innovations of the GLP1PP class will likely enable medically induced weight loss and glycemic control in diabesity to rival or even out-perform those resulting from bariatric surgery. [ABSTRACT FROM AUTHOR]

Obesity and type 2 diabetes (T2DM) are major public health concerns associated with serious morbidity and increased mortality. Both obesity and T2DM are strongly associated with adiposopathy, a term that describes the pathophysiological changes of the adipose tissue. In this review, we have highlighted adipose tissue dysfunction as a major factor in the etiology of these conditions since it promotes chronic inflammation, dysregulated glucose homeostasis, and impaired adipogenesis, leading to the accumulation of ectopic fat and insulin resistance. This dysfunctional state can be effectively ameliorated by the loss of at least 15% of body weight, that is correlated with better glycemic control, decreased likelihood of cardiometabolic disease, and an improvement in overall quality of life. Weight loss can be achieved through lifestyle modifications (healthy diet, regular physical activity) and pharmacotherapy. In this review, we summarized different effective management strategies to address weight loss, such as bariatric surgery and several classes of drugs, namely metformin, GLP-1 receptor agonists, amylin analogs, and SGLT2 inhibitors. These drugs act by targeting various mechanisms involved in the pathophysiology of obesity and T2DM, and they have been shown to induce significant weight loss and improve glycemic control in obese individuals with T2DM. [ABSTRACT FROM AUTHOR]

Objective(s): CB1 antagonism arbitrates a dormant shape to the endocannabinoid system that alleviates diverse pathological incidents of diabesity. The present study pursued the synthesis and evaluation of thiazolidine derivative (BAC) having pleiotropic action on CB1R, with or without AM251 (selective antagonist of the CB1 receptor) against high-fat diet (HFD) induced diabesity in C57BL/6 mice. Materials and Methods: A molecular docking study for CB1 antagonistic potential was conducted by Maestro 11.4 program (Schrodinger Inc., USA), and the thiazolidine derivative BAC was synthesized. The assessment of varied parameters including anthropometric, neurobehavioral, hyperglycemia, dyslipidemia, oxidative stress, and inflammatory cytokines was evaluated in HFD-fed animals as compared with individual and combined treatments of BAC and AM251. Results: Incomparable to AM251, the treatment of BAC was reported for a significant reduction in food intake and obesity, diabetic biomarkers, lipid profile, oxidative stress, and proinflammatory cytokine release. Moreover, the BAC treatment showed no significant alteration in neurobehavioral activity, including anxiety and depression. Conclusion: The preliminary in silico study suggests that BAC has a close interaction with CB1 antagonism but has no sign of neurobehavioral alteration. Simultaneously, this compound showed significant ability to ameliorate diversity by the underlying mechanisms of minimizing oxidative stress, regularizing the lipid profile, and reducing pro-inflammatory cytokines.

The dual epidemic of obesity and diabetes mellitus is becoming an important worldwide public health issue. “Diabesity” is the term used to describe the combined detrimental health effects of both diabetes mellitus and obesity/overweight. Currently, food-derived bioactive compounds are suggested to alleviate diabesity. Blueberries are rich in bioactive anthocyanins, which are associated with contributing to preventing obesity and diabetes mellitus. However, the accurate active compounds and the underlying mechanism are still unclear. The objective of this study was to investigate the beneficial effects of blueberry anthocyanin on diabesity. In total, five anthocyanins (delphinidin-3-O-galactoside, delphinidin-3-O-glucoside, petunidin-3-O-galactoside, petunidin-3-O-glucoside, and malvidin-3-O-galactoside) were isolated from rabbiteye blueberry (Vaccinium virgatum) cultivar “Garden blue.” All these anthocyanins exhibited oxygen radical absorbance capacity (ORAC), scavenging power of ABTS+, and DPPH-free radical and inhibitory activity of α-glucosidase in vitro. Moreover, some compounds improved glucose uptake and attenuated lipid accumulation in high glucose and oleic acid-treated HepG2 cells. All these results suggest that blueberry anthocyanins have potential antioxidant, hypoglycemic, and hypolipidemic effects, which may benefit the treatment of diabesity.

