Bariatric Times

JUL 2017

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

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19 News and Trends Bariatric Times • July 2017 t ools to help patients recognize obesity risks. Recent studies have also shown that most medical schools do not provide nutrition education in the clinical portion of t heir curricula, leaving future physicians ill-prepared to effectively address obesity and understand how to recognize and treat the nutritional and roots causes of the c ondition. Two medical schools that are part of the AMA's Accelerating Change in Medical Education Consortium— NYU School of Medicine and U niversity of Chicago School of Medicine—have incorporated nutrition education into their curricula. Through these new courses, both schools are working to e nsure that their medical students gain the knowledge they will need to help their patients make healthy food and beverage choices when in the clinical setting. T he AMA launched its Accelerating Change in Medical Education initiative in 2013— providing $11 million in grants to fund major innovations at 11 of the nation's medical schools. Together, these schools formed a Consortium that shares best practices with a goal of widely disseminating the new and innovative curricula being developed. The AMA expanded its Consortium in 2015 with grants to an additional 21 schools to develop new curricula that better align undergraduate medical education with the modern healthcare system. Most recently, through its work with the 32-school Consortium, the AMA launched a new health systems science textbook that can be used by all medical schools to help future physicians navigate the changing landscape of modern healthcare, especially as the nation's healthcare system moves toward value-based care. Another recent innovation to emerge through its initiative to create the medical school of the future is the Regenstrief EHR Clinical Learning Platform developed by Indiana University School of Medicine and the Regenstrief Institute. The AMA and Regenstrief are currently working together to disseminate the platform to medical schools throughout the country to ensure more medical students and medical trainees gain real-world experience using electronic health records during their training. The AMA will continue its efforts to accelerate change in medical education to ensure future physicians learn about the newest technologies, healthcare reforms and scientific discoveries that continue to alter what physicians need to know to practice in modern health care systems. About the AMA. The American Medical Association is the premier n ational organization providing timely, essential resources to empower physicians, residents and medical students to succeed at every phase of their medical lives. P hysicians have entrusted the AMA to advance the art and science of medicine and the betterment of public health on behalf of patients for more than 170 years. For more i nformation, visit ama-assn.org. To access the full release, visit https://www.ama-assn.org/ama- adopts-policy-help-physicians- s tudents-prevent-manage-obesity SEVERE OBESITY IN HIGH-RISK YOUTH CORRELATES DIRECTLY TO INCREASED INCIDENCE OF TYPE 2 DIABETES SAN DIEGO, California—The risk of developing type 2 diabetes mellitus (T2DM) by age 20 was 12 times as high in American Indian c hildren with severe obesity 5 to 9 years of age as in normal-weight youth in that age range, according to a study titled "Long-term Risk of Type 2 Diabetes in Youth with Increasing Severity of Obesity," presented at the American Diabetes Association's 77th Scientific Sessions ® at the San Diego Convention Center. Obesity is a serious health problem among youth, especially in populations at high risk of developing T2DM. Previous studies of obesity in youth have reported a strong relationship between body mass index (BMI) and subsequent incidence of T2DM in adults and adolescents. However, prior studies have not assessed the long-term risk in youths with extremely high BMIs, (i.e., the severe degrees of obesity often seen today). This longitudinal study examined the risk of diabetes and other metabolic abnormalities in American Indian youths with obesity and severe obesity from the southwestern United States., a population with a high risk of developing T2DM. The incidence of T2DM was computed in 2,728 children without diabetes aged 5 to 9 years, and a partially overlapping group of 4,317 youths aged 10 to 17 years. They were followed up to age 45 or until the onset of T2DM. Age- sex specific BMI percentiles were defined by the 2000 US Centers for Disease Control and Prevention (CDC) growth charts. The CDC defines obesity as being at or above a cut-point specified as the 95th BMI percentile. T2DM incidence rates increased in direct proportion with severity of obesity. Compared with 5 to 9-year old nonobese children with BMIs in the middle of the BMI distribution, children of the same age with BMIs at least 40 percent above the cut- point defining obesity had 12 times t he incidence rates of T2DM by age 20 years and three times the incidence rates of T2D by age 45 years. BMI had similar effects on T2D incidence in those 10 to 17 y ears old at baseline. "We had previously found BMI in youth to be a strong predictor of type 2 diabetes, but we had not examined diabetes incidence rates i n those with the severe degree of obesity that is prevalent today. We did not know if diabetes incidence rates among the obese plateaued among those with extremely high B MI," said study author Madhumita Sinha, MD, MHSM, staff clinician at the Diabetes Epidemiology and Clinical Research Section of the National Institute of Diabetes and D igestive and Kidney Diseases (NIDDK) at the National Institutes of Health (NIH) in Phoenix, Arizona. "This study clearly shows that the risk of developing type 2 diabetes is a ssociated with BMI, especially at very high extremes." "Parents and healthcare providers should be aware of the future diabetes risk associated with obesity in youth, especially as more severe degrees of obesity become more prevalent," explained Sinha. "Results of our analysis emphasize the importance of developing effective means of preventing or treating obesity in youth, and a dditional risk factors for type 2 diabetes in youth should be explored for their interactions with severe obesity." About the American Diabetes A ssociation. More than 29 million Americans have diabetes, and every 23 seconds another person is diagnosed with diabetes. The American Diabetes Association ( Association) is the global authority on diabetes and since 1940 has been committed to its mission to prevent and cure diabetes and to improve the lives of all people affected by d iabetes. To tackle this global public health crisis, the Association drives discovery in research to treat, manage and prevent all types of diabetes, as well as to search for c ures; raises voice to the urgency of the diabetes epidemic; and provides support and advocacy for people living with diabetes, those at risk of developing diabetes and the health c are professionals who serve them.

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