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PubMed2005

Implication of socio-economic status on the prevalence of overweight and obesity in Greek adults: the ATTICA study.

BACKGROUND: Although ooverweight and obesity are considered as a health problem that affects millions of people worldwide, the implication of socio-economic status (SES) in these healthy conditions have rarely been investigated. We evaluated the associations of overweight and obesity with SES, in a population based sample of Greek adults. METHODS: During 2001-2002 we randomly enrolled 1514 men (18-87 years old) and 1528 women (18-89 years old), stratified by the age-sex distribution (census 2001) of the Attica area, Greece. We studied several demographic, anthropometric, lifestyle, dietary and bio-clinical factors of the participants. SES (low, middle and high) was defined through the education and economical level of the participants. RESULTS: The prevalence of overweight and obesity was 53 and 20% in men, and 31 and 15% in women, respectively, while an increase in the prevalence of obesity was observed with progressing age. Both men and women in the higher SES group had significantly lower prevalence of obesity as compared to the middle and lower SES group (p<0.001). However, multivariate analysis showed that the observed associations between SES and obesity were mainly explained by differences in physical activity status and energy intake of the participants. CONCLUSION: Overweight and obesity seems to be a serious health problem, affecting more prominently people in the lower SES. However, eating and other lifestyle habits mainly explained the association between SES and obesity.

Adolescent↗
PubMed2005

Family environment and pediatric overweight: what is a parent to do?

Although the causes of pediatric overweight are many and the levels of intervention required to prevent overweight in children extend from the child's immediate environment to the larger societal level, one critical intervention target is the parent. Scientific evidence points to specific dietary and physical activity/inactivity behaviors that families can adopt to encourage healthful weight status. Dietary recommendations include providing children with ample access to nutrient-dense foods and beverages and high-fiber foods, both at meals and snack times, reducing children's access to high-calorie, nutrient-poor beverages and foods both when eating at home and at restaurants, avoiding excessive food restriction or use of food as a reward, and encouraging children to eat breakfast on a daily basis. Physical activity recommendations include providing opportunities and encouragement for children to be physically active while reducing children's television and video game time. Parental modeling of healthful eating and physical activity practices is recommended to reinforce these patterns in youth. Dietetics professionals, physicians, and other health care professionals can assist parents in their efforts to prevent pediatric overweight by providing information and supporting these key behaviors, while working to create environments that support healthful lifestyle changes.

Adult↗
PubMed2005

Participation in a behavioral weight-loss program worsens the prevalence and severity of underreporting among obese and overweight women.

Underreporting of energy intake is a serious and pervasive problem, especially among women with overweight and obesity. The aim of this study was to determine if the prevalence and severity of underreporting changed after participating in a behavioral weight-loss program. Women with overweight and obesity (N=156, mean age 39.4 years, mean body mass index 31.9) completed a 6-month behavioral weight-loss program. Basal metabolic rate, physical activity level, and energy intake from 7-day food records were collected at baseline and 6 months. The major finding was that underreporting significantly increased in prevalence (39.7% vs 60.3%; P<.001), as did severity of misreporting (-105+/-583 vs -415+/-504 kcal/day; P<.001) following the behavioral weight-loss program. Thus, after completing a behavioral weight-loss program, the prevalence of underreporting and severity of misreporting became significantly worse among women with overweight and obesity.

Adult↗
PubMed2006

Overweight trends among children enrolled in the New York State special supplemental nutrition program for women, infants, and children.

The objective of this study is to describe overweight trends in a large, multiethnic, low-income population of preschool children by race/ethnicity and examine cohort changes in body mass index (BMI) distribution. Cross-sectional data were collected January 1 through March 31, every year, from 1989 to 2003. Subjects were children aged 2 to 4 years participating in the Special Supplemental Nutrition Program for Women, Infants, and Children in New York State. The prevalence of overweight (BMI > or =95th age- and sex-specific percentile of the 2000 Centers for Disease Control and Prevention growth charts) was calculated for each year. Least squares regression compared trends in prevalence by race/ethnicity. Changes in BMI distribution were assessed graphically. Overweight prevalence increased 33% (12% to 16%). Prevalence was highest for Hispanics and lowest for non-Hispanic whites. Rates of increase (0.28 percentage points per year) were the same for Hispanic, non-Hispanic black, and non-Hispanic white children. The BMI distribution shifted toward higher values for all children studied; for 3- and 4-year-old children, the difference increased as BMI increased, indicating that, in 2003, the heaviest children were considerably heavier than the heaviest children were in 1989.