Background: Diabetes and obesity in adults are global issues. Obesity and type 2 diabetes mellitus (T2DM) are increasingly categorized under the umbrella term “diabesity.” Health risk factors (HRFs), which include altering sleep habits and reducing sugar-sweetened beverages (SSBs) consumption, have emerged as relatively novel and crucial strategies for preventing and treating diabetes. Objective: We aimed to explore: 1) whether SSBs could affect diabesity in China’s community; 2) whether HRFs could moderate this relationship; and 3) whether a three-way interaction exists between HRFs, SSBs, and diabesity. Methods: On December 10, 2018, we investigated diabetes complications in four cities in Anhui Province and obtained basic and lifestyle information using a detailed questionnaire. The primary exposure was SSBs and outcomes were body mass index (BMI) and waist circumference (WC), while glycated hemoglobin (HbA1c) and sleep patterns (including duration and disorders) were considered moderators. Results: Overall, 1920 participants were enrolled, and those who did not complete the questionnaire were excluded. Finally, this study included 1765 participants, with a response rate of 92.0%. The mean age was (57.10 ± 10.0) years. Patients with lower educational levels were more likely to have a lower prevalence of WC (c2 = 2.73) and BMI (c2 = 3.47), and some HRFs were positively correlated with WC and BMI. Additionally, SSBs were significantly associated with BMI (b = 1.29) and WC (b = 2.97), and there was also differences based on sex, some HRFs, such as HbA1c, FBG and TG, showed higher levels in male participants, whereas TC level was higher in female participants. In the moderation analysis, sleep patterns were also associated with total cholesterol, triglyceride, and BMI. Furthermore, there were three-way interaction effects among HbA1c, sleep patterns, and SSBs on total cholesterol, triglyceride, BMI, and WC. Moreover, sensitivity analysis demonstrated that our results were robust. Conclusion: SSBs positively correlated with patterns dose-dependently. Moreover, SSBs could also be associated with sleep patterns, and blood glucose levels were correlated with diabesity. A three-way interaction effect was discovered between SSBs, sleep patterns, blood glucose levels, and patterns. Therefore, understanding the diabesity caused by SSBs and other HRFs can help prevent its occurrence. [ABSTRACT FROM AUTHOR]

Copyright of Farmacia is the property of Societatea de Stiinte Farmaceutice Romania and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: A large number of epidemiologic studies across the world indicate a growing link between obesity and diabetes. The metropolitan city of Chennai in South India is experiencing an alarming increase in diabetes and obesity. Aim: The aim of this study was to determine the prevalence of and risk factors for diabetes and obesity together termed as "diabesity" among adults in urban Chennai. Materials and Methods: This was a community-based cross-sectional door-to-door study done as part of a large National Institute of Health and Care Research (NIHR)--a funded project aimed to understand patterns and determinants of health in South Asia. Of the 200 wards in Chennai, 34 wards were surveyed in the main project and two wards were selected randomly for this substudy. Five community enumeration blocks were selected using a systematic sampling technique. Participants aged ≥18 years were selected using a consecutive sampling method. Results: Of the 1138 participants studied, the prevalence of diabesity was found to be 34.3%(n = 390). Of the study participants, 74.8% had obesity (61.9%--generalized obesity; 68.5%--abdominal obesity) and 43.0% had diabetes. As age increased, the diabesity risk also increased gradually from 30 to 39 years (odds ratio [OR]: 3.6[95%, confidence interval [CI]: 1.4-8.9]) to 50-59 years (OR: 5.4[95%, CI: 2.2-13.2]), whereas there was a slight decrease in risk after 60 years (OR: 5.1[95%, CI: 2.1-12.3]). Females had nearly twice the risk of diabesity compared to men (OR: 1.8, P < 0.001), and physically inactive individuals had 1.7 times increased risk (P < 0.001). Conclusion: We report in this study that the prevalence of the dual metabolic defect (diabesity) is alarmingly high in urban Chennai. This study was an attempt to understand the epidemiology of diabesity. [ABSTRACT FROM AUTHOR]

