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Three “DS” - Elements for Successful Weight Loss Outcomes: Role of Healthcare Professionals
( Dror Dicker ),( Assim A Alfadda ),( Pernille Auerbach ),( Ian D Caterson ),( Ada Cuevas ),( Jason Halford ),( Masato Iwabu ),( Jae-Heon Kang ),( Rita Nawar ),( Ricardo Arturo Reynoso Mendoza ),( Nic 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: In people with obesity (PwO), body weight loss of ≥5% is generally considered to be clinically meaningful. Some PwO do receive treatment and guidance from healthcare professionals (HCPs), but there remains a substantial unmet medical outcomes and weight maintenance need. To identify aspects that might contribute to a successful weight loss outcome (WLO; ≥5% body weight loss maintained for ≥1 year), we investigated the characteristics and experience of PwO with and without successful WLOs using data from the ACTION-IO study (NCT03584191). Methods: An online survey was completed by adults with obesity and HCPs in 11 countries: Australia, Chile, Israel, Italy, Japan, Mexico, Saudi Arabia, South Korea, Spain, UAE and UK. A successful WLO was defined as ≥5% body weight loss in the past 3 years maintained for ≥1 year. Results: A total of 14,502 PwO completed the survey. General characteristics were similar between those who had a successful WLO (n=1,559; 11%) vs those who had not (n=12,943; 89%): 53% vs 52% were male; the mean age was 49 vs 48 years; the mean number of comorbidities was 2.0 vs 1.8. The mean number of serious weight loss attempts was 4 for both groups. However, more PwO who had a successful WLO weighed themselves every day (20%) compared with those who had not had a successful WLO (10%). In terms of interactions with HCPs, more PwO who had a successful WLO had discussed weight (58%) with an HCP within the past 5 years than those who did not have a successful WLO (53%). In addition, more PwO who had a successful WLO compared with those who did not had been diagnosed with obesity (42% vs 35%) and had subsequent direction through the scheduling of a follow-up appointment (25% vs 21%). Conclusions: A 3D approach from HCPs (diagnosis, discussion and direction) appears to be a key element in facilitating a successful WLO. Neither gender, nor age, nor number of weight loss attempts was associated with a successful WLO.
Donor Islet Endothelial Cells in Pancreatic Islet Revascularization
Nyqvist, Daniel,Speier, Stephan,Rodriguez-Diaz, Rayner,Molano, R. Damaris,Lipovsek, Saš,a,Rupnik, Marjan,Dicker, Andrea,Ilegems, Erwin,Zahr-Akrawi, Elsie,Molina, Judith,Lopez-Cabeza, Maite,Villat American Diabetes Association 2011 Diabetes Vol.60 No.10
<P><B>OBJECTIVE</B></P><P>Freshly isolated pancreatic islets contain, in contrast to cultured islets, intraislet endothelial cells (ECs), which can contribute to the formation of functional blood vessels after transplantation. We have characterized how donor islet endothelial cells (DIECs) may contribute to the revascularization rate, vascular density, and endocrine graft function after transplantation of freshly isolated and cultured islets.</P><P><B>RESEARCH DESIGN AND METHODS</B></P><P>Freshly isolated and cultured islets were transplanted under the kidney capsule and into the anterior chamber of the eye. Intravital laser scanning microscopy was used to monitor the revascularization process and DIECs in intact grafts. The grafts’ metabolic function was examined by reversal of diabetes, and the ultrastructural morphology by transmission electron microscopy.</P><P><B>RESULTS</B></P><P>DIECs significantly contributed to the vasculature of fresh islet grafts, assessed up to 5 months after transplantation, but were hardly detected in cultured islet grafts. Early participation of DIECs in the revascularization process correlated with a higher revascularization rate of freshly isolated islets compared with cultured islets. However, after complete revascularization, the vascular density was similar in the two groups, and host ECs gained morphological features resembling the endogenous islet vasculature. Surprisingly, grafts originating from cultured islets reversed diabetes more rapidly than those originating from fresh islets.</P><P><B>CONCLUSIONS</B></P><P>In summary, DIECs contributed to the revascularization of fresh, but not cultured, islets by participating in early processes of vessel formation and persisting in the vasculature over long periods of time. However, the DIECs did not increase the vascular density or improve the endocrine function of the grafts.</P>