Body Mass Index↗
PubMed2006

Self-assessment of height, weight, and sexual maturation: validity in overweight children and adolescents.

PURPOSE: To evaluate the validity of self-reported height, weight, and sexual maturation ratings among overweight children and adolescents. METHODS: This cross-sectional study included 77 overweight children and adolescents (39 girls, 38 boys) aged 8-18 years, with a mean body mass index (BMI) of 35.2 +/- 8.9 kg/m2 who visited the Optimal Weight for Life program at Boston Children's Hospital for weight management over a period of six months in 1999. Each patient's weight, height, and sexual maturation ratings were self-reported and measured. RESULTS: The intra-class correlation coefficients between measured and self-reported weights, heights, and BMI values ranged from .64 to .95 among boys, and from .49 to .84 among girls. The kappa statistics between measured and self-assessed Tanner stage ratings ranged from .21 to .50. The percentages of agreement for breast development and pubic hair ratings among girls were 37.8% and 61.1%, respectively. The percentages of agreement for pubic hair and genitalia ratings among boys were 51.7% and 40.0%, respectively. The self-assessed ratings by boys for pubic hair and genitalia were less likely to be correct with increased measured weight and height (p < .05). Boys aged 15 years or older were more likely to underestimate their pubic hair or genitalia stages than those younger than 15 years of age (p < .05). CONCLUSIONS: Among overweight children and adolescents aged 8-18 years, this pilot study suggests that self-reports of height, weight, and Tanner stages are not valid proxy measures for a physician's assessment.

Adolescent↗
PubMed2006

Feasibility of SHARK: a physical activity skill-development program for overweight and obese children.

This study aimed to assess the feasibility of a community-based physical activity motor development program, called SHARK, among overweight and obese children. Thirteen overweight or obese children aged 8-12 years were recruited to the 10-week program from the Illawarra region of NSW, Australia. Measures at baseline, post-treatment and 9-month follow-up included BMI, motor development, perceived competence, objectively measured physical activity and performance of an activity of daily living. At post-treatment and follow-up motor development, perceived athletic competence and perceived global self-worth had significantly increased. Although recorded minutes in moderate-to-vigorous activity significantly declined at post-treatment and follow-up, activity daily counts did not. The results indicate that community-based activity programs designed to improve the motor development and perceived competence of overweight and obese children are feasible and may have important and sustainable benefits. However, a larger sample size and a comparison group are required to determine whether this approach can impact on activity levels and weight status.

Child↗
PubMed2004

Preserved circadian rhythm of serum insulin concentration at low plasma glucose during fasting in lean and overweight humans.

Circadian rhythms in glucose metabolism are well documented. Most studies, however, evaluated such variations under conditions of continuous glucose supply, either via food intake or glucose infusion. Here we assessed in 30 subjects circadian variations in concentrations of plasma glucose, serum insulin, and C-peptide during a 72-hour fasting period to evaluate rhythms independent from glucose supply. Furthermore we assessed differences in these parameters between normal-weight (n = 20) and overweight (n = 10) subjects. Blood was sampled every 4 hours. During fasting, plasma glucose, serum insulin, and C-peptide levels gradually decreased (all P < .001). While there was no circadian variation in plasma glucose levels after the first day of fasting, serum levels of insulin were constantly higher in the morning (8.00 h) than at night (0.00 h) (P < .001), although the extent of this morning-associated rise in insulin levels decreased with the time spent fasting (P = .001). Also, morning C-peptide concentrations were higher compared to the preceding night (P < .001). The C-peptide/insulin ratio (CIR) decreased during prolonged fasting (P = .030), suggesting a decrease in hepatic insulin clearance. Moreover, CIR was significantly lower in the morning than at the night of day 1 and day 2 of fasting (P = .010 and P = .004, respectively). Compared to normal-weight subjects, overweight subjects had higher plasma glucose, as well as serum insulin and C-peptide levels (all P < .03). Data indicate preserved circadian rhythms in insulin concentrations in the presence of substantially decreased glucose levels in normal-weight and overweight subjects. This finding suggests a central nervous system contribution to the regulation of insulin secretion independent of plasma glucose levels.

Adult↗
PubMed2005

Influence of nutrients on cardiac autonomic function in nondiabetic overweight subjects.

