Diet and exercise in the prevention and treatment of type 2 diabetes mellitus
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Diet and exercise in the prevention and treatment of type 2 diabetes mellitus. / Magkos, Faidon; Hjorth, Mads Fiil; Astrup, Arne.
In: Nature Reviews Endocrinology, Vol. 16, No. 10, 2020, p. 545-555.Research output: Contribution to journal › Review › Research › peer-review
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TY - JOUR
T1 - Diet and exercise in the prevention and treatment of type 2 diabetes mellitus
AU - Magkos, Faidon
AU - Hjorth, Mads Fiil
AU - Astrup, Arne
N1 - CURIS 2020 NEXS 220
PY - 2020
Y1 - 2020
N2 - Evidence from observational studies and randomized trials suggests that prediabetes and type 2 diabetes mellitus (T2DM) can develop in genetically susceptible individuals in parallel with weight (that is, fat) gain. Accordingly, studies show that weight loss can produce remission of T2DM in a dose-dependent manner. A weight loss of ~15 kg, achieved by calorie restriction as part of an intensive management programme, can lead to remission of T2DM in ~80% of patients with obesity and T2DM. However, long-term weight loss maintenance is challenging. Obesity and T2DM are associated with diminished glucose uptake in the brain that impairs the satiating effect of dietary carbohydrate; therefore, carbohydrate restriction might help maintain weight loss and maximize metabolic benefits. Likewise, increases in physical activity and fitness are an important contributor to T2DM remission when combined with calorie restriction and weight loss. Preliminary studies suggest that a precision dietary management approach that uses pretreatment glycaemic status to stratify patients can help optimize dietary recommendations with respect to carbohydrate, fat and dietary fibre. This approach might lead to improved weight loss maintenance and glycaemic control. Future research should focus on better understanding the individual response to dietary treatment and translating these findings into clinical practice.
AB - Evidence from observational studies and randomized trials suggests that prediabetes and type 2 diabetes mellitus (T2DM) can develop in genetically susceptible individuals in parallel with weight (that is, fat) gain. Accordingly, studies show that weight loss can produce remission of T2DM in a dose-dependent manner. A weight loss of ~15 kg, achieved by calorie restriction as part of an intensive management programme, can lead to remission of T2DM in ~80% of patients with obesity and T2DM. However, long-term weight loss maintenance is challenging. Obesity and T2DM are associated with diminished glucose uptake in the brain that impairs the satiating effect of dietary carbohydrate; therefore, carbohydrate restriction might help maintain weight loss and maximize metabolic benefits. Likewise, increases in physical activity and fitness are an important contributor to T2DM remission when combined with calorie restriction and weight loss. Preliminary studies suggest that a precision dietary management approach that uses pretreatment glycaemic status to stratify patients can help optimize dietary recommendations with respect to carbohydrate, fat and dietary fibre. This approach might lead to improved weight loss maintenance and glycaemic control. Future research should focus on better understanding the individual response to dietary treatment and translating these findings into clinical practice.
U2 - 10.1038/s41574-020-0381-5
DO - 10.1038/s41574-020-0381-5
M3 - Review
C2 - 32690918
VL - 16
SP - 545
EP - 555
JO - Nature Reviews Endocrinology
JF - Nature Reviews Endocrinology
SN - 1759-5029
IS - 10
ER -
ID: 245231369