References of "LETIEXHE, Michel"
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See detailObesite et diabete de type 2.
Rorive, Marcelle ULg; Letiexhe, Michel ULg; Scheen, André ULg et al

in Revue Médicale de Liège (2005), 60(5-6), 374-82

Obesity is an epidemic disease associated with numerous cardiovascular risk factors as diabetes mellitus, dyslipidemia, hypertension. Insulin resistance seems to be an important promoter for the ... [more ▼]

Obesity is an epidemic disease associated with numerous cardiovascular risk factors as diabetes mellitus, dyslipidemia, hypertension. Insulin resistance seems to be an important promoter for the development of most of these abnormalities. Besides genetic background, obesity, especially abdominal adiposity, is by far the most important factor for the development of type 2 diabetes. The treatment of a diabetic obese subject begins with diet and regular physical activity, eventually with a psychological support. In case of failure of such lifestyle approach alone, addition of drug therapy should be considered. It may include pharmacological agents able to promote weight loss (orlistat, sibutramine, possibly rimonabant) and/or antihyperglycaemic compounds capable of reducing insulin resistance (metformin, glitazones, acarbose). In case of severe/morbid obesity complicated with type 2 diabetes not well controlled with medical means, bariatric surgery is the only treatment that can induce an important and sustained weight loss, associated with marked improvement of metabolic control and amelioration of overall prognosis. [less ▲]

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See detailL'etude clinique du mois. Chirurgie bariatrique: les resultats a 10 ans de la Swedish Obese Subjects Study"."
Scheen, André ULg; Letiexhe, Michel ULg; Rorive, Marcelle ULg et al

in Revue Médicale de Liège (2005), 60(2), 121-5

The 10-year results of the prospective, controlled Swedish Obese Subjects Study were recently reported in the New England Journal of Medicine by L. Sjostrom and colleagues. This trial compared obese ... [more ▼]

The 10-year results of the prospective, controlled Swedish Obese Subjects Study were recently reported in the New England Journal of Medicine by L. Sjostrom and colleagues. This trial compared obese subjects who underwent gastric surgery and contemporaneously matched, conventionally treated obese control subjects. The follow-up rate for laboratory examinations was 74.5 percent at 10 years. At that time, data of 627 patients of the control group (mean age of 48 years, body mass index of 41 kg/m2) were compared to those of 641 patients who were submitted to surgery (banding n = 156, vertical banded gastroplasty n = 451 and gastric bypass n =34). At 10 years, the body weight had increased by 1.6 percent in the control group and decreased by 16.1 percent in the surgery group (p < 0.001), and similar changes were observed for waist circumference (+2.8 percent versus -10.1 percent, respectively, p < 0.001). Energy intake was lower and the proportion of physically active subjects higher in the surgery group than in the control group throughout the observation period. Ten-year rates of recovery from diabetes, hypertriglyceridaemia, low levels of high-density lipoprotein cholesterol, hypertension, and hyperuricaemia were more favourable in the surgery than in the control group. The surgery group had lower 10-year incidence rates of diabetes, hypertriglyceridaemia, and hyperuricaemia (but not of hypertension) than the control group. In conclusion, as compared with conventional therapy, bariatric surgery appears to be a valuable option for the treatment of severe obesity, resulting in long-term weight loss, improved lifestyle, and, except for hypercholesterolaemia that was not significantly affected, amelioration in cardiovascular risk factors that were elevated at baseline. Obtaining long-term data concerning the effect of weight loss on overall mortality and on the incidence rates of myocardial infarction, stroke, and cancer remains a key-objective of this landmark study. [less ▲]

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See detailIntact cross-talk between insulin secretion and insulin action after postgastroplasty recovery of ideal body weight in severely obese patients.
Letiexhe, Michel ULg; Desaive, Claude ULg; Lefebvre, Pierre ULg et al

in International Journal of Obesity & Related Metabolic Disorders (2004), 28(6), 821-3

Most reports investigating the hormonal and metabolic effects of bariatric surgery studied obese subjects after partial weight loss only. Nevertheless, all studies showed significant improvements of ... [more ▼]

Most reports investigating the hormonal and metabolic effects of bariatric surgery studied obese subjects after partial weight loss only. Nevertheless, all studies showed significant improvements of insulin secretion, action, clearance and inhibition of its own secretion, although the parallel kinetics of all these changes remained questionable. Using the intravenous glucose tolerance test, we demonstrated a full normalization of insulin secretion, action on glucose metabolism and clearance in eight obese women who recovered and maintained ideal body weight following gastroplasty. Reciprocal changes were observed between postglucose acute insulin secretion and insulin-mediated glucose disposal so that the so-called disposition index (product of these two variables) remained unchanged after vs before gastroplasty in those individuals with normal glucose tolerance. These favourable results should encourage obtaining a drastic and sustained weight loss in patients with severe obesity at risk of developing type II diabetes. [less ▲]

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See detailPrevention du diabete de type 2: style de vie ou medicaments?
Scheen, André ULg; Letiexhe, Michel ULg; Ernest, Philippe ULg

in Revue Médicale de Liège (2003), 58(4), 206-10

The World Health Organisation strongly recommends strategies for the prevention of type 2 diabetes, knowing the epidemics