The current study sought to determine whether there is a link between cardiac autonomic dysfunction and food intake in overweight subjects. One hundred five nondiabetic overweight (body mass index >27 kg/m2) subjects were studied. Heart rate variations were analyzed during 3 bedside standard tests investigating mainly vagal control: deep breathing, lying-to-standing, and Valsalva tests. The resting metabolic rate and substrate oxidation rates were measured by indirect calorimetry. Dietary intake was estimated from a 3-day recall of food intake. Cardiac parasympathetic dysfunction (PSD) was found in 39 subjects. The sex ratio, age, anthropometric parameters, biochemical parameters and insulin resistance index, resting metabolic rate, and substrate oxidation rates did not differ in the subjects with or without PSD. The total 24-hour energy intake was similar, but the carbohydrate intake was significantly higher in the subjects with PSD (P = .006), and the fat and protein intakes were significantly lower (P = .026 and .045, respectively). In the logistic regression analyses, PSD correlated with carbohydrate and fat intake, independently of serum insulin levels. Glucose oxidation rate correlated negatively with fasting and postglucose serum insulin levels only in the subjects with PSD (P = .006 and .005, respectively). Cardiac parasympathetic dysfunction is associated with higher carbohydrate intake and lower fat and protein intakes in overweight subjects. A sympathetic override may contribute to reducing the glucose oxidation rate in subjects with PSD.

Adolescent↗
PubMed2005

Aerobic exercise training improves insulin sensitivity without changes in body weight, body fat, adiponectin, and inflammatory markers in overweight and obese girls.

The aim of this study was to examine the effect of aerobic exercise training on insulin sensitivity in overweight and obese girls. Nineteen overweight and obese girls (mean +/- SD: age, 13.1+/-1.8 years; body mass index, 26.8+/-3.9 kg/m(2)) volunteered for this study. Body composition (dual-energy x-ray absorptiometry), insulin sensitivity (oral glucose tolerance test and homeostasis model assessment estimate of insulin resistance; n=15), adiponectin, C-reactive protein (CRP), interleukin (IL) 6, insulin-like growth factor-1, soluble intercellular adhesion molecule-1 and soluble vascular cell adhesion molecule-1 serum levels, and blood lipids and lipoproteins were assessed before and after 12 weeks of aerobic training. Cardiorespiratory fitness increased by 18.8% (P<.05) as a result of training. The area under the insulin concentration curve (insulin area under the curve) decreased by 23.3% (12781.7+/-7454.2 vs 9799.0+/-4918.6 microU.min/mL before and after intervention, respectively; P=.03). Insulin sensitivity was improved without changes in body weight (pre-intervention, 67.9+/-14.5 kg; post-intervention, 68.3+/-14.0 kg) or percent body fat (pre-intervention, 41.4% +/- 4.8%; post-intervention, 40.7%+/-5.2%). The lower limb fat-free mass increased by 6.2% (P<.01) as a result of training, and changes in lower limb fat-free mass were correlated with changes in the insulin area under the curve (r= -.68; P< .01). Serum adiponectin, IL-6, and CRP concentrations did not change (pre-intervention vs post-intervention: adiponectin, 9.57+/-3.01 vs 9.08+/-2.32 microg/mL; IL-6, 1.67+/-1.29 vs 1.65+/-1.25 pg/mL, CRP, 3.21+/-2.48 vs 2.73+/-1.88 mg/L) whereas insulin-like growth factor-1 was lower after training (pre-intervention, 453.8 +/- 159.3 ng/mL; post-intervention, 403.2+/- 155.1 ng/mL; P<.05). In conclusion, 12 weeks of aerobic training improved insulin sensitivity in overweight and obese girls without change in body weight, percent body fat, and circulating concentrations of adiponectin, IL-6, CRP, and other inflammatory markers. These findings suggest that increased physical activity may ameliorate the metabolic abnormalities associated with obesity in children with a mechanism other than the parameters cited earlier.

Adiponectin↗
PubMed2005

Relationship of C-reactive protein with components of the metabolic syndrome in normal-weight and overweight elderly.

BACKGROUND AND AIM: C-reactive protein (CRP) is known to be elevated in the metabolic syndrome. We aimed to explore in more detail the relationship between CRP and other components of the metabolic syndrome in a general population of 605 Dutch elderly individuals aged 65-84 years. METHODS AND RESULTS: Data were collected on body mass index (BMI), plasma CRP, plasma plasminogen activator inhibitor 1 (PAI-1), serum insulin, serum lipids, blood pressure, lifestyle and medical history. CRP was log-transformed (ln-CRP) to improve normality. Associations of ln-CRP with components of the metabolic syndrome were studied by multivariate linear regression analysis, in strata of gender and overweight status, with adjustment for age, physical activity, and smoking habits. A total of 322 subjects (53%) were overweight (BMI > or =25 kg/m2). CONCLUSIONS: In normal-weight women, ln-CRP was significantly associated with BMI, PAI-1, serum insulin, and HDL-cholesterol. In overweight women, however, these relationships were weak and not statistically significant. Findings were similar in men, although less pronounced than in women. Our data suggest that the role of CRP in the metabolic syndrome is modified by the amount of body fat.

