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Interdisciplinary Department of Medicine, University of Bari Aldo Moro Medical School, Bari, 70124, Italy

Correspondence: Giuseppina PiazzollaInterdisciplinary Department of Medicine, University of Bari Aldo Moro Medical School, Policlinico, Piazza G. Cesare 11, Bari, 70124, ItalyFax +39 080 5478126Email [emailprotected]

Introduction: New antidiabetic drugs have simplified treatment regimens in patients with type-2 diabetes (T2D). More importantly, they have proven to reduce cardiovascular risk by lowering insulin-resistance, blood pressure and body weight, in addition to avoiding inappropriate insulin therapy, responsible for hypoglycemic episodes and weight gain. In this context, accurate assessment of the metabolic status of T2D patients becomes essential. The C-peptide assay is a simple but often overlooked test that can provide a fundamental contribution to the correct disease classification and optimal therapeutic management of diabetic patients.Clinical Case: We report the case of a 72-year-old patient, treated with insulin for 26 years after a diagnosis of type-1 diabetes (T1D), resulting in inadequate glycemia control and a severe evolution of cardiovascular complications. After an accurate evaluation of the clinical history, phenotype and laboratory data, including the determination of C-peptide serum levels, a diagnosis was made of T2D not T1D. Considering the patients very high cardiovascular risk and dysmetabolic profile, insulin therapy was discontinued and more appropriate therapy with dulaglutide and metformin was instituted. These overall therapeutic modifications yielded remarkable clinical advantages in terms of the glycometabolic profile, weight reduction, abdominal circumference and body mass index decrease, as well as a better quality of life, with complete resolution of the dangerous hypoglycemic episodes.Conclusion: In the era of new cardioprotective antidiabetic drugs, we believe the importance of the C-peptide assay should be re-evaluated in order to avoid misdiagnosis and to improve the therapeutic approach to T2D.

Keywords: diabetes, metabolic syndrome, hypoglycemia, obesity, dulaglutide, quality of life

Type-2 diabetes (T2D) is becoming more prevalent in the general population, especially in individuals over the age of 65 years, and is closely linked to cardiovascular diseases (CVDs). The treatment of diabetes is challenging, since the aims addressed are to achieve metabolic compensation and to reduce micro and macrovascular complications.1,2 Cardiovascular outcome trials (CVOTs) have provided useful information on the cardiovascular safety and cardio- and nephro-protection achieved with the new anti-diabetes drugs, namely Glucagon-like-peptide-1 receptor agonists (GLP-1 RA) and sodium-glucose transporter-2 inhibitors (SGLT2i). These are both very effective pharmacological approaches, currently recommended for T2D, particularly in patients with established heart disease or at high risk for cardiovascular events. Nowadays, since the emergence of these revolutionary drugs for the treatment of T2D, routine determination of the pancreatic cells reserve has become essential. C-peptide is a biomarker of residual -cell function and can provide valuable clinical information, but it is rarely used to classify the diabetes type in clinical practice or to manage T2D.3,4 While type-1 diabetes (T1D) is an autoimmune process leading to the loss of pancreatic -cell function, T2D is a heterogeneous disease characterized by a combination of varying degrees of relative insulin secretory deficiency and insulin-resistance linked to the metabolic syndrome, featuring a slower, more protracted course. We report the case of a 72-year-old dysmetabolic patient, treated with insulin for 26 years after a diagnosis of T1D, who developed severe CVDs. An accurate evaluation of the clinical history, phenotype and especially the measurement of C-peptide levels allowed us to correct the T1D misdiagnosis to T2D, and set up a more appropriate therapy resulting in metabolic and glycemic advantages and a marked improvement of the patients quality of life. Regular use of the C-peptide assay in clinical practice, particularly at the time of first diagnosis, might help clinicians to avoid inappropriate use of insulin and prevent a detrimental delay in the introduction of new cardioprotective antidiabetic drugs.

A 72-year-old man with a history of T1D was admitted to the Department of Internal Medicine complaining of alternating hyperglycemia and numerous hypoglycemic episodes.

The patient signed the informed consent for the acquisition, analysis, and publishing of the anonymized data collected. Since no personal identification data were used in this manuscript, the ethics committee approval is not needed.

The patient had been diagnosed with T1D in 1994 at a diabetes center and treated with insulin thereafter, continuing follow-up at an endocrinology department. He was a former smoker (15 pack-years), non-drinker, and reported a family history of diabetes and cardiovascular diseases. After the T1D diagnosis, his clinical course was complicated by peripheral neuropathy, arterial hypertension, OSAS (obstructive sleep apnea syndrome) and multiple episodes of angina, requiring placement of intracoronary stents for an N-STEMI (non-ST-segment elevation myocardial infarction) in 2011. At the time of our first observation, the patients medications included a -blocker, an angiotensin-converting enzyme (ACE)-inhibitor, double antiplatelet therapy, ranolazine, statins, furosemide and pregabalin. Diabetes medications consisted of basal-bolus insulin therapy, in the form of long-acting insulin glargine 30 I.U. at bedtime, and short-acting insulin lispro at meals (8 I.U. at breakfast and dinner, 15 I.U. at lunch). Last year, his family doctor had recommended increasing the doses of short-acting insulin at meals, in order to improve the glycemic control, but his conditions were deteriorating due to the onset of numerous hypoglycemic episodes (up to 4 per day) and an increased appetite. At physical examination, the patient had a high body mass index (BMI) and abdominal circumference, and his condition was classified as metabolic syndrome with class I obesity (Table 1). The laboratory tests showed unsatisfactory glycemic compensation and a suboptimal lipid profile but preserved renal function (see Table 1). Serum C-peptide levels had never been determined in any of the patients clinical records. Nor had the presence of autoantibodies to diabetes-associated antigens ever been evaluated since the T1D diagnosis. The fasting serum C-peptide assay was performed and resulted within the normal range. The patients clinical history, as well as his phenotype, suggested a diagnosis of T2D rather than T1D. This view was confirmed by the finding of normal C-peptide levels. Ezetimibe and metformin were added to the therapy, and the short-acting insulin dose was tapered until complete discontinuation at 10 days. Owing to the patients very high cardiovascular risk, either an SGLT2i or a GLP-1RA was particularly indicated.58 His obesity status and referred increase in appetite led us to institute therapy with dulaglutide, a long-acting GLP-1RA. Over the next 4 weeks, the long-acting insulin doses were also completely discontinued. After 4 weeks of treatment, the patients glycated hemoglobin values had normalized and no further hypoglycemic episodes occurred. After 2 months of dulaglutide treatment, and the insulin discontinuation, the patient achieved 10 kg of weight loss and a reduction in abdominal circumference by 13 cm.

