References of "De Flines, Jenny"
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See detailComment gérer la nutrition artificielle chez un patient diabétique ?
PAQUOT, Nicolas ULg; DE FLINES, Jenny ULg; Preiser, Jean-Charles

in Nutrition Clinique et Metabolisme (2014)

Hyperglycaemia in patients receiving enteral or parenteral nutrition is a major problem due to its high prevalence and possible consequences interms of morbidity and mortality. However, the management of ... [more ▼]

Hyperglycaemia in patients receiving enteral or parenteral nutrition is a major problem due to its high prevalence and possible consequences interms of morbidity and mortality. However, the management of diabetes/stress hyperglycaemia during artificial nutrition remains largely unknown,especially in non-critically ill patients. The indications and access routes for artificial nutrition are not different in patients with diabetes/stressdiabetes than in non-diabetics. We do not recommend using enteral formulas designed for patients with diabetes. The glycaemic objective mustbe individualized. We recommend a preprandial blood glucose levels between 100 and 140 mg/dL (5.5 and 7.8 mmol/L) and postprandial levelsbetween 140 and 180 mg/dL (7.8 and 10 mmol/L). A frequent monitoring of capillary glycaemias is mandatory. The best drug treatment for treatinghyperglycaemia/diabetes is insulin and we recommend to adapt the theoretical insulin action to the nutrition infusion regimen. The managementof these patients needs the help of a multidisciplinary experimented staff. [less ▲]

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See detailComment gérer la nutrition artificielle chez un patient diabétique ?
PAQUOT, Nicolas ULg; DE FLINES, Jenny ULg; Preiser, Jean-Charles

in Journée de développement professionnel continu de la SFNEP (2013, September 11)

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See detailObésité et carences préopératoires
DE FLINES, Jenny ULg; BRUWIER, Laurent; DE ROOVER, Arnaud ULg et al

in Nutrition Clinique et Metabolisme (2013), 27(2), 82-86

It is a common belief that nutritional deficiencies are rare in the Western world due to a wide variety of food supply. However, obese people usually consume dense-energy food but of poor nutritional ... [more ▼]

It is a common belief that nutritional deficiencies are rare in the Western world due to a wide variety of food supply. However, obese people usually consume dense-energy food but of poor nutritional value that lacks proteins, vitamins, minerals and fiber; consequently, a high prevalence of micronutrient deficiencies in obese subjects has been reported. Moreover, bariatric surgery has been proven the most effective treatment of morbid obesity, but micronutrient deficiency following bariatric surgery is a major concern, worsening pre-operative nutritional deficiencies. In this article, we reviewed the litterature and highlighted the prevalence of nutritional deficiencies in the morbidly obese population prior to bariatric surgery, clinical consequences of these deficiencies and practical recommendations for these subjects. [less ▲]

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See detailL’ALCOOLISME, UN MODÈLE D’ADDICTION AUX COMPLICATIONS SOMATIQUES MULTIPLES
PAQUOT, Nicolas ULg; DE FLINES, Jenny ULg; SCHEEN, André ULg

in Revue Médicale de Liège (2013), 68(5-6), 272-280

Alcoholism is, after smoking, the most common addiction in our society. It is associated with multiple familial, social and professional negative consequences. In addition, alcohol disturbs cellular ... [more ▼]

Alcoholism is, after smoking, the most common addiction in our society. It is associated with multiple familial, social and professional negative consequences. In addition, alcohol disturbs cellular metabolism and its excessive chronic consumption may lead to multiple dysfunctions that can provoke somatic complications targeting numerous tissues or organs. The present article describes the most important ones involving the liver, the digestive tract, the heart, both the central and peripheral nervous system, and bone marrow. We also discuss the metabolic disturbances associated with chronic alcohol consumption, among which those affecting glucose regulation, lipid profile, uric acid and various vitamins. Finally, we describe the nutritional deficiencies that may be observed in alcoholic people and may contribute to aggravate somatic complications. [less ▲]

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See detailRecommandations europeennes pour la prise en charge du diabete, du pre-diabete et des maladies cardio-vasculaire. 1ere partie. Gestion du diabete et des facteurs de risque cardio-vasculaire.
Scheen, André ULg; RADERMECKER, Régis ULg; PHILIPS, Jean-Christophe ULg et al

in Revue medicale de Liege (2013), 68(11), 585-92

The patient with prediabetes or diabetes has a high or very high risk of cardiovascular diseases.We summarize the recent guidelines jointly published by the European Society of Cardiology and the European ... [more ▼]

The patient with prediabetes or diabetes has a high or very high risk of cardiovascular diseases.We summarize the recent guidelines jointly published by the European Society of Cardiology and the European Society for the Study of Diabetes. In this first article, we focus mainly on the preventive approaches of cardiovascular diseases in patients with prediabetes or (type 1 or type 2) diabetes. The crucial importance of a global multifactorial strategy is emphasized and the target levels of various risk factors are updated. The management of these cardiovascular complications in presence of diabetes will be considered in a second article. [less ▲]

