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Printable Handouts
Navigable Slide Index
- Introduction
- Type 2 diabetes and obesity
- Prevalence of obesity in diabetes
- Obesity and diabetes
- Current hypotheses linking obesity to diabetes
- Stores of white adipose tissue in the body
- ‘Lipid overflow’
- Effects of ectopic fat in tissues
- Glucolipotoxicity and the beta-cell
- The ‘inflammation’ hypothesis
- Key cytokines effects on inflammation (1)
- Synergism between interleukins, TNF & FFA
- Key cytokines effects on inflammation (2)
- Metabolic effects of inflammation
- The ‘adipokine’ hypothesis
- Key adipokines (1)
- Key adipokines (2)
- The ‘adipokine’ hypothesis: tying it all together
- The gut microbiota
- The ‘microbiome’ hypothesis
- Gut microbiota and obesity
- Brown adipose tissue
- Summary
- Diabetes remission after bariatric surgery
- Types of bariatric surgery
- Effects of bariatric surgery on diabetes
- Diabetes remission
- ADA criteria for diabetes remission
- Higher remission with RYGB
- Factors that influence diabetes remission
- Time course of diabetes remission
- Temporal changes in insulin sensitivity
- Mechanisms for remission
- Calorie restriction (1)
- VLCD and RYGB effects on insulin
- Calorie restriction (2)
- The foregut hypothesis
- Gut hormones
- Gut hormone changes after RYGB
- GLP-1 & insulin post meal secretion after RYGB
- Overall effect of gut hormones changes after RYGB
- Fat distribution
- Fat distribution after RYGB surgery
- Fat loss and improvement in diabetes
- Bile acids
- Bile acids go up post RYGB
- Bile acid action via FXR
- Elevated FGF-19 post RYGB
- Bile acids also act via TGR6
- Bile acid summary post RYGB
- Bariatric surgery and the microbiome
- Summary (2)
- Conclusions
Topics Covered
- Type 2 diabetes and obesity
- Current hypotheses linking obesity to diabetes
- Mechanisms of remission of diabetes after bariatric surgery
Links
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Talk Citation
Tan, T. (2016, August 31). Diabetes, obesity and mechanisms of remission after bariatric surgery [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved November 21, 2024, from https://doi.org/10.69645/HNZM9658.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Tricia Tan has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Other Talks in the Series: Obesity: Science, Medicine and Society
Transcript
Please wait while the transcript is being prepared...
0:00
Hello.
My name is Professor Tricia Tan.
I'm a consultant
in metabolic medicine
and endocrinology
at Imperial College.
My lecture today
will be on diabetes, obesity,
and the mechanisms
of remission of diabetes
after bariatric surgery.
0:17
To start with,
let me say that from now on
whenever I mention diabetes,
I will be particularly referring
to type 2 diabetes,
the most common type.
The intimate relationship
between diabetes and obesity
has been clear
for the last 50 years.
This slide shows
the progressive rise in obesity
in the United States driven
by the availability of cheap,
tasty, and high-calorie foods,
plus reduced opportunity
to expend energy.
This has been paralleled
by the rise
in diabetes' prevalence.
The same story is being noted
all over the world
and UK is no exception.
0:57
This graph shows
the prevalence of obesity
in patients with diabetes.
It serves to show that many
diabetic patients are obese.
Generally speaking,
between 30% to 80% of patients
with diabetes are obese
on the BMI criteria,
depending on ethnicity
of the population studied.
Chinese populations appeared
to have a relatively
low prevalence of obesity
in diabetes by BMI criteria.
However, if we'd look
at waist circumference
as a measure
of visceral adiposity,
the prevalence is higher.
We can therefore say
that there is clear relationship
between obesity and diabetes,
but the strength
of this relationship
depends on ethnicity
of the population
you are studying.
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