Metabolic syndrome (MS) is a growing disorder affecting thousands of people worldwide, especially in industrialised countries, increasing mortality. Oxidative stress, hyperglycaemia, insulin resistance, inflammation, dysbiosis, abdominal obesity, atherogenic dyslipidaemia and hypertension are important factors linked to MS clusters of different pathologies, such as diabesity, cardiovascular diseases and neurological disorders. All biochemical changes observed in MS, such as dysregulation in the glucose and lipid metabolism, immune response, endothelial cell function and intestinal microbiota, promote pathological bridges between metabolic syndrome, diabesity and cardiovascular and neurodegenerative disorders. This review aims to summarise metabolic syndrome’s involvement in diabesity and highlight the link between MS and cardiovascular and neurological diseases. A better understanding of MS could promote a novel strategic approach to reduce MS comorbidities.

Background: A city’s planning, design, and construction can have a profound influence on health, specifically on non-communicable diseases such as diabetes and obesity, which are often referred to as “diabesity.” This study describes the designs and methods to understand the relationship between food and physical activity environments on diabesity. Materials and Methods: This study was a community-based cross-sectional door-to-door survey conducted as part of a large National Institute of Health and Care Research-funded surveillance project. For this study, two wards in Chennai were selected randomly. In each ward, five community enumeration blocks were selected using systematic random sampling technique. A consecutive sampling approach was used to select the study participants. Two categories of data were collected: (1) health data and (2) built environment (BE) data. Health and lifestyle questionnaires, anthropometric, and biochemical data were collected from all the study participants. For categorizing BE, an online questionnaire was developed using the KoBo toolbox to collect information about food and physical activity environments, as well as geographic locations. Expected Outcome: This study is expected to reveal data on the relationship between food and physical activity environments and diabesity. It will help policy-makers to understand the importance of access to healthy foods and spaces for physical activity in prevention and control of diabesity. It can also enable community-based interventions to improve health outcomes and help urban planners to plan cities that promote active lifestyles for its residents.

Background: Diabesity is a growing problem internationally. Taking into account the importance of physical activity and diet in its prevention and treatment, the objective of this study was to delve into the impact of healthy habits on diabesity. Methods: A descriptive, cross-sectional study was carried out in 386,924 Spanish adult workers. Obesity was determined according to eleven different formulas. Life habits were also valued; sociodemographic variables; and educational level; as well as analytical and clinical variables such as blood pressure and blood glucose levels. The association between the different variables was performed using the chi-square and the Student's t-tests when the samples were independent. A multivariate analysis was performed using the multinomial logistic regression test by calculating the odds ratio and a 95% confidence interval. The Hosmer–Lemeshow goodness-of-fit test was also performed. Results: The overall prevalence of diabesity ranged between 0.3% (95% CI 0.3–0.4) when obesity was assessed according to the abdominal volume index and 8.3% (95% CI 8.2–8.4) when evaluated according to the CUN-BAE (Clínica Universitaria de Navarra Body Adiposity Estimator) formula. The prevalence of diabesity was also higher in workers with a non-heart-healthy diet and in those who did not exercise regularly. Conclusions: The most disadvantaged socioeconomic classes are those with the highest prevalence of diabesity. It is important to prioritise prevention in populations and communities with the most unfavourable social and environmental conditions to reduce the burden of diabesity. [ABSTRACT FROM AUTHOR]

A city’s planning, design, and construction can have a profound influence on health, specifically on non-communicable diseases such as diabetes and obesity, which are often referred to as “diabesity.” This study describes the designs and methods to understand the relationship between food and physical activity environments on diabesity. Materials and Methods: This study was a community-based cross-sectional door-to-door survey conducted as part of a large National Institute of Health and Care Research-funded surveillance project. For this study, two wards in Chennai were selected randomly. In each ward, five community enumeration blocks were selected using systematic random sampling technique. A consecutive sampling approach was used to select the study participants. Two categories of data were collected: (1) health data and (2) built environment (BE) data. Health and lifestyle questionnaires, anthropometric, and biochemical data were collected from all the study participants. For categorizing BE, an online questionnaire was developed using the KoBo toolbox to collect information about food and physical activity environments, as well as geographic locations. Expected Outcome: This study is expected to reveal data on the relationship between food and physical activity environments and diabesity. It will help policy-makers to understand the importance of access to healthy foods and spaces for physical activity in prevention and control of diabesity. It can also enable community-based interventions to improve health outcomes and help urban planners to plan cities that promote active lifestyles for its residents. [ABSTRACT FROM AUTHOR]