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See detailChirurgie bariatrique chez le patient diabétique de type 1 : résultats d’une expérience limitée.
FRANCK, Marie ULg; DE FLINES, Jenny ULg; PAQUOT, Nicolas ULg et al

in Diabète & Métabolisme (2013), 39(suppl), 102

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See detailGestion de l'hyperglycémie au cours de la nutrition parentérale
DE FLINES, Jenny ULg; PAQUOT, Nicolas ULg; PREISER, Jean-Charles ULg

in Nutrition Clinique et Metabolisme (2012), 26(3), 143-147

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See detailL'obésité: un modèle d'interactions complexes entre génétique et environnement
PAQUOT, Nicolas ULg; DE FLINES, Jenny ULg; RORIVE, Marcelle ULg

in Revue Médicale de Liège (2012), 67(5-6), 332-336

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See detailLa chirurgie metabolique, vers une (r)evolution de la chirurgie bariatrique ?
SCHEEN, André ULg; DE FLINES, Jenny ULg; RORIVE, Marcelle ULg et al

in Revue Médicale de Liège (2011), 66(4), 183-90

Bariatric surgery has proven its efficacy to obtain a marked and sustained weight loss and dramatically improves metabolic control in obese patients. The frequently observed remission of type 2 diabetes ... [more ▼]

Bariatric surgery has proven its efficacy to obtain a marked and sustained weight loss and dramatically improves metabolic control in obese patients. The frequently observed remission of type 2 diabetes occurs very early, before any marked weight reduction. Increasing evidence suggests that this favourable effect results from profound changes in gut hormones involved in the regulation of energy intake behaviour and glucose homeostasis rather than simply from mechanical food restriction or malabsorption imposed by the surgical procedure. The better knowledge of these pathophysiological mechanisms, especially well studied with Roux-en Y gastric bypass, resulted in recent innovation in the technical procedures leading to a shift from bariatric surgery to metabolic surgery. Such type of surgery is currently evaluated in patients with type 2 diabetes, but with only a moderate obesity (BMI < 35 kg/m2), or even without obesity (BMI < 30 kg/m2). The Belgian Metabolic Intervention (BMI) Study Group would like to contribute very soon to this evaluation in a multidisciplinary approach. [less ▲]

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See detailObesite, insulinoresistance et diabete de type 2: facteurs de risque du cancer du sein.
SCHEEN, André ULg; Beck, Emmanuel ULg; DE FLINES, Jenny ULg et al

in Revue Médicale de Liège (2011), 66(5-6), 238-44

Obesity and type 2 diabetes are two risk factors of breast cancer, especially after menopause. Underlying mechanisms are multiple and include hyperinsulinism due to insulin resistance (insulin, as insulin ... [more ▼]

Obesity and type 2 diabetes are two risk factors of breast cancer, especially after menopause. Underlying mechanisms are multiple and include hyperinsulinism due to insulin resistance (insulin, as insulin-like-growth factor -IGF-, is a growth factor), hyperleptinaemia associated with hypoadiponectinaemia, and high levels of estrogens resulting from aromatization of androgens in adipose tissue. In presence of type 2 diabetes associated with obesity, hyperglycaemia might provide energy substrate promoting tumour growth. These data have therapeutic implications with expected favourable effects of weight loss, resulting in a reduction of fat mass and insulin resistance, and the promising results recently reported with metformin contrasting with the negative effects of exogenous administration of high doses of insulin. [less ▲]

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See detailDe la chirurgie bariatrique à la chirurgie métabolique : vers un nouveau paradigme dans le traitement du diabète de type 2
SCHEEN, André ULg; DE FLINES, Jenny ULg; DE ROOVER, Arnaud ULg et al

in Médecine des Maladies Métaboliques (2011), 5(3),

Bariatric surgery induces numerous hormonal changes that could contribute to reduce hunger sensation and improve glucose homeostasis in patients with type 2 diabetes. The better knowledge of these ... [more ▼]

Bariatric surgery induces numerous hormonal changes that could contribute to reduce hunger sensation and improve glucose homeostasis in patients with type 2 diabetes. The better knowledge of these pathophysiological mechanisms, especially well studied with Roux-en Y gastric bypass, resulted in recent innovation in the technical procedures and to propose them to patients with type 2 diabetes but without severe obesity (body mass index <35 kg/m² or even <30 kg/m²). Therefore, we may progress in a near future from bariatric surgery to a so-called metabolic surgery, which may open a new paradigm for the management of type 2 diabetes. This innovative approach, promising but still insufficiently validated yet, deserves further careful evaluation in a multidisciplinary approach involving digestive surgeons, gastroenterologists, endocrinologists and diabetologists. [less ▲]