Adipose Tissue↗
PubMedDate not supplied

Fiber intake, constipation, and overweight among adolescents living in Sao Paulo City.

OBJECTIVE: This study evaluated the dietary fiber intake of adolescents in the metropolitan area of Sao Paulo city and any association between low dietary fiber intake with constipation and overweight. METHODS: In total, 716 adolescents were included within the study, of whom 314 attended private school and 402 attended public school. Evaluation of fiber intake was based on a 24-h daily intake record and a frequency questionnaire. Data concerning bowel movements and height and weight measurements were also taken. RESULTS: Fiber consumption, below that recommended ("age + 5"), was found in 61.8% and 41.4% (P = 0.000) of girls attending private and public schools, respectively, and in 44.1% and 25.6% of boys (P = 0.001). Adolescents who did not eat beans on more than 4 d/wk presented a higher risk of fiber intake below that recommended (age + 5; P < 0.05), with odds ratios ranging from 10.4 to 14.2 according gender and private or public schooling. Dietary fiber intake below that recommended was associated with a greater risk (P < 0.05) toward overweight in students attending public schooling (odds ratios 2.84 and 2.95 for males and females, respectively). Low dietary fiber intake was not associated with constipation. CONCLUSION: Intake of beans more than four times per week is associated with the appropriate level of fiber intake. Dietary fiber intake below the recommendation was not associated with constipation but was associated with being overweight among those students attending public schooling.

Adolescent↗
PubMed2003

Emotions in overweight and normal-weight women immediately after eating foods differing in energy.

Immediate effects of low-, medium-, and high-energy foods on the emotional state of normal-weight and overweight women were studied experimentally. Nineteen normal-weight (body mass index [BMI]: 19-25 kg/m2) and 19 overweight women (BMI: 26-40 kg/m2) aged 18-40 years received samples of food that differed in energy content (low vs. medium vs. high energy) and rated their emotional state immediately after eating. Perceived characteristics of the foods and associations elicited by the foods were also obtained. Negative emotions (anger, fear, shame, and sadness) and sleepiness increased, while happiness decreased with energy of foods. Emotionally negative associations were more frequent, while positive emotions were less frequent the higher the energy content of the foods. Sadness, shame, fear, and sleepiness after eating high-energy food tended to be more intense in overweight women. Additional analyses demonstrated influences of eating habits, e.g., disinhibition. The higher the energy content of a food stimulus, the more it was viewed as "unhealthy" and "dangerous." It is suggested that immediate food-induced changes of emotions can be explained by activation of associative emotion networks.

Adolescent↗
PubMed2003

Reduction in obesity and coronary risk factors after high caloric exercise training in overweight coronary patients.

BACKGROUND: The majority of patients with coronary heart disease (CHD) are overweight. However, little weight loss occurs with participation in a standard cardiac rehabilitation (CR) program. METHODS: Fifteen overweight patients (average body mass index of 31.0 kg/m2) with CHD completed a 4-month exercise training program in a CR program. The exercise program consisted primarily of walking long duration (60-90 minutes per session) 5 to 7 days per week at a relatively low intensity of 50% to 60% of peak VO2. Measures of body composition by dual-energy x-ray absorptiometry, body fat distribution by computed tomography, plasma lipid-lipoprotein, glucose and insulin concentrations, and peak VO2 were obtained before and after the exercise intervention. Patients maintained an isocaloric diet throughout the study. RESULTS: Patients had reductions in total body weight (-4.6 kg), fat mass (-3.6 kg), percent body fat (-2.9%), and waist circumference (-5.6 cm) (all P <.001) while maintaining fat-free mass. Subcutaneous adipose tissue was reduced by 12% (P <.001) and visceral adipose tissue was lowered by 14% (P <.001). There were favorable changes in the lipid-metabolic profile with reductions in triglyceride levels (-23.7%), total cholesterol/HDL-C ratio (-14.3%), and fasting insulin levels (-22.3%) (all P <.05). Peak VO2 increased by 21.2% (P <.001). CONCLUSIONS: The present pilot study results suggest that a high caloric training exercise training program in the CR setting may be effective in promoting weight loss and improving coronary risk factors in overweight coronary patients. Although additional research with randomized control patients is needed, this alternative to traditional CR may be considered to maximize weight loss as part of a secondary prevention program.