Aim/objectives: This study aims to ascertain the prevalence and influencing factors of diabesity among adult patients visiting the General Outpatient clinic of three government healthcare facilities in Calabar, Nigeria. The objective is to enhance healthcare delivery to at-risk patients., Methods: A cross-sectional descriptive study design incorporating a mixed method approach, including quantitative and qualitative components such as Focused Group Discussions (FGD) and Key Informant Interviews (KII), was employed. The study population consisted of 190 participants aged 18 to 72 years with a body mass index (BMI) of ≥ 30kg/m2, selected using a systematic random sampling technique and analysed using SPSS and Atlas.ti., Results: Sociodemographic variables indicated that the highest number of respondents fell within the 35-44 years (37.3%), with 83.7% being female and 76.8% married. Furthermore, 65.8% were classified as having class 1 obesity, while only 38% self-identified as obese. The occurrence of diabesity was found to be 12.6% (i.e., BMI ≥30 vs. FBS ≥ 7.0), with 38% of cases being previously undiagnosed. Qualitative assessment through KIIs and FGDs revealed that unhealthy diets and lack of exercise were major contributing factors to diabesity., Conclusion: This study has disclosed a 12.6% occurrence of diabesity within the study population, with 38% of cases being previously undiagnosed. Unhealthy diets, snacking, and lack of exercise were identified as significant indicators of diabesity., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2024 by West African Journal of Medicine.)

Overweight and obesity are conditions associated with serious comorbidities, such as diabetes and cardiovascular disease. Prevalence of excessive fat accumulation is increasing worldwide, and thus the need for efficient and sustainable weight loss regimes has become a major issue in clinical practice. Despite the important advances in the development of anti-obesity medications (AOM), their side effects, cost, and accessibility, are limiting factors for their routine use. Conversely, the studies of medicinal plants for weight management holds strong promise as a growing area of research. This review consolidates the representative evidence about the beneficial impacts of Morus alba on weight management and associated metabolic parameters, encompassing: inhibition of digestive enzymes, and thus contribution to the energy deficit required for weight loss, improvements in glucose and lipid metabolism, and attenuation of adiposity. Findings from in vitro, in vivo , and clinical investigations reviewed in the paper, demonstrate that white mulberry extracts have the potency to supplement efficiently and safely a healthy weight management approach., Competing Interests: Authors FN and AT were employed by company Herbalist P.C., (Copyright © 2024 Ntalouka and Tsirivakou.)

Obesity stands as a prominent health challenge in our society, with metabolic bariatric surgery (MBS) emerging as a solution due to its efficacy in addressing obesity-related type 2 diabetes mellitus (T2DM). Roux-en-Y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB) remain the most common MBS after sleeve gastrectomy. Complications from RYGB are uncommon but include anastomotic stricture, marginal ulcers, small bowel obstruction, and nutritional complications. We present a 52-year-old lady with an initial body mass index (BMI) of 27.6 kg/m 2 and poorly controlled T2DM who presented with generalized body weakness and uncontrolled weight loss after an RYGB performed four months earlier. She was cachexic with a BMI of 17 kg/m 2 ,with generalized anasarca with a multitude of electrolyte disturbances. After nutritional optimization, she underwent a reversal surgery back to normal anatomy. Reversal of RYGB to normal anatomy is a complex surgical procedure and is often the last resort undertaken in patients experiencing severe complications from the initial surgery. Indications include malnutrition, severe dumping syndrome, excessive weight loss, and recalcitrant marginal ulcers. Our case outlines the importance of proper patient selection for MBS and highlights the preoperative management of RYGB reversal to normal anatomy. We also describe the surgical procedure using a stepwise approach. In conclusion, the reversal of RYGB to normal anatomy should only be undertaken after a careful period of prehabilitation to reduce perioperative complications. The inclusion of dietitians, endocrinologists, and physiotherapists is crucial to ensure the best possible outcome., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Sadu Singh et al.)