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See detailLe tractus digestif comme organe endocrine : une nouvelle vision de la chirurgie bariatrique
SCHEEN, André ULg; DE FLINES, Jenny ULg; DE ROOVER, Arnaud ULg et al

in Médecine des Maladies Métaboliques (2011), 5(2), 155-161

Bariatric surgery has proven its efficacy to obtain a marked and sustained weight loss and dramatically improve metabolic control in obese patients with type 2 diabetes. The frequently observed remission ... [more ▼]

Bariatric surgery has proven its efficacy to obtain a marked and sustained weight loss and dramatically improve metabolic control in obese patients with type 2 diabetes. The frequently observed remission of diabetes occurs very early, before any significant weight reduction. Increasing evidence suggests that this favourable effect results from profound changes in gut hormones involved in the regulation of energy intake behaviour and glucose homeostasis rather than simply from mechanical food restriction or malabsorption imposed by the surgical procedure. These hormonal changes result from partial stomach amputation (leading to reduced ghrelin secretion), from bypass of duodenal-jejunal foregut (leading to reduced secretion of still unknown factors that may counteract insulin secretion and/or action) and from an earlier contact of food with hindgut (leading to enhanced secretion of incretin hormones such as glucagon-like peptide-1 [GLP-1] by the ileal L cells, neuropeptide YY and oxyntomodulin). The better knowledge of these pathophysiological mechanisms, especially well studied with Roux-en Y gastric bypass, resulted in recent innovation in the technical procedures leading to a shift from bariatric surgery to metabolic surgery. [less ▲]

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See detailManagement of metabolic syndrome and associated cardiovascular risk factors.
De Flines, Jenny ULg; Scheen, André ULg

in Acta Gastro-Enterologica Belgica (2010), 73(2), 261-6

Patients with metabolic syndrome have a 1.5- to 3-fold increase in the risk of coronary heart disease and stroke. The association between metabolic syndrome and cardiovascular diseases raises important ... [more ▼]

Patients with metabolic syndrome have a 1.5- to 3-fold increase in the risk of coronary heart disease and stroke. The association between metabolic syndrome and cardiovascular diseases raises important questions about the underlying pathological processes, especially for designing targeted therapeutic interventions. Cardiovascular risk reduction in individuals with metabolic syndrome should include at least three levels of interventions: 1) control of obesity, unhealthy diet and lack of physical activity; 2) control of the individual components of metabolic syndrome, especially atherogenic dyslipidaemia, hypertension, dysglycaemia and prothrombotic state; and 3) control of insulin resistance, a defect closely linked to metabolic syndrome. Metabolic syndrome generally precedes and is often associated with type 2 diabetes. Because of this intimate relationship, appropriate management of metabolic syndrome should be able to prevent the progression from impaired glucose tolerance to frank diabetes and thus to prevent type 2 diabetes, another important cardiovascular risk factor. The importance of prevention of diabetes in high-risk individuals (such as people with metabolic syndrome are) is highlighted by the substantial and worldwide increase in the prevalence of type 2 diabetes in recent years. Owing to the complex pathophysiology and phenotypic expression of metabolic syndrome, lifestyle changes are crucial as they are able to positively and simultaneously influence almost all components of the syndrome. If such measures are not sufficient or not adequately followed, a pharmacological intervention may be considered. However, no official guidelines are available yet concerning the pharmacological management of individuals with metabolic syndrome. [less ▲]

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See detailLa vignette thérapeutique de l'étudiant. Prise en charge d'une personne obèse avec syndrome métabolique
Rorive, Marcelle ULg; De Flines, Jenny ULg; Paquot, Nicolas ULg et al

in Revue Médicale de Liège (2009), 64(12), 651-656

The management of an obese person requires a careful evaluation first, a multidisciplinary approach and a stepwise therapeutic strategy. The latter should favour lifestyle modifications, eventually the ... [more ▼]

The management of an obese person requires a careful evaluation first, a multidisciplinary approach and a stepwise therapeutic strategy. The latter should favour lifestyle modifications, eventually the use pharmacological agents in good responders, and reserve bariatric surgery to well selected cases, refractory to medical treatment. Continuous motivational reinforcement is crucial for long-term success. In obese individuals at high metabolic risk, such strategy should aim at reducing the incidence of new-onset type 2 diabetes. [less ▲]

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See detailBariatric surgery in patients with Type 2 diabetes: benefits, risks, indications and perspectives.
Scheen, André ULg; De Flines, Jenny ULg; De Roover, Arnaud ULg et al

in Diabètes & Métabolism (2009), 35(6 Pt 2), 537-43

Obesity plays a key role in the pathophysiology of type 2 diabetes (T2DM), and weight loss is a major objective, although difficult to achieve with medical treatments. Bariatric surgery has proven its ... [more ▼]

