I ran across this study, which is interesting. It suggests that fat receptor ( PPAR gamma agonists) promoters may help those with insulin resistance. I would not be surprised if the study was supported by drug (thiazolidinedione) manufacturers.
My question: if a drug promotes increased fat formation, will it not ultimately make it more difficult than ever to lose weight?
Effects of PPAR gamma agonists on cardiovascular function in obese, non-diabetic patients.
Vascul Pharmacol. 2006 Jul;45(1):29-35. Epub 2006 Jun 14.
Panunti B, Fonseca V.
Source
Department of Medicine, Tulane University Health Sciences Center, and Department of Medicine, Veterans Affairs Medical Center, New Orleans, LA 70112, United States.
Abstract
Peroxisome proliferator-activated receptors (PPARs) are nuclear receptors, and when activated by their ligands, they induce perixosome proliferation. Three receptors have been identified: PPAR gamma, PPAR delta, and PPAR alpha, all with different tissue expression. PPAR gamma is predominantly expressed in adipose tissue and regulates the formation of fat cells and their function. The effect of PPAR gamma activation is to enhance the action of insulin in insulin-sensitive tissue by increasing peripheral glucose disposal and decreasing hepatic glucose production.
The thiazolidinediones (TZDs) are a class of medications used for treatment and possibly the prevention of type 2 diabetes, which are potent agonists for the PPAR gamma receptor. Because the thiazolidinediones target insulin resistance, these agents may improve many of the risk factors associated with obesity and insulin resistance including dyslipidemia, hypertension, impaired fibrinolysis, and atherosclerosis. The impact of the thiazolidinediones on cardiovascular mortality is currently unclear but it appears that the thiazolidinediones exert numerous non-glycemic effects that may improve cardiovascular outcomes. Several non-TZD PPAR gamma agonists and combined PPAR gamma/alpha effect on cardiovascular disease are also being evaluated. These drugs have anti-inflammatory and vascular properties and are currently the subject of numerous studies targeting the primary and secondary prevention of macrovascular disease in patients with diabetes and insulin resistance and might be developed as anti-atherogenic agents on the basis of their actions.
PMID:1677749
Effect of thiazolidinediones on body weight in patients with diabetes mellitus
The American Journal of Medicine
Volume 115, Issue 8, Supplement 1 , Pages 42-48, 8 December 2003
Abstract
Treatment of diabetes mellitus with medications, including insulin, sulfonylureas, and thiazolidinediones (TZDs), often leads to weight gain through a variety of mechanisms. Weight gain can have adverse consequences for patients with type 2 diabetes, many of whom are overweight or obese, because obesity is linked to insulin resistance and other medical consequences such as cardiovascular disease. TZDs improve glycemic control and insulin sensitivity in patients with type 2 diabetes, despite their potential to cause weight gain. Studies have attempted to elucidate the mechanisms behind the apparent paradox of TZDs improving insulin sensitivity while causing weight gain. Data indicate that with TZD treatment, there is a favorable shift in fat distribution from visceral to subcutaneous adipose depots that is associated with improvements in hepatic and peripheral tissue sensitivity to insulin.
Although weight gain may occur with TZD therapy, it is not inevitable. A weight-management program combining a low-calorie, low-sodium diet with education and behavior modification has been shown to be effective in patients with type 2 diabetes being treated with TZDs. Further research is needed to define the optimal dietary modifications that can be used universally in TZD-treated patients to minimize weight gain while effectively treating insulin resistance and hyperglycemia.
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Speculating about these drugs (thiazolidinediones (TZDs) is academic, since most of them have been banned because of dangerous side effects.
The best thing for obesity-related insulin resistance is to go on a serious weight loss diet, monitored by a physician. The CR Way to Great Glucose Control offers a special protocol for this purpose.
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