Table 1 Relevant Patient Data Before (Baseline) and 2, 4 and 8 Weeks After Instituting the New Therapy

In past decades, randomized trials compared the effect of more versus less intensive glycemic control, showing that the potential benefit of strict glycemic control on microvascular diabetes complications was counteracted by the increased risk of cardiovascular disease and mortality.9 In contrast to the more traditional focus on glycemic control, new diabetes guidelines increasingly highlight the importance of multifactorial management focused on cardiovascular risk benefits. Recent CVOTs have provided useful information on cardio- and nephro-protection conferred by the new antidiabetic drugs.6,10 In this context, an accurate evaluation of the diabetic disease and correct determination of pancreatic reserves are crucial to ensure optimal care. C-peptide is the part of pro-insulin cleaved prior to co-secretion with insulin by pancreatic -cells. It is produced in equimolar amounts to endogenous insulin and provides the best gauge of -cells ability to produce insulin in diabetic patients, including those treated with exogenous insulin.3,11,12 The determination of serum C-peptide levels can help to identify subjects whose residual -cell function is still sufficient to indicate the use of emerging antidiabetic drugs, avoiding the administration of exogenous insulin. Instead, very low C-peptide levels, suggestive of a defective -cell secretory function, have been indicated as predictors of poor response to GLP-1 RA.13 Serious errors may arise when T1D is diagnosed later in life; in fact, more than 50% of the patients diagnosed with T1D after age 35 have been found to have T2D at long-term follow-up.14 Furthermore, among T2D patients, too often the timing of insulin administration is anticipated due to suboptimal glycemic control, potentially leading to hypoglycemic episodes, weight gain and increased cardiovascular risk. In this context, the C-peptide assay is a simple, inexpensive but often overlooked laboratory test that can provide an essential contribution to the differential diagnosis between T1D and T2D and to a correct determination of pancreatic reserves in T2D.15,16 This patient did not have the typical hallmarks of immune-mediated T1D and his normal C-peptide value was poorly compatible with a diagnosis of T1D 26 years after the disease onset. The patients complaint of an increased appetite, the absence of clinical evidence of heart failure, as well as our aim to simplify the therapeutic schedule, constituted the rationale for prescribing metformin and dulaglutide and discontinuing exogenous insulin therapy. After only 4 weeks of treatment the C-peptide levels had further increased, indicating a satisfactory residual -cell function. Following these therapeutic changes, the patients quality of life significantly improved, thanks to the reduced subcutaneous administration of drugs (from 4 per day to 1 per week) and resolution of the frequent hypoglycemic episodes. Hypoglycemia has long been recognized as a dangerous side effect of treating diabetes with insulin or insulin secretagogues. Indeed, hypoglycemia is associated with negative life consequences, ranging from the disruption of daily activities to psychosocial problems for both patients and their family members, in addition to increasing cardiovascular risk and mortality.9,17 After a few days of treatment with dulaglutide and insulin discontinuation, the quality of life of our patient had improved considerably, as also his therapeutic compliance. Other clinical advantages included the normalization of glycated hemoglobin values, a decreased appetite, 10 kg of weight loss in only 2 months and a 13 cm reduction in abdominal circumference, all yielding unquestionable health benefits.

The study's strong point lies in the evidence that C-peptide evaluation changed the diagnosis and therapeutic management of our patient. Accordingly, the use of C-peptide as a preliminary test in clinical practice may help clinicians to institute the most suitable antidiabetic therapy as early as possible, and also encourage them to refrain from prescribing insulin at all, when it may actually be useless.

The main limitation is that the c-peptide assay is a well-known but overlooked test and the official guidelines on medical care in diabetes and pre-diabetes do not exploit it for the correct classification of patients. For this reason, there are not yet data in the literature to support our view that re-evaluating c-peptide dosage as a key tool may offer a novel approach to diabetic disease management.

We believe that in the era of the new cardioprotective antidiabetic drugs, the C-peptide assay may be the natural laboratory complement to clinical signs and symptoms in T2D patients, offering the advantage of avoiding inappropriate prescription of insulin to dysmetabolic and insulin-resistant patients. A correct clinical classification of our patient and the determination of a preserved pancreatic -cell function with this simple test led us to introduce a more beneficial and appropriate antidiabetic therapy. The application of this test in clinical practice might have important implications on cardioprotection and body wellness in diabetic patients. Certainly, inappropriate or overuse of insulin in dysmetabolic and high cardiovascular risk patients is no longer acceptable, and should be considered deleterious to their health and quality of life. This strongly suggests that the C-peptide assay needs to be re-evaluated as a key tool for use in daily clinical practice.

T2D, type-2 diabetes; T1D, type-1 diabetes; CVD, cardiovascular disease; CVOTs, cardiovascular outcome trials; GLP-1RA, glucagon-like-peptide-1 receptor agonists; SGLT2i, sodium-glucose transporter-2 inhibitors; OSAS, obstructive sleep apnea syndrome; N-STEMI, non-ST-segment elevation myocardial infarction; ACE, angiotensin-converting enzyme; I.U., International Units; BMI, body mass index; HbA1c, glycated hemoglobin; LDL, low-density lipoprotein; HDL, high-density lipoprotein; eGFR, estimated glomerular filtration rate; SBP, systolic blood pressure; DBP, diastolic blood pressure.

We are grateful to Mary Pragnell for language revision.

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

The authors report no actual or potential conflicts of interest in relation to this work.

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3. Jones AG, Hattersley AT. The clinical utility of C-peptide measurement in the care of patients with diabetes. Diabet Med. 2013;30:803817. doi:10.1111/dme.12159

4. Hope SV, Wienand-Barnett S, Shepherd M. Practical Classification Guidelines for Diabetes in patients treated with insulin: a cross-sectional study of the accuracy of diabetes diagnosis. Br J Gen Pract. 2016;66:E315E322. doi:10.3399/bjgp16X684961

5. Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomized placebo-controlled trial. Lancet. 2019;394:121130.

6. Giorgino F, Caruso I, Moelimann J, et al. Differential indication for SGLT-2 inhibitors versus GLP-1 receptor agonists in patients with established atherosclerotic heart disease or at risk for congestive heart failure. Metabolism. 2020;104:154045. doi:10.1016/j.metabol.2019.154045

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8. Standards of medical care in diabetes 2021 ADA (American Diabetes Association). Diabetes Care. 2021;44(Suppl1):S111S124. doi:10.2337/dc21-S009

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10. Zelniker TA, Wiviott SD, Raz I, et al. SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet. 2019;393:3139. doi:10.1016/S0140-6736(18)32590-X

11. Becht FS, Walther K, Martin E, et al. Fasting C-peptide and related parameters characterizing insulin secretory capacity for correctly classifying diabetes type and for predicting insulin requirement in patients with type 2 diabetes. Exp Clin Endocrinol Diabetes. 2016;124:148156. doi:10.1055/s-0035-1565177

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When Inappropriate Use of Insulin is Dangerous: The Utility of C-Pepti | DMSO - Dove Medical Press

It soon became apparent that people who were overweight, obese, or suffering from diabetes were more susceptible to severe COVID-19 symptoms. Now we are learning more about who is at greatest risk of long-term complications.

This health effect of chronic COVID is common in patients with moderate to severe obesity, said Dr. Ariaminian, director of the Obesity Metabolism Institute at Cleveland Clinic.

