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- November 20, 2008 |
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Welcome to the #1 online source of information for Diabetes Specialists! An international online community of more than 10,000 Diabetes Specialists.
CME on Diabetes is a website built to transmit top-level CME conferences given by international experts in endocrinology, insulin resistance, prediabetes, metabolic syndrome and type 2 diabetes. More than 2.6 million slides have been viewed since the website launch. Thank you for your continued support and commitment!
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"Toxic Waist : Why And How to measure it"Dr. Soji Swaraj (biography)
English - 2007-11-16 - 21 minutes
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Summary :
Dr. Swaraj discusses the importance of waist circumference (WC) measurement in the context of a worldwide epidemic of obesity, which is often accompanied by insulin resistance and metabolic syndrome. In this presentation, he refers to a number of weight related conditions, for which he has coined the term 'adipotoxicosis' because of the possibility that adipose cytokines, secreted by adipose tissue, are a contributing factor.
Thus, the measurement of waist circumference is a key tool in the improvement of insulin sensitivity, which directly translates to decreased morbidity in patients at risk of developing Type 2 Diabetes (T2D). However, as, Dr. Swaraj explains, we lack clear guidelines on what are acceptable exercise levels, food intake, and waist circumference.
Other central adiposity measurement options are the body mass index (BMI), computed tomography (CT), and dual-energy X-ray absorptiometry (DEXA) technology. Whereas the BMI is increasingly viewed as having limitations in the indication of overweight status, waist circumference measurement presents a more accurate alternative that is also more practical than CT and DEXA.
However, waist circumference is seldom measured, and Dr. Swaraj addresses this issue by suggesting an easily reproducible landmark for waist circumference to be used until a standardized measurement of central adiposity is defined, such as is the case for blood pressure.
In addition, Dr. Swaraj presents his intervention plan for patients who are found to have an unacceptable waist circumference. It consists of setting goals, motivating patients, and possibly rewarding them by the weaning off of some medications as fat masses decrease. He quotes several examples to demonstrate the very satisfactory results this method has yielded in his clinic.
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Learning objectives :
After viewing this presentation the participant will be able to discuss:
-The utility of waist circumference (WC) measurement in the context of insulin resistance states and adiposity
-Some difficulties encountered in measurement of WC; a new practical landmark for assessment of WC
-Strategies to address central adiposity in patients
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