Obesity plays a key role in the pathophysiology of type 2 diabetes (T2DM), and weight loss is a major objective, although difficult to achieve with medical treatments. Bariatric surgery has proven its efficacy in obtaining marked and sustained weight loss, and is also associated with a significant improvement in glucose control and even diabetes remission. Roux-en-Y gastric bypass appears to be more effective in diabetic patients than the restrictive gastroplasty procedure. This may be explained not only by greater weight reduction, but also by specific hormonal changes. Indeed, increased levels of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) may lead to improved beta-cell function and insulin secretion as well as reduced insulin resistance associated with weight loss. The presence of T2DM in obese individuals is a further argument to propose bariatric surgery, and even more so when diabetes is difficult to manage by medical means and other weight-related complications may occur. Bariatric surgery is associated with a better cardiovascular prognosis and reduced mortality, even though acute and long-term complications are present. The observation that surgical rerouting of nutrients triggers changes in the release of incretin hormones that, in turn, ameliorate the diabetic state in the absence of weight loss has led to the recent development of innovative surgical procedures. Thus, bariatric surgery may be said to be progressing towards so-called 'metabolic surgery', which merits further evaluation in patients with T2DM within a multidisciplinary approach that involves both surgeons and endocrinologists. [less ▲]

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See detailOptimisation du traitement pharmacologique chez un patient avec un diabete de type 2 nouvellement diagnostique.
De Flines, Jenny ULg; Radermecker, Régis ULg; Jandrain, Bernard ULg et al

in Revue Médicale de Liège (2009), 64(2), 109-14

The diabetic patient, when type 2 diabetes is newly diagnosed, raises a therapeutic problem commonly observed in clinical practice, which is more complex than expected at first glance. The physician has ... [more ▼]

The diabetic patient, when type 2 diabetes is newly diagnosed, raises a therapeutic problem commonly observed in clinical practice, which is more complex than expected at first glance. The physician has to select the most appropriate antidiabetic oral agent as first choice, to consider the potential of using combined glucose-lowering therapies, to fix glycaemic target taking into account the individual benefit/risk ratio, and to offer the best protection against cardiovascular complications. The present clinical case illustrates such therapeutic problem describing a patient with a high cardiovascular risk profile who experienced a hypoglycaemic episode after the prescription of glibenclamide following the discovery of a moderate hyperglycaemia. [less ▲]

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See detailLe traitement du diabète de type 2: entre insulinosensibilisateurs et insulinosécrétagogues
Scheen, A. J.; Radermecker, R. P.; Philips, J. C. et al

in Revue Médicale de Liège (2007), 62 Spec No

Type 2 diabetes is a complex disease characterized by a dual defect of insulin secretion and insulin sensitivity, which may vary from patient to patient, but also along the natural history of the disease ... [more ▼]

Type 2 diabetes is a complex disease characterized by a dual defect of insulin secretion and insulin sensitivity, which may vary from patient to patient, but also along the natural history of the disease in a particular patient. Besides the lifestyle changes, the treatment strategy comprises the administration of agents that promote insulin secretion and/or that improve insulin sensitivity. Drugs facilitating weight loss also improve glucose control by reducing insulin resistance. A global approach should be recommended to reduce the high cardiovascular risk of diabetic patients. The present article aims at summarizing our contribution to the development of drugs designed for the treatment of type 2 diabetes. [less ▲]

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See detailGlitazones et insuffisance cardiaque: resultats des etudes PROactive, ADOPT, DREAM et RECORD.
De Flines, Jenny ULg; Scheen, André ULg

in Revue Médicale Suisse (2007), 3(122), 18761878-83

Thiazolidinediones (TZDs) are used as insulin sensitizers in the treatment of type 2 diabetes, but are associated with an increased risk of congestive heart failure (CHF). The odds ratio of ICC was 1.43 ... [more ▼]

Thiazolidinediones (TZDs) are used as insulin sensitizers in the treatment of type 2 diabetes, but are associated with an increased risk of congestive heart failure (CHF). The odds ratio of ICC was 1.43 (pioglitazone vs placebo) in diabetic patients with high cardiovascular risk in the PROactive trial while it averaged 1.22 (rosiglitazone vs metformin) and 2.20 (rosiglitazone vs metformin) in the ADOPT study. In the interim analysis of the ongoing RECORD trial, the odds ratio averaged 2.15 (rosiglitazone vs metformin or sulfonylureas). In four real life registries, the relative risk of CHF with TZDs varied between 1.06 and 1.76 (between 1.10 and 1.44 combined with insulin) as compared to a treatment without TZDs. Such higher CHF risk should be appreciated according to the potential benefits of glitazones in the management of type 2 diabetes. [less ▲]

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