Weight loss surgeons at the Cleveland Clinic are studying the long-term effects of COVID-19 infection among obese people.

Patients with moderate to severe obesity are 28% to 30% more likely to be admitted to the hospital after recovery from the initial infection when compared to the group of COVID-19 survivors with a normal classification of obesity index. I understand.

They also needed more medical tests to assess their symptoms.

They have experienced all sorts of long-term complications, from heart and lungs to digestive and mental health problems.

Previous studies at the Cleveland Clinic have shown that people with a history of weight loss surgery have a less severe COVID-19 infection.

Further research is needed to see if it leads to milder long-term symptoms.

The COVID-19 vaccine is very effective in obese patients and can reduce the risk of getting sick, said Aminian.

The Cleveland Clinic hopes that this study will realize the importance of vaccination of obese people and require follow-up in the care of COVID-19 survivors.

We are learning more and more about the long-term effects of this disease, and although it is not yet known who is likely to have these long-term effects, this study shows that obesity may be a risk factor. It was the first study, said Aminian.

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Cleveland Clinic studying long-term effects of COVID-19 among people who are obese Source link Cleveland Clinic studying long-term effects of COVID-19 among people who are obese

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Cleveland Clinic studying long-term effects of COVID-19 among people who are obese - California News Times

If you're looking to lose weight , conventional wisdom for decades has been to eat less calories and to move more.But experts question this approach.

Increased high rates of chronic illness and obesity, which haven't budged despite efforts to help people eat less calories, suggests there is more to weight loss and health than caloric intake.

Dr. Robert Lustig, a pediatric endocrinologist and author of "Metabolical," a new book on the health risks of our industrialized food system, told Insider the calorie is an outdated and misleading concept for healthy eating.

Other nutrition experts, however, say it's a powerful tool for some people to take control of their health and to strengthen their relationship with food. While calories are a limited, sometimes inaccurate metric for assessing food, the tool can help people to understand what, and how much, they're eating.

Relying on calorie counts to manage weight and health is misleading, because it doesn't account for the damaging effect processed foods has on our bodies, according to Lustig.

"The entire disaster that we're dealing with is built on this notion that a calorie is a calorie.It's just not true," he told Insider.

Processed foods, particularly refined sugar, can damage cells and cause inflammation, which can to a whole host of potential health issues, Lustig said.

In contrast, whole foods like produce contain compounds that reduce inflammation and stave off oxidation and stress.

Both types of food may have the same number of calories, but dramatically different effects, making the concept of calories an unhelpful way to differentiate between healthy and unhealthy foods, according to Lustig.

Lustig argues that conventional science miscalculates how much energy we absorb from foods. During digestion, our bodies rely on beneficial bacteria, known as the gut microbiome, to help process nutrients. A portion of what we eat feeds these microscopic critters, helping them to thrive and keep us healthy.

"How do you know whether any individual molecule of nutrients is going to you or the bacteria?" Lustig said.

He compared it to "eating for two" while pregnant except in this case, each of us is eating for 100 trillion friendly bacteria in our gut.

While not all calories are equal from a health perspective, that's not a reasonto scrap the whole system,according to Layne Norton, a nutrition and fitness coach, bodybuilder, and power lifter with a PhD in nutrition.

"Calories are the same because calories are a unit of measurement. What is different is that sources of calories are not equal in how they affect energy intake and energy expenditure," he said.

For instance, a dieter might find that snacking on chips leaves them feeling hungry and tired, while the same amount of calories from chicken and broccoli is more filling and energizing. They can then change their habits accordingly.

One of the major advantages of calories, according to Norton, is that it offers a neutral way for people to measure and assess their food.Labeling foods as "good" or "bad" may be well intentioned, but it can backfire into excessive restriction and ultimately bingeing behavior, he said.

Calorie data, combined with other information about food, can help people make a more informed decision about what works best for their unique lifestyle and goals.

"This is the advice that no one wants to hear because it's not sexy: you should choose the diet that's easiest for you to sustain in the long term, and that depends on the individual," Norton said.

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Why counting calories is pointless for weight loss but you shouldn't ignore them completely - Insider

As we age, our health needs change. In other words, what worked when we were younger may have a detrimental impact on our body and mind later in life. What health habits are the most damaging? Eat This, Not That! surveyed some of the top experts in the country, who revealed some of the worst ways you can ruin your body in your senior years. Read on for 13 ways you're ruining your body after 60and to ensure your health and the health of others, don't miss these Sure Signs You Have "Long" COVID and May Not Even Know It.

Darren P. Mareiniss, MD, FACEP, Assistant Professor of Emergency Medicine, Sidney Kimmel Medical College Thomas Jefferson University notes that one of the biggest mistakes is ignoring concerning symptoms like unintended weight loss, blood in the stool, chest pain, lower extremity edema or shortness of breath, which can lead to serious maladies going undiagnosed. Don't let these simmer, or fear you're a hypochondriac; at your age, get them checked out, he advises.

Dr. Mareiniss points out that you should always pay attention to your sleep. "Symptoms like daytime drowsiness or significant snoring can indicate sleep apnea. Appropriate interventions like CPAP can avoid long term consequences like right heart failure and pulmonary hypertension," he says. "Poor sleep patterns can lead to increased risk of hypertension, diabetes and even heart attacks."

Smoking, drinking, and drug use is always bad, but even worse after 60. "Habits like smoking, daily drinking and drug abuse continue to present issues in older age," explains Dr. Mareiniss. For drinkers, they may become cirrhotic or have alcohol dependence issues or experience withdrawal if they attempt to suddenly stop drinking. Smokers have the potential for developing COPD, cancer, hypertension, coronary artery disease, stroke, and kidney disease. "Beyond these effects, smoking cigarettes increases the risk of essentially every type of cancer, not just lung cancer. So, smoking cessation is one of the smartest things you can do to improve your health and avoid cancer," he says.

Watching what you eat and exercising is key to healthy aging. "Obesity is also a major issue that can have health consequences in this age group. It contributes to type II diabetes, hypertension, arthritis and atherosclerosis," Dr. Mareiniss points out. "Exercise, eat healthy and avoid obesity. Also, isometric exercises can help avoid calcium/bone loss and prevent osteoporosis."

Get your COVID-19 vaccine ASAP to protect your health, urges Dr. Mareiniss. "People above 60 are at the highest risk of death if they contract COVID-19," he points out. "So, if you would like to avoid ruining your body, you should get vaccinated. Working in the ED, I am amazed at how many high-risk elderly people are still not vaccinated. Failing to vaccinate is a key way you will ruin your body after 60."

For people above 60, failing to take medication and dietary indiscretion can result in avoidable hospitalizations, Dr. Mareiniss reveals. "Many people above 60 have chronic medical conditions such as diabetes mellitus, heart failure and atrial fibrillation that require daily medications. Diabetics often require insulin, people with heart failure may require diuretics and individuals with PE or atrial fibrillation may require anticoagulation. Failing to take medication can lead to avoidable hospitalization, morbidity and even death." He adds that diabetics and people with heart failure often need to follow restrictive diets. "Heart failure often requires a low sodium diet and diabetics need to avoid excessive sugars/carbohydrates," he continues. "Failure to observe these restrictions can land them in the hospital with acute exacerbations of their conditions. These are avoidable ways people ruin their body."