Aged↗
PubMedDate not supplied

Onset of binge eating and dieting in overweight women: implications for etiology, associated features and treatment.

This study investigated differences between overweight binge eating women who reported the onset of binge eating prior to or following the onset of dieting (binged first [BF], or dieted first [DF]). Of overweight binge eating subjects enrolled in a treatment study, 38.7% indicated binge eating first, and 48.1% dieting first. The mean age of onset of binge eating differed significantly between the two groups (11.8 years vs. 25.7 years). More of the BF group (82.5%) satisfied proposed binge eating disorder (BED) criteria than did the DF group (52.0%), although short of significantly. The results suggest that: (a) the leading hypothesis concerning dieting as a cause of binge eating does not apply to a substantial number of individuals who binge eat; (b) there may be an early pattern and a late pattern in the development of binge eating among overweight individuals; and (c) the early or binge first pattern may be more likely to result in BED.

Adolescent↗
PubMed1997

Effect of prolonged exercise training without weight loss on high-density lipoprotein metabolism in overweight men.

This study examined the effect of exercise training without weight loss on high-density lipoprotein (HDL) metabolism in overweight men. We evaluated HDL metabolism using 125I-radiolabeled autologous HDL in 17 overweight men aged 40 +/- 7 years (mean +/- SD) before and after 1 year of exercise training. Subjects consumed defined diets in a metabolic kitchen during the metabolic studies. They performed endurance exercise under supervision for 1 hour four times weekly and maintained their pretraining body weight. Maximal oxygen uptake (VO2max) increased 27% (P < .001) with exercise training. HDL-cholesterol (HDL-C) and apolipoprotein (apo) A-I increased 10% and 9%, respectively (P < .001 for both), whereas triglycerides and apo B decreased 7% and 10%, respectively (P < .05). Postheparin lipoprotein lipase increased 11% (P = NS). Hepatic triglyceride lipase activity (HTGLA) decreased 12% (P < .05). The fractional catabolic rate (FCR) of HDL protein and of apo A-I decreased 5% and 7%, respectively (P < .05 for both). The synthetic rate of apo A-I increased 13% (P < .01). Increased HDL after exercise training is associated with both decreased HDL protein catabolism and increased HDL apo A-I synthesis. Weight loss is not required to increase HDL-C with exercise training in overweight men, but without weight loss, even prolonged exercise training produces only modest changes in HDL-C concentrations.

Adult↗
PubMed1999

Growth hormone (GH) response to GH-releasing peptide-6 and GH-releasing hormone in normal-weight and overweight patients with non-insulin-dependent diabetes mellitus.

