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      Factors affecting weight management in overweight or obese diabetic patients: the 2018-2021 Korea national health and nutrition examination survey

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          Abstract

          [Purpose]

          Diabetes is a chronic metabolic disease that affects approximately 422 million people worldwide and leads to the death of 1.5 million people every year. The prevalence of diabetes among the population aged 30 or older in Korea has steadily increased since 2018, reaching 16.7% in 2020, with one in six adults having diabetes. This study was conducted to identify factors affecting weight management in overweight or obese patients with diabetes (OOPD) in Korea using data from the 2018-2022 National Health and Nutrition Examination Survey. Therefore, the goal of this study is to analyze weight perception and factors related to weight perception and to identify factors that influence weight loss efforts among OOPD in Korea.

          [Methods]

          Socioeconomic characteristics, disease morbidity, weight perception, and weight loss efforts were investigated in 950 participants. Data were analyzed using descriptive statistics, cross-tabulation, and logistic regression.

          [Results]

          Among the overweight or obese patients with diabetes, 24.4% perceived their weight to be normal, with a higher proportion among men (29.6%) than among women (14.6%). Weight loss efforts were 5.11 times (95% CI: 3.02−8.66) higher in people with overweight perceptions than in those with normal weight perceptions. Additionally, the rate was 1.54 times (95% CI: 1.06 2.25) higher in people with dyslipidemia than in those without dyslipidemia.

          [Conclusion]

          These results suggest that weight management approaches for overweight or obese patients with diabetes should be designed individually based on weight perception and disease morbidity.

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          Most cited references32

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          Diabetes, Pancreatogenic Diabetes, and Pancreatic Cancer

          The relationships between diabetes and pancreatic ductal adenocarcinoma (PDAC) are complex. Longstanding type 2 diabetes (T2DM) is a risk factor for pancreatic cancer, but increasing epidemiological data point to PDAC as also a cause of diabetes due to unknown mechanisms. New-onset diabetes is of particular interest to the oncology community as the differentiation of new-onset diabetes caused by PDAC as distinct from T2DM may allow for earlier diagnosis of PDAC. To address these relationships and raise awareness of the relationships between PDAC and diabetes, a symposium entitled Diabetes, Pancreatogenic Diabetes, and Pancreatic Cancer was held at the American Diabetes Association’s 76th Scientific Sessions in June 2016. This article summarizes the data presented at that symposium, describing the current understanding of the interrelationships between diabetes, diabetes management, and pancreatic cancer, and identifies areas where additional research is needed.
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            Why does obesity cause diabetes?

            The accumulation of an excessive amount of body fat can cause type 2 diabetes, and the risk of type 2 diabetes increases linearly with an increase in body mass index. Accordingly, the worldwide increase in the prevalence of obesity has led to a concomitant increase in the prevalence of type 2 diabetes. The cellular and physiological mechanisms responsible for the link between obesity and type 2 diabetes are complex and involve adiposity-induced alterations in β cell function, adipose tissue biology, and multi-organ insulin resistance, which are often ameliorated and can even be normalized with adequate weight loss.
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              Trying to lose weight, losing weight, and 9-year mortality in overweight U.S. adults with diabetes.

              The aim of this study was to examine the relationships between intention to lose weight, actual weight loss, and all-cause mortality among overweight individuals with diabetes. We performed a prospective analysis among 1,401 overweight diabetic adults aged > or =35 years sampled in the National Health Interview Survey. The previous year intention to lose weight and weight change were assessed by self-report. Nine-year mortality rates were examined according to intent to lose weight and weight loss, which were adjusted for age, sex, education, ethnicity, smoking, initial body weight, and diabetes complications. Individuals trying to lose weight had a 23% lower mortality rate (hazard rate ratio [HRR] 0.77, 95% CI 0.61-0.99) than those who reported not trying to lose weight. This association was as strong for those who failed to lose weight (0.72, 0.55-0.96) as for those who succeeded in losing weight (0.83, 0.63-1.08). Trying to lose weight was beneficial for overweight (BMI 25-30 kg/m2) individuals (0.62, 0.46-0.83) but not for obese (BMI>30) individuals (1.17, 0.72-1.92). Overall weight loss, without regard to intent, was associated with an increase of 22% (1.22, 0.99-1.50) in the mortality rate. This increase was largely explained by unintentional weight loss, which was associated with a 58% (1.58, 1.08-2.31) higher mortality rate. Overweight diabetic adults trying to lose weight have a reduced risk of all-cause mortality, independent of whether they lose weight. Actual weight loss is associated with increased mortality only if the weight loss is unintentional.
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                Author and article information

                Journal
                Phys Act Nutr
                Phys Act Nutr
                PAN
                Physical Activity and Nutrition
                Korean Society for Exercise Nutrition
                2733-7545
                March 2024
                31 March 2024
                : 28
                : 1
                : 24-30
                Affiliations
                [1 ]Department of Nursing, Kangwon National University, Gangwondo, Republic of Korea
                [2 ]DEU Exe-Physio Lab, Department of physical education, Dong-Eui University, Busan, Republic of Korea
                [3 ]Department of Hygiene, Kangwon National University, Gangwondo, Republic of Korea
                Author notes
                [* ]Corresponding author : Yi Sub Kwak DEU Exe-Physio Lab, Department of physical education, Dong-Eui University, 176, Eomgwangno, Busanjin-gu, Busan, 47340, Republic of Korea. Tel: +82-51-890-1546 E-mail: ysk2003@ 123456deu.ac.kr
                [* ]Corresponding author : Hye-Young Kim Department of Hygiene, Kangwon National University, 346 Hwangjogil, Dogyeeup, Samcheok, Gangwondo, 25949, Republic of Korea. Tel: +82-33-540-3392 E-mail: khy0606@ 123456kangwon.ac.kr
                [†]

                These authors contributed equally to this study

                Article
                pan-2024-0004
                10.20463/pan.2024.0004
                11079378
                38719463
                b3d3e83e-37da-4ce2-b7a2-e2abac82fd90
                Copyright © 2024 Korean Society for Exercise Nutrition

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/2.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 November 2023
                : 6 March 2024
                : 15 March 2024
                Categories
                Original Article

                diabetes,dyslipidemia,obese,weight management,weight perception

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