Kellyann Petrucci, a naturopathic doctor and the author of Dr. Kellyann's Bone Broth Diet, maintains that the biggest mistake people make later in life is shorting themselves on healthy fats, eating too little protein and drinking too many smoothies. She suggests amping up intake of olive oil, coconut oil, and pastured butter, which are not only good for your body but skin. Also, amping up protein will help build muscle. (She suggests 60 to 100 grams per day.) And, juice smoothies are full of sugar, which can jack up your blood sugar and put you at extra risk for metabolic syndrome or even diabetes. "If you're a fan of smoothies, add a healthy dose of protein-rich collagen to each one, and stick to no more than one serving of fruit per smoothie," she says.

Dr. Petrucci explains that lifting weights isn't just for young people. "You can build strong muscles at any age, and the best way to do this is by doing resistance training (lifting weights or using your body's weight in exercises like planks and pushups) every other day. Just start with light weights, and don't overdo it," she says.

According to Dr. Petrucci, good balance is a "use it or lose it" skill, "and as you age, it's also a life-or-death skill, because falls can be dangerous or even deadly," she points out. "Make it a regular habit to do activities that improve your balance, such as yoga, Tai Chi, or ballet."

Saying "I'm too old," is a surefire way to ruin your body in your later years of life. "One of the biggest keys to staying physically strong in your sixties is to have the right mindset," Dr. Petrucci points out. "Not trying new adventures or learning new things is the fastest way to age your mind and body. So erase the words 'I can't' from your vocabulary, and keep challenging yourself to be the best 'you' that you can beat any age."

Jessica Mazzucco, NYC Certified Fitness Trainer, warns that when it comes to exercising later in life, too much of a good thing is very possible. "We all know that exercising regularly can reduce the risk of cardiovascular disease and keep you active as you age. The key to exercise over 60 is to focus on starting slow and to constantly improve over time. If you haven't been active in a while, you should build up your exercise routine little by little," she explains. For example, try increasing your time on the treadmill by two minutes every day, or try performing one to two more sit-ups than you did last time. "If you try to accomplish too much too quickly, you can place strain on your joints and muscles, put yourself at risk for injury, and suffer from exercise burnout."

Sanam Hafeez, PsyD, NYC Neuropsychologist and Faculty Member Columbia University, explains that exercising your mind is just as important as your body. "Your brain is a muscle that needs to be kept active. Don't let it go to mush by not using it," she says. If you are not working or are not in school, there are things you can do to flex your brain power and keep your brain sharp. "Playing brain games like bridge, advanced crossword puzzles, sudoku, and chess can keep the brain active and improve brain function," she suggests.

RELATED: 9 Everyday Habits That Might Lead to Dementia

Gbolahan Okubadejo, MD, NYC Area Spinal and Orthopedic Surgeon, urges you not to ignore any back pain you are experiencing. "You may think that bed rest will make your body heal faster and that by resting in bed, you will be back on your feet in no time," he says. However, contrary to popular belief, bed rest slows the healing time for back pain, and the back will actually take longer to heal if you remain inactive. "Lying down can even make the pain worse. Try swimming, light cycling, or walking to stay active and bounce back from your back pain. If your back pain is intolerable and very severe, you should see a doctor." And to get through life at your healthiest, don't miss The #1 Cause of "Deadly" Cancer.

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13 Ways You're Ruining Your Body After 60, Say Experts | Eat This Not That - Eat This, Not That

Remember that you are worthy of your own love, no matter how you look or feel.

While most symptoms of inflammatory bowel disease (IBD) are invisible, weight loss is an extremely visible one that takes a physical and mental toll on those who experience it.

Maintaining adequate weight is often an ongoing challenge because weight can fluctuate easily in people with IBD. In a culture that praises smaller bodies, we are sometimes even complimented for weight loss, which is perceived as a sign of health, rather than a sign of a chronic invisible illness flaring.

Losing weight and struggling to maintain a healthy weight with IBD is something I worked to balance for many years. During that time, I lacked self-confidence and self-love.

Even at times when I felt really well, I could not get past a certain number on the scale. I often felt like I was disappearing into thin air. I felt bones that people are not supposed to feel because they are normally protected by fat, which was scary and unnerving.

However, I did manage to gain weight and keep it on long-term using the strategies outlined below.

The small intestine is where most of our nutrients from food are absorbed. Since the small intestine is involved with Crohns disease, this can be a significant hurdle to gaining and maintaining weight.

Even though ulcerative colitis (UC) is only in the large intestine, it does not mean that those with UC shouldnt focus on healing inflammation. Thats because inflammation can occur from gut permeability, bacterial and fungal overgrowths, food sensitivities, and more not just from inflammation directly from having IBD. Additionally, inflammation in the large intestine presents its own concerns.

The more inflammation you have, the more your body will struggle to absorb nutrients. That hurts your chances of achieving an adequate weight.

I saw improvements in my weight when I made my diet simple but nutrient-dense. I left out some of the fun gluten-free snacks I enjoyed and zeroed in on proteins, grass-fed butter and extra virgin olive oil, bone broth, teas, and herbs.

I even swapped out some of the products I used on my skin and in my home to eliminate them as a potential source of stress for my body.

To start healing inflammation, focus on eating an anti-inflammatory diet and incorporating the best foods for gut health.

In general, an anti-inflammatory diet is low in sugar and free of refined grains. The focus should be on whole foods like quality proteins, fats, fruits, vegetables, nuts and seeds as tolerated, and water as the main source of hydration.

You may consider additional supplements like collagen, ginger, turmeric, tart cherry juice, and other foods or herbs that have been shown to improve inflammation.

Its important to evaluate what you are eating on a typical day and see how you can optimize the types and quantities of your food. Not eating enough macronutrients, including protein, carbohydrates, or fat, can be detrimental, especially if you are already underweight.

When youre looking to gain weight, its not the right time to cut any macronutrients (Im looking at you, keto.)

Try to prioritize whole-food macronutrients. What I mean is, pick sweet potatoes over bread. Choose chicken, beef, and fish over protein powders. Opt for extra virgin olive oil, grass-fed butter (if tolerated), and coconut oil over vegetable oils. This provides nutrients that are much more easily usable and have health benefits.

Give yourself a mental checklist and make sure there is always protein, fat, and carbohydrates on your plate. You may want to work with a dietitian or nutritionist to make sure your portions are adequate for your goals.

Some foods have more calories than others, which can be a great thing when you are trying to gain weight.

Fats have the most calories per gram compared to protein and carbohydrates. Foods with higher fat content like coconut, avocado, nuts and the products made from them are foods to consider daily.

Start to think about how you can add more of these high-calorie foods to your diet.