The growth hormone (GH) response to GH-releasing hormone (GHRH) in patients with non-insulin-dependent diabetes mellitus (NIDDM) was found to be either decreased or normal. The recent introduction of a new and potent GH stimulus, GH-releasing peptide-6 (GHRP-6), allowed further investigation of the functional properties of somatotropes in a variety of metabolic diseases. The aim of the present study was to investigate the response of GH to GHRP-6, GHRH, and GHRP-6 + GHRH in NIDDM patients. Twenty-one patients with NIDDM were divided into two groups: group A, normal weight (body mass index [BMI], 23.31+/-0.62 kg/m2); and group B, overweight (BMI, 27.62+/-0.72 kg/m2). Eight normal-weight control subjects (group C) were studied. Each subject received GHRP-6 (90 microg intravenously [i.v.]), GHRH (100 microg i.v.), and GHRP-6 + GHRH on three separate occasions. There was no difference between the GH response after GHRP-6 in groups A, B, and C in terms of the GH peak (50.95+/-11.55, 51.96+/-7.71, and 70.07+/-15.59 mU/L, P>.05) and the area under the curve (AUC) for GH (2,340.06+/-617.36, 2,684.54+/-560.57, 3,462.78+/-1,223.53 mU/L/120 min, P>.05). A decreased GH response to GHRH was found in group B in comparison to group A (B v A: peak GH response, 8.25+/-1.90 v 22.19+/-8.81, P<.05; AUC GH, 479.62+/-84.0 v 1,443.21+/-743.76, P<.05). There was no difference in the GH response between group A and group C (peak GH response, 22.19+/-8.81 v 26.42+/-6.71, P>.05; AUC, 1,443.21+/-743.76 v 1,476.51+/-386.56, P>.05). There was a significant difference between the same parameters in group B versus group C (8.25+/-1.90 v 26.42+/-6.71, P<.05; AUC, 479.62+/-84.0 v 1,476.51+/-386.56, P<.05). The combined administration of GHRP-6 + GHRH elicited a synergistic GH response in NIDDM patients and controls. There was a significant difference between groups A and B for the GH peak (96.49+/-9.80 v 68.38+/-8.25, P<.05), whereas there was no difference for the AUC (5,111.13+/-703.77 v 3,425.95+/-459.67, P>.05). There was no difference in the peak GH after the combined test between group A and group C (96.49+/-9.80 v 139.82+/-24.16, P>.05), whereas the peak GH in the same test was significantly decreased in group B in comparison to group C (68.38+/-8.25 v 139.82+/-24.16, P<.05). The AUC for GH after combined GHRP-6 + GHRH in group A versus group C was not significantly different (5,111.13+/-703.77 v 9,274.71+/-1,541.46, P>.05), whereas there was a significant difference for the same test between group B and group C (3,425.95+/-459.67 v 9,274.71+/-1,541.46, P<.05). Our results demonstrate that normal-weight NIDDM patients have a preserved GH response to GHRP-6, GHRH, and GHRP-6 + GHRH, and overweight NIDDM patients have a blunted response to GHRH and GHRP-6 + GHRH. The preserved GH response to GHRP-6 in both diabetic groups suggests that the secretory potential of somatotropes is preserved in NIDDM patients. The impairment of the GH response to GHRH in overweight NIDDM patients could be a functional defect due to the obesity, since it could be overridden by administration of GHRP-6.

Area Under Curve↗
PubMed1989

40-year follow-up of overweight children.

504 overweight children admitted to hospital between 1921 and 1947 were followed up for 40 years by questionnaires at 10 year intervals. The mean weight for height (W/H) standard deviation score (SDS) reached a maximum in puberty (+3.5). The SDS fell to about +1 in adulthood. 47% patients were still obese (SDS greater than +1) in adulthood; 84.6% of these had SDS more than +2 in childhood. The degree of obesity in the family (parents and grandparents) and the degree of overweight in puberty were the most important factors for weight level in adulthood. Even when their food intake was in accordance with recommended levels, obese children had higher than normal weight as adults. Excessive overweight in puberty (SDS greater than +3) was associated with higher than expected morbidity and mortality in adult life. Weight-reducing measures should be started early in life to improve the unfavourable long-term prognosis for very obese children.

Adolescent↗
PubMed2000

Effects of the treatment with acarbose in elderly overweight type 2 diabetic patients in poor glycemic control with oral hypoglycemic agents or insulin.

The aim of this study was to evaluate the efficacy of acarbose, an inhibitor of alpha-glucosidase, on glycemic control in elderly overweight type 2 diabetic patients poorly controlled by oral hypoglycemic agents (OHA) or insulin. Our study included 22 overweight patients, 60-75-years-old, treated with OHA and/or insulin who, after a period of 4 weeks of controlled diet, showed a poor metabolic control. They were divided into two groups: Group I (nine patients) on OHA treatment; Group II (13 patients) undergoing treatment with insulin alone or in combination with OHA. Acarbose was administered to all the patients (100 mg three times a day at meal times) for 6 months in addition to their previous treatment. The addition of acarbose caused a significant reduction in both groups with regard to fasting glycemia (after 3 and 6 months, respectively, 20.7 and 21.9%, P<0.04 in Group I; 19.1 and 21.8%, P<0.04 in Group II), and postprandial glycemia (after 3 and 6 months, respectively, 41.6 and 42.5%, P<0.0001 in Group I; 35.6 and 38%, P<0.0006 in Group II). There was also a significant reduction in the values of HBA(1c) in Group I after 6 months of treatment (24.3%, P<0.05) and in Group II after 3 and 6 months (respectively 13.4%, P<0.02 and 20.6%, P<0.01). Three months after treatment with acarbose ended, fasting and postprandial glycemia and HBA(1c) values returned to original baseline values. In conclusion, the addition of acarbose to the OHA in elderly overweight type 2 diabetic patients poorly controlled by OHA or insulin regimes improved metabolic control.

Journal Article↗