Evidence mapPaperPMID 37791244Full record

ArticleAJPM focus2022

Lifestyle Therapy Targeting Hyperinsulinemia Normalizes Hyperglycemia and Surrogate Markers of Insulin Resistance in a Large, Free-Living Population.

Peter J Cummings, Timothy D Noakes, David M Nichols, Kathleen D Berchou, Maria D Kreher, Paul J Washburn

Open access · goldAbstract read
In one paragraph

Article in AJPM focus, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Peter J CummingsDepartment of Health and Rehabilitation, Restore Medical Fitness Center, Williamsville, New York.
Timothy D NoakesDepartment of Applied Design, Cape Peninsula University of Technology, Bellville, South Africa.
David M NicholsDepartment of Family Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania.
Kathleen D BerchouDepartment of Health and Rehabilitation, Restore Medical Fitness Center, Williamsville, New York.
Maria D KreherDepartment of Health and Rehabilitation, Restore Medical Fitness Center, Williamsville, New York.
Paul J WashburnDepartment of Preventive and Lifestyle Medicine, Health Medical Institute, Cheyenne, Wyoming.
Cape Peninsula University of Technology · ZALehigh Valley Hospital-Pocono · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: This article reports the evaluation of a personalized, team-based comprehensive lifestyle modification program targeting known triggers of hyperinsulinemia and insulin resistance. Methods: A retrospective chart review was undertaken for 536 participants in a novel high-intensity lifestyle behavioral modification program. Surrogate markers of insulin resistance and metabolic syndrome‒related pathologies were measured before and after participation in the the program. Results: Reversal of metabolic syndrome was present in 42% of participants who met the criteria for this syndrome. Additional changes seen in this cohort include: 36% decrease in triglyceride to high-density lipoprotein cholesterol ratio; 5% (-7.2 mm Hg) decrease in systolic blood pressure and 4% (-3.8 mm Hg) decrease in diastolic blood pressure; decreased abdominal adiposity and waist circumference (-7.6 cm); increased high-density lipoprotein cholesterol (1.3 mg/dL); and 23% (-57.1 mg/dL) decrease in serum triglycerides. Hyperglycemia was normalized in 35% of participants with prediabetes. Only 2% of those with prediabetes progressed to type 2 diabetes mellitus. Among those with type 2 diabetes mellitus, 46% experienced a reduction in HbA1c to below diabetic cut offs. Compared to baseline, the Metabolic Syndrome Severity Score decreased by 30% among those with metabolic syndrome, 11% among those with prediabetes, 26% among those with type 2 diabetes mellitus, and 38% among those with uncontrolled type 2 diabetes mellitus. Cardiorespiratory fitness, measured by the calculated Metabolic Equivalent of Task maximum, increased by 30% in the metabolic syndrome cohort, 28% in the prediabetic cohort, 29% in the type 2 diabetes mellitus cohort, 29% in the uncontrolled type 2 diabetes mellitus cohort, and 32% in the cohort with obesity. Conclusion: Modifying lifestyle factors that trigger hyperinsulinemia provided pleiotropic improvements to all measured surrogate markers of insulin resistance, mitigated the progressive nature of the insulin resistance and metabolic syndrome‒related chronic pathologies, reduced Metabolic Syndrome Severity Score, and improved cardiorespiratory fitness. These results suggest that earlier identification of the diagnostic criteria of metabolic syndrome and/or Metabolic Syndrome Severity Score and the prompt initiation of a comprehensive therapeutic lifestyle approach would significantly mitigate disease burden.

Indexed as

hyperinsulinemiainsulin resistanceLifestyle interventionmetabolic syndromeMetabolic Syndrome Severity Scoretherapeutic carbohydrate reduction

Identifiers

PMID37791244
PMCPMC10546563
OpenAlexW4296196319

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.