When I needed to gain and maintain weight, I was adding sliced avocado onto dishes, having smoothies in between meals, and snacking on rice cakes with nut butter.

An extra drizzle of extra virgin olive oil or slices of avocado will add up when you make these choices consistently.

These are just a handful of ways you can start including high-calorie (but still nutrient-dense) foods to your plate.

Its common for larger meals to cause gastrointestinal distress in IBD. Larger meals during the day could trigger diarrhea in some, which is not helpful for weight gain.

If you are experiencing gastrointestinal symptoms while trying to gain weight, eating smaller meals and snacks throughout the day will likely feel better for you and not cause additional symptoms in the long run.

To ensure you have access to plenty of food options that you can reach for daily, buy and prepare some easy-to-grab foods. Some extra snacks I have stocked up on are:

Be sure to leave extra snacks where you work or wherever you spend time outside your home.

It can be hard to get in enough calories without feeling like youre eating all day long.

Not only that, but not everyones job or lifestyle can accommodate eating so frequently.

Thats where liquid nutrition can be a helpful supplement to support a nutrient-dense diet or to temporarily replace solid food when needed.

An important note: Do some research on liquid nutrition supplements before you buy or start incorporating them. Some popular liquid nutrition supplements on the market use poor ingredients. Remember, you want to heal inflammation at the same time as gain weight, so avoid things like corn fillers, vegetable oils, and artificial ingredients.

Use these as a supplement to your diet. They can be consumed in between meals, when you dont have the time to eat a full meal, or as a replacement for solid food to give your digestive system a break.

For so long, I did not move my body in a productive way. Aside from occasional short walks, exercise was not part of my lifestyle.

I was either too tired or afraid that the exercise would burn calories that I could not afford to lose. At that time, it did not occur to me that I should try exercising with intention.

Strength training helps build muscle, which will benefit your body composition goals. Additionally, it is important to maintain muscle mass, which being sedentary and having nutrient deficiencies puts you at risk for losing.

I did not start strength training with weights, and I dont recommend you do either if you are in or recovering from a flare or generally feel weak. Bodyweight exercises are great to start with and include in your routine down the line.

Try anything from lunges, squats, pushups, planks, and more. Start slow and gradually increase your reps as tolerated.

You dont need a lot of time to do these exercises. Start your day with some of these exercises or taking breaks during your workday and pumping out a few reps.

This is a more drastic option and considers your health and vitality in the big picture. You should consider the pros, cons, and state of your health.

I list this as an option because having a bowel resection surgery is what allowed me to make leaps and bounds with my weight and overall health.

How does this work? A surgeon will remove the parts of your intestine that have been scarred from inflammation and maybe other very inflamed areas. Without these compromised areas, you are able to absorb nutrients much easier and experience less pain.

For me, this was like being given a clean slate. I was able to gain weight and have maintained that weight more than 2 years into remission so far.

The surgery gave me other added benefits, like abundant energy and a reduction in symptoms.

Is bowel resection surgery right for you? This is a question you need to bring up with your doctor and discuss with a gastrointestinal surgeon. If you have a hard time getting out of flares, maintaining weight, or managing pain that interrupts your life daily, your doctors may feel this is a good option for you.

Keep in mind that every body and every case of IBD works differently. People gain and maintain weight in different capacities.

Weight gain also takes time, especially when youre working with inflammation and pain. Be gentle with yourself and your journey and reach out to your doctor and other health professionals that can guide and support you through this.

The most important thing I want you to take away is that you are worthy of your own love, no matter how you look or feel.

Looking back, I can see how I did not love myself in the times I really needed it. Have an appreciation for the challenges your body is pushing through and dont lose sight of what you can accomplish.

Alexa Federico is an author, nutritional therapy practitioner, and autoimmune paleo coach who lives in Boston. Her experience with Crohns disease inspired her to work with the IBD community. Alexa is an aspiring yogi who would live in a cozy coffee shop if she could! Shes the Guide in the IBD Healthline app and would love to meet you there. You can also connect with her on her website or Instagram.

More:
7 Tips That Helped Me Maintain Weight in an IBD Flare-Up - Healthline

Lots of diet plans have come and gone (cabbage soup diet, anyone?) but DASH is here to stay. The DASH eating plan (or DASH diet) has been around for decades because it has solid science to prove that it works.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.Policy

Dive into what the DASH diet is and how you can use it to boost your health with dietitian Kate Patton, MEd, RD, CSSD, LD.

DASH stands for Dietary Approaches to Stop Hypertension. This eating plan was designed to lower the risk of hypertension (high blood pressure). High blood pressure affects 1 in 3 American adults and is a major risk factor for heart disease.

When you follow the DASH diet, you consume higher amounts of potassium a heart-healthy mineral. You also consume less sodium, which can help lower your blood pressure and improve heart health.

The benefits of DASH are well-documented. Multiple studies have found that people who follow DASH can lower their blood pressure within a few weeks, says Patton.

But its not just about improving blood pressure. The DASH diet can help you lose excess weight and cut your risk for certain health problems. Research has found that following DASH could lower your risk of:

The best part about the DASH diet? Its flexible. It doesnt require special foods and you dont have to go hungry or eliminate treats, notes Patton. Instead, DASH recommends incorporating heart-healthy foods into your daily life.

The DASH diet focuses on eating heart-healthy foods that you can find in your grocery store. These foods are naturally high in fiber, magnesium, potassium and calcium. Theyre also low in sodium.

If you follow the DASH diet, youll eat plenty of:

DASH also encourages you to cut back on foods that can raise your blood pressure. These include:

If you follow DASH, you dont have to eliminate these foods, says Patton. Instead, take steps toward healthier choices each day. The plan will be easier to stick with. For instance, consider replacing a meat entre with a meatless option once a week.

Most Americans eat more meat than necessary at the expense of their vegetable intake. DASH recommends consuming no more than 6 ounces of meat per day. In its place, eat more fruits and veggies, which contain disease-fighting antioxidants, fiber and other nutrients.

Many Americans eat too much sodium (salt). And eating a diet high in sodium can increase blood pressure and heart disease risk.

The standard DASH diet limits sodium intake to 2,300 milligrams per day. But if you want stronger results, go with the lower-sodium DASH diet. On this plan, you aim for 1,500 milligrams of sodium or less per day.

The DASH combination of nutrient-rich foods and lower sodium intake has a proven effect on blood pressure. Multiple studies have found that following the DASH diet quickly lowers blood pressure in as little as two weeks.

Most of the sodium people consume doesnt come from the saltshaker. Processed and packaged foods are often high in salt, even if they dont taste salty, says Patton. Restaurant and takeout foods can also be very high in sodium.

If youre following DASH, read food labels for sodium content and keep track of how much youre getting. If youre eating out, try these tips to cut back on sodium:

If you follow the DASH eating plan, youll likely shed pounds. Combine the DASH diet with calorie cutting if you want to lose more weight. Find out how many calories you should eat based on your age and activity level. Keep track of your calorie intake and cut back a little at a time.

But dont go to extremes, cautions Patton. If you try to cut calories quickly and dramatically, youll probably feel hungry and tired, she says.

If you need help creating your weight loss plan, talk with your healthcare provider. Your doctor can help you get started or refer you to a nutritionist or dietitian.

A DASH diet meal plan can look different for everyone. The key is to emphasize healthy foods and sideline the less healthy ones, says Patton.

When you go to the grocery store, fill your cart with whole foods and choose boxed, bagged or canned options that are low sodium.For example, original or quick cook oats in the canister have zero milligrams of sodium, but instant oatmeal packets have sodium added.

Beans are also an important part of the DASH diet. If you dont have time to prepare dry beans, canned beans are a good alternative. Look for no-salt-added versions, though, and be sure to rinse them.

Build your meals around foods you like that fit into the DASH plan. Dont like green peppers? Enjoy red peppers, celery or carrots instead. Make your favorite stir fry, but use less salt, add more veggies and swap whole grain brown rice for white rice.

Take recipes you already love and make them DASH-friendly by:

Looking for some inspiration? There are plenty of DASH-friendly recipes to explore. These tasty recipes contain higher amounts of fruits and veggies with low saturated fat and sodium.

Start your day right with a nutrient-rich breakfast:

Skip the afternoon slump by filling up with nutritious foods on your lunch break:

These recipes help keep dinner simple and healthy after a long day:

If you want to increase your weight loss and health benefits, pair the DASH plan with more movement and activity, says Patton.

This doesnt mean you have to join a gym or start hard-core training. Instead, aim for at least 30 minutes of exercise a day. Walking, biking and swimming are all good options. And you dont have to do it all at once. Break it up into two 15-minute chunks or three 10-minute chunks.

Youll boost your health even more if you get 60 minutes of moderate-intensity exercise five days a week. Moderate intensity means your heart rate is about 50% higher than your resting heart rate. There are endless options for moderate-intensity exercise, from taking a brisk walk to swimming laps or playing basketball.

These steps can also boost your heart health:

You dont have to follow DASH perfectly to reap its benefits. Each day, take small steps toward healthier eating, says Patton. Over time, youll start to feel better and lose weight, which can motivate you to keep going.

The flexibility of DASH makes healthy eating fit in with your tastes and lifestyle. And that helps you stick with it for the long-term.

Follow this link:
DASH Diet: What Is It, Meal Plans and Recipes - Health Essentials from Cleveland Clinic

The sight is well known to all fans of mixed martial arts (MMA). A fighter walks onto a stage on a Friday evening, waving to the cheering crowd before stepping onto a scale. The fighter waits nervously for a few moments as an official checks their weight to see if theyve qualified for their chosen weight division.

Weigh-ins happen the day before every MMA fight. Theyre designed to ensure both competitors are the same size, theoretically making a fair contest. Importantly, this is the only time a fighters weight is checked by organisers meaning they only need to be on weight for those few seconds. But in order to make sure they qualify for the weight division theyre competing in, MMA competitors will spend weeks drastically reducing their body weight in a process called weight cutting.

Weight cutting generally happens in two stages: chronic weight loss (eating less and training more often for several weeks before the weigh-in), and rapid weight loss (taking extreme measures to lose even more weight in the days before weigh-in such as through eating less or fasting and through dehydration.

After the weigh-in the race is on to regain as much lost weight as possible in the 24 hours before the fight, as its believed being larger than your opponent will help you win. This is usually done by eating energy dense foods high in easily digestible carbohydrates and by consuming increased fluids to attempt rapid rehydration.

Though weight cutting is common in all combat sports, as well as in horse-racing, MMA fighters cut more weight than other combat sport athletes, and cut more in the 24 hours before weigh-in using extreme methods. The majority of MMA fighters report using saunas or sweat suits to dehydrate themselves to lose weight. Most also miss up to two meals a day (sometimes even fasting all day) during weight cutting and sometimes even eating as little as 300-750 calories a day.

Such energy and fluid restriction can reduce brain and nervous system function and a muscles speed and capacity to work when required, meaning more effort is needed to complete athletic activities. There are also significant detriments to health to consider alongside these negative effects on performance.

One study tracked a professional MMA fighter during training preparations to see their weight loss and physiological responses to both chronic and rapid weight loss.

Over this eight-week period, the fighter lost 17kg 7kg of which was lost mostly via dehydration in the 36 hours before weigh-in. This caused a severe reduction in their testosterone production, a sign the body does not have enough energy to maintain basic hormone function which is important for all aspects of health. There was also a sharp increase in cortisol (a hormone linked to our stress response), to break down muscle tissue to provide the energy needed to survive.

This fighter also experienced a large increase in both urea and creatinine in their blood, alongside extremely high blood sodium content, each of which indicate kidney malfunction. Together, these findings would give cause to book this particular fighter into a hospital bed not a professional fight.

Its highly unlikely that this is an isolated incident either with 43% of athletes at a UK MMA event in 2017 found to be severely dehydrated prior to competition, suggesting they hadnt been able to fully restore their fluids. Alarmingly, the fighters in this study also displayed hydration and weight loss readings similar to those reported in weight cutting fatalities in US collegiate wrestling in the 1990s. It was these tragic events that led to widespread rule and culture changes within wrestling, including changing the timings of weigh-ins and enforcing minimum athlete weights in some places to prevent extreme weight loss.

Following wrestlings example, since 2017 the California State Athletic Commission have taken measures to reduce the amount of weight that fighters are allowed to cut. But despite this, many fighters are still taking extreme measures to cut their weight and with negative health consequences.

Since weight divisions were introduced in MMA in the late 1990s, theres been at least one fighter death formally linked to weight cutting in medical case reports. Theres also the case of Yang Jian Bing who died in 2015 following heart failure while undergoing severe dehydration to make weight for a professional fight. There are also numerous videos and posts on social media showing high-level MMA fighters collapsing both before and during their official weigh-ins, demonstrating the immediate dangers of these practices.

Though its currently uncertain what the long-term effects of repeated weight cutting may be, its been linked to higher levels of obesity after retirement, eating disorders, kidney damage and endocrine dysfunction.

Despite the widely held beliefs of athletes and coaches, theres little to be gained from extreme weight loss with evidence showing it may actually hamper, not improve, performance. Data from high-level and elite MMA competition shows no difference in the amount of weight lost or regained between winners or losers with most competitors stepping in the cage weighing one to two divisions heavier than their official weigh-in.

Similarly, another study found that MMA fighters who cut more weight lost their fights more often than those who cut less. It has also been shown that fighters who dont restrict energy as severely during the rapid weight loss stage stand more chance of winning.

But for these practices to change, it would require active and preemptive engagement from everyone involved in the industry. With amateur MMA bringing more athletes into the sport from a younger age, the International MMA Federation has recently established a task force to prevent extreme weight cutting and promote safer, more effective weight management practices. Such widespread cultural change will not be quick or easy, but will make a difference for the long-term health of all the athletes involved.

Christopher Kirk, Lecturer in Sport and Exercise Physiology, Sheffield Hallam University

The article was first published on The Conversation.

Read the original post:
Fitness watch: MMA, combat sports illustrate the dangers of extreme weight cutting - Scroll.in

When you start a new diet, sometimes it's easy to get caught up in how your body lookswhen it's also worth remembering that losing weight and eating better is ultimately about improving your health for the long-term. That's the precise focus of a particular eating plan that a registered dietitian at the Cleveland Clinic says is transformative for a lot of patients who try it. Not only does this list of foods help a lot of people slim down, but science shows this nutritional approach also slashes the risk of some cancers, diabetes, and heart disease.

Continue reading to learn about the DASH diet and its benefits, and sign up for the Eat This, Not That! newsletter for the nutrition news you need. Also don't miss One Major Effect Coffee Has on Your Metabolism, Expert Says.

According to a Cleveland Clinic blog post featuring insights from Kate Patton, MEd, RD, CSSD, LD, the DASH diet is the acronym for Dietary Approaches That Stop Hypertension (which you may recognize as the clinical term for "high blood pressure"). The DASH diet brings an individual's sodium intake to 2,300 milligrams per day (1,500 milligrams for individuals who need to lower their sodium more aggressively). The DASH diet also increases the amount of potassium one eats, since potassium has been shown to lower blood pressure.

According to the Cleveland Clinic's blog, research has found that following the DASH diet "could lower your risk of" breast cancer, colorectal cancer, metabolic syndrome (which is a group of conditions that together raise the risk of Type 2 diabetes), heart disease, and stroke.

RELATED: The Surprising Reason Why You Could Get a Stroke

If strict food regimens aren't super appealing to you, the DASH diet could be a plan that provides healthy parameters, without making you feel stuck or bored. "It doesn't require special foods," Patton said, "and you don't have to go hungry or eliminate treats."

RELATED:Every State's Signature DishesRanked

The DASH diet is definitely not limitingkeep reading to see a few main components. Also, read up onUnderrated Exercises Everyone Over 40 Should Do, Says Trainer.

The DASH diet calls for fruits such as these, which drive the most weight loss, according to science (some which are also found in40+ Best-Ever Breakfast Smoothies For Weight Loss).

These sweet potatoes are just one example of the many potassium-rich vegetablesbut there are a lot more in this list of21 High Potassium Foods That Keep Your Muscles Healthy and Strong.

Oatmeal is just one of several whole grains with a healthy potassium content. Others include brown rice, buckwheat, and bran cereal. (Gotta love a diet that leaves in healthy carbs!)

RELATED: What Happens To Your Body When You Eat Oatmeal

Legumes like many beans (including black beans) pack a lot of potassium.

A small handful of nuts can pack a powerful amount of potassium, plus they deliver many other health benefitsread15 Nuts Better than Supplements and Protein Powder.

A 2020 study funded by the National Dairy Council concluded that milk contains nine essential nutrients, including potassium and Vitamin DreadMajor Recent Findings About Dairy You Should Know.

The Cleveland Clinic's blog lists fatty meats (think red meat or poultry with skin), full-fat dairy like butter and whole milk, high-sugar foods and drinks, and "oils that are solid at room temperature, such as coconut and palm oils."

Even if you love the foods on the non-DASH list, Patton says it's not entirely necessarily to quit them all cold turkey or stop enjoying them occasionally.

You might find it impressive that focusing on just two elements of diet can help put your health on a better path. Check out This Is the Best Coffee for Weight Loss, Says an Expert, and keep reading:

Excerpt from:
This Exact Diet Lowers Risk of Cancer and Heart Disease, Expert Says | Eat This Not That - Eat This, Not That

A severely overweight potbellied pig is recovering at the Animal Foundation after being abandoned in a cage outside a Las Vegas home.

The female pig, which rescuers named Cupcake, was found June 2 in a wire dog kennel by a resident on the sidewalk outside his home, near East Hacienda Avenue and South Nellis Boulevard.

The approximately 3-year-old pig was taken to the Animal Foundation, where her weight 175 pounds, rather than the 140 to 150 pounds that would be normal for a pig of her size immediately raised concerns. Cupcake is extremely obese and struggles to move, said Tasha Crabtree, a licensed veterinarian technician at the foundation.

She also had overgrown hooves and dirty ears.

Veterinarians sedated Cupcake to trim her hooves, clean her eyes and ears and perform several exams. Since then, the pig has been recovering in a large enclosure where she is fed a balanced diet and regularly monitored. Staff still have concerns about arthritis in Cupcakes back legs, stemming from the obesity, but expect mobility to increase as she loses weight.

Lone Mountain Animal Hospital veterinarian Taylor Parker, who donated her time to help Cupcake, said she sees many obese pigs in her practice because of improper feeding. Pig owners will sometimes use dog food, which has an overly high protein content and can cause excessive weight gain. Parker also said that it can take months for pigs to lose weight because the animals store fat well.

Feeding them table scraps, dog food and people food is how you slowly kill your pet pig because they cant get up, cant move, get arthritis and theyre miserable, Taylor said. Pigs are big, but theyre also supposed to be able to move.

Crabtree added that many pig owners end up with a much larger pet than expected after being told they were buying or adopting a miniature or teacup pig. Crabtree said those pigs are simply babies that will grow to full size. In captivity, pigs average a life expectancy of 15 to 18 years, she said.

Theres really no such thing as a teacup or mini pig, so if youre not willing to take on a 90 to 150-pound animal in your house, then you probably shouldnt get that pig, Crabtree advised.

As for Cupcake, a partner of the Animal Foundation will pick her up Saturday and provide ongoing medical care during her weight loss journey. Long-term plans for the animal are still being determined, but the hope is that she will be put up for adoption.

The Animal Foundation helps about 25,000 animals per year.

Contact Mathew Miranda at mmiranda@reviewjournal.com. Follow @mathewjmiranda on Twitter.

Link:
Obese pig abandoned in cage on Las Vegas street is on the mend - Las Vegas Review-Journal

SAN FRANCISCO and SUZHOU, China, June 24, 2021 /PRNewswire/ --Innovent Biologics, Inc. ("Innovent") (HKEX: 01801), a world-class biopharmaceutical company that develops, manufactures and commercializes high-quality medicines for the treatment of oncology, metabolic, autoimmune and other major diseases, announces that results of a phase 1 clinical trial of IBI362, a glucagon-like petide-1 (GLP-1) and glucagon receptor dual agonist in overweight or obese Chinese participants are presented in an e-poster at the American Diabetes Association 81st Scientific Sessions.

This randomized, double-blind, placebo-controlled multiple-ascending-dose study evaluated the safety, tolerability and pharmacokinetics/pharmacodynamics characteristics of IBI362 in overweight or obese Chinese participants. Twelve participants in each of the three cohorts were randomized 2:1 to receive 1.0-2.0-3.0 mg (cohort 1), 1.5-3.0-4.5 mg (cohort 2) or 2.0-4.0-6.0 mg (cohort 3) IBI362 or placebo for 12 weeks. IBI362 was well tolerated and showed a favorable safety profile. No adverse event leading to dose interruption or dose reduction of the study drug was reported. No participant discontinued the study due to a safety reason. No serious adverse event, no hypoglycemic event and no pancreatitis was reported. Gastrointestinal adverse events and decreased appetite were the most common adverse events. At week 12, reductions in mean body weight from baseline were 3.80 kg (4.81%), 5.77 kg (6.40%) and 5.12 kg (6.05%) for participants receiving IBI362 in cohort 1, 2 and 3, respectively, compared with a 0.37 kg (0.60%) increase in participants receiving placebo (least square means using mixed effect model for repeated measures). Meanwhile, waist circumference, body mass index, blood pressure and lipid profile were also improved in participants receiving IBI362.

"Obesityis a gravepublic health threatwith progressive increase in incidence. However, there is still a lack of effective therapeutic drugs for obese and overweight patients worldwide, which poses a great and unmet medical need. IBI362 has shown good safety, robust weight loss efficacy and multiple benefits in metabolic profile in the phase 1 clinical study, and the preliminary clinical results are very encouraging. We hope that IBI362, as a new generation of GLP-1 and glucagon receptor dual agonists, will show more inspiring results in the subsequent phase 2 clinical studies in subjects with overweight or obesity." said the Professor Linong Ji from Peking University People's Hospital and principal investigator of this study.

"IBI362 is a global innovative drug candidate. As an OXM analog, IBI362 can confer dual benefits of appetite suppression and energy expenditure through the activation of GLP-1receptor (GLP-1R) and glucagon receptor. Compared with traditional GLP-1 receptor agonists, IBI362 may not only achieve higher weight loss, but also improve the overall metabolic situation including fatty liver disease and lipid metabolism in overweight or obese people. These results suggest that IBI362 may be superior to currently available GLP-1R mono agonists for weight loss in obesity, underlining the potential benefits of targeting multiple receptors in improving metabolic disorders." said Dr. Lei Qian, Executive Director of Medical Sciences and Strategies of Special Diseases of Innovent.

About Obesity

China has the largest obese population in the world, which shows a gradually increasing trend. Obesity can lead to a range of complications or related diseases that impact life expectancy or lead to a decrease in quality of life. In more severely obese patients, the incidence and mortality of cardiovascular disease, diabetes, and certain tumors increase significantly. Obesity is a chronic disease that requires long-term management, and there is a lack of long-term effective and safe treatments. Lifestyle intervention is the first choice and basic treatment for patients with overweight or obesity. However, a considerable number of patients cannot achieve the desired weight loss goal due to various reasons and may use medications. Traditional anti-obesity drugs have limited weight-loss effects and safety problems.

About IBI362

Innovent entered into a licensing agreement with Eli Lilly and Company (Lilly) for the development and potential commercialization of OXM3, a GLP-1 and glucagon receptor dual agonist, in China (IBI362). In parallel, Lilly is developing OXM3 outside China. IBI362 is a long-acting synthetic peptide related to mammalian oxyntomodulin (OXM), which uses a fatty acid side chain to prolong the duration of action and allow once-weekly administration. IBI362, similar to the mechanism of OXM, is thought to exert its biological effects by activating glucagon-like peptide-1 receptor (GLP-1R) and glucagon receptor (GCGR) in human beings, which is estimated to improve glucose tolerance and lose weight.

In addition to the effects of GLP-1R agonists on promoting insulin secretion, lowering blood glucose and reducing body weight, IBI362 may also increase energy expenditure and improve hepatic fat metabolism through the activation of glucagon receptor. The treatment of metabolic diseases by activating multiple metabolism-related targets simultaneously is currently the worldwide trend in drug development.

About Innovent

Inspired by the spirit of "Start with Integrity, Succeed through Action," Innovent's mission is to develop, manufacture and commercialize high-quality biopharmaceutical products that are affordable to ordinary people. Established in 2011, Innovent is committed to developing, manufacturing and commercializing high-quality innovative medicines for the treatment of cancer, autoimmune, metabolic and other major diseases. On October 31, 2018, Innovent was listed on the Main Board of the Stock Exchange of Hong Kong Limited with the stock code: 01801.HK.

Since its inception, Innovent has developed a fully integrated multi-functional platform which includes R&D, CMC (Chemistry, Manufacturing, and Controls), clinical development and commercialization capabilities. Leveraging the platform, the company has built a robust pipeline of 24 valuable assets in the fields of cancer, metabolic, autoimmune disease and other major therapeutic areas, with 5 products TYVYT (sintilimab injection), BYVASDA (bevacizumab biosimilar injection), SULINNO(adalimumab biosimilar injection), HALPRYZA (rituximab biosimilar injection) and PEMAZYRE (pemigatinib oral inhibitor) officially approved for marketing, sintilimab's Biologics License Application (BLA)acceptance in the U.S., 5 assets in Phase 3 or pivotal clinical trials, and an additional 14 molecules in clinical trials. In 2019, TYVYT was the first PD-1 inhibitor included in the National Reimbursement Drug List (NRDL) and the only PD-1 inhibitor included in the NRDL in that year.

Innovent has built an international team with advanced talent in high-end biological drug development and commercialization, including many global experts. The company has also entered into strategic collaborations with Eli Lilly and Company, Adimab, Incyte, MD Anderson Cancer Center, Hanmi and other international partners. Innovent strives to work with many collaborators to help advance China's biopharmaceutical industry, improve drug availability and enhance the quality of the patients' lives. For more information, please visit: http://www.innoventbio.com.

Note: TYVYT (sintilimab injection)BYVASDA (bevacizumab biosimilar injection), SULINNO (adalimumab biosimilar injection) andHALPRYZA (rituximab biosimilar injection)are not approved in the United States.

Innovent Biologics, Inc. Forward-Looking Statements

This news release may contain certain forward-looking statements that are, by their nature, subject to significant risks and uncertainties. The words "anticipate", "believe", "estimate", "expect", "intend" and similar expressions, as they relate to Innovent, are intended to identify certain of such forward-looking statements. Innovent does not intend to update these forward-looking statements regularly.

These forward-looking statements are based on the existing beliefs, assumptions, expectations, estimates, projections and understandings of the management of Innovent with respect to future events at the time these statements are made. These statements are not a guarantee of future developments and are subject to risks, uncertainties and other factors, some of which are beyond Innovent's control and are difficult to predict. Consequently, actual results may differ materially from information contained in the forward-looking statements as a result of future changes or developments in our business, Innovent's competitive environment and political, economic, legal and social conditions.

Innovent, the Directors and the employees of Innovent assume (a) no obligation to correct or update the forward-looking statements contained in this site; and (b) no liability in the event that any of the forward-looking statements does not materialise or turn out to be incorrect.

SOURCE Innovent Biologics

http://www.innoventbio.com/

Continue reading here:
Innovent Releases Results of a Phase 1 Clinical Study of IBI362, a Glucagon-like Peptide-1 and Glucagon Receptor Dual Agonist in Overweight or Obese...

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