Objective: Type 2 diabetes with obesity is regarded as an incurable, progressive disease with many complications. The hypothesis was tested that glycated haemoglobin (HbA1c) and the insulin release curve can be restored by traceable systematic methods. Methods: 122 people with diabesity were investigated before and after three and 6 months of traceable systematic management methods. Basal body mass index (BMI), fatty liver, HbA1c, and insulin release curve were measured. Results: After 3 months of traceable systematic management, BMI decreased from 30.76 ± 0.48 to 21.86 ± 0.09 kg/m2 (p < 0.001) and remained stable during the last 3 months (21.82 ± 0.09 kg/m2 at 6 months). Colour Doppler ultrasound showed non-alcoholic fatty liver disease (NAFLD) in all diabesity participants at baseline. At 3 months, only one participant had low-grade fatty liver, and fatty liver was reversed in other participants (p < 0.001). The number and grade of fatty liver at 6 months were the same as at 3 months. Fasting plasma glucose decreased and continued to decrease thereafter (p < 0.001). Two-hour postprandial plasma glucose decreased and continued to decline until 6 months (p < 0.001). HbA1c also decreased and maintained this level at 6 months. At baseline, the peak value of insulin release was 1,141.09 ± 43.02 pmol/L at 2 h after meals, and the early phase of insulin secretion was lost. After 3 months of management, the insulin concentration was 621.62 ± 19.32 pmol/L at 2 h after meals. After 6 months, the value decreased, and the early phase of insulin secretion recovered. Conclusions: Normalization of the insulin release curve in type 2 diabetes was achieved by traceable systematic methods. This was associated with recovery from NAFLD. Diabesity is reversible by traceable systematic management. [ABSTRACT FROM AUTHOR]

Objective(s): CB1 antagonism arbitrates a dormant shape to the endocannabinoid system that alleviates diverse pathological incidents of diabesity. The present study pursued the synthesis and evaluation of thiazolidine derivative (BAC) having pleiotropic action on CB1R, with or without AM251 (selective antagonist of the CB1 receptor) against high-fat diet (HFD) induced diabesity in C57BL/6 mice. Materials and Methods: A molecular docking study for CB1 antagonistic potential was conducted by Maestro 11.4 program (Schrodinger Inc., USA), and the thiazolidine derivative BAC was synthesized. The assessment of varied parameters including anthropometric, neurobehavioral, hyperglycemia, dyslipidemia, oxidative stress, and inflammatory cytokines was evaluated in HFD-fed animals as compared with individual and combined treatments of BAC and AM251. Results: Incomparable to AM251, the treatment of BAC was reported for a significant reduction in food intake and obesity, diabetic biomarkers, lipid profile, oxidative stress, and proinflammatory cytokine release. Moreover, the BAC treatment showed no significant alteration in neurobehavioral activity, including anxiety and depression. Conclusion: The preliminary in silico study suggests that BAC has a close interaction with CB1 antagonism but has no sign of neurobehavioral alteration. Simultaneously, this compound showed significant ability to ameliorate diversity by the underlying mechanisms of minimizing oxidative stress, regularizing the lipid profile, and reducing pro-inflammatory cytokines. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is the leading cause of death in the world. In 2019, 550 million people were suffering from CVD and 18 million of them died as a result. Most of them had associated risk factors such as high fasting glucose, which caused 134 million deaths, and obesity, which accounted for 5.02 million deaths. Diabesity, a combination of type 2 diabetes and obesity, contributes to cardiac, metabolic, inflammation and neurohumoral changes that determine cardiac dysfunction (diabesity-related cardiomyopathy). Epicardial adipose tissue (EAT) is distributed around the myocardium, promoting myocardial inflammation and fibrosis, and is associated with an increased risk of heart failure, particularly with preserved systolic function, atrial fibrillation and coronary atherosclerosis. In fact, several hypoglycaemic drugs have demonstrated a volume reduction of EAT and effects on its metabolic and inflammation profile. However, it is necessary to improve knowledge of the diabesity pathophysiologic mechanisms involved in the development and progression of cardiovascular diseases for comprehensive patient management including drugs to optimize glucometabolic control. This review presents the mechanisms of diabesity associated with cardiovascular disease and their therapeutic implications. [ABSTRACT FROM AUTHOR]