Modelling Remission from Overweight Type 2 Diabetes Reveals How Altering Advice May Counter Relapse

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aut.relation.articlenumber109180
aut.relation.journalMathematical Biosciences
aut.relation.volume371
dc.contributor.authorHassell Sweatman, Catherine
dc.date.accessioned2024-04-23T00:01:23Z
dc.date.available2024-04-23T00:01:23Z
dc.date.issued2024-03-20
dc.description.abstractThe development or remission of diet-induced overweight type 2 diabetes involves many biological changes which occur over very different timescales. Remission, defined by, or fasting plasma glucose concentration mg/dl, may be achieved rapidly by following weight loss guidelines. However, remission is often short-term, followed by relapse. Mathematical modelling provides a way of investigating a typical situation, in which patients are advised to lose weight and then maintain fat mass, a slow variable. Remission followed by relapse, in a modelling sense, is equivalent to changing from a remission trajectory with steady state mg/dl, to a relapse trajectory with steady state mg/dl. Modelling predicts that a trajectory which maintains weight will be a relapse trajectory, if the fat mass chosen is too high, the threshold being dependent on the lipid to carbohydrate ratio of the diet. Modelling takes into account the effects of hepatic and pancreatic lipid on hepatic insulin sensitivity and -cell function, respectively. This study leads to the suggestion that type 2 diabetes remission guidelines be given in terms of model parameters, not variables; that is, the patient should adhere to a given nutrition and exercise plan, rather than achieve a certain subset of variable values. The model predicts that calorie restriction, not weight loss, initiates remission from type 2 diabetes; and that advice of the form ‘adhere to the diet and exercise plan’ rather than ‘achieve a certain weight loss’ may help counter relapse.
dc.identifier.citationMathematical Biosciences, ISSN: 0025-5564 (Print); 0025-5564 (Online), Elsevier, 371. doi: 10.1016/j.mbs.2024.109180
dc.identifier.doi10.1016/j.mbs.2024.109180
dc.identifier.issn0025-5564
dc.identifier.issn0025-5564
dc.identifier.urihttp://hdl.handle.net/10292/17445
dc.publisherElsevier
dc.relation.urihttps://www.sciencedirect.com/science/article/pii/S0025556424000403
dc.rights© 2024 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by/nc-nd/4.0/).
dc.rights.accessrightsOpenAccess
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject01 Mathematical Sciences
dc.subject06 Biological Sciences
dc.subjectBioinformatics
dc.subject31 Biological sciences
dc.subject49 Mathematical sciences
dc.titleModelling Remission from Overweight Type 2 Diabetes Reveals How Altering Advice May Counter Relapse
dc.typeJournal Article
pubs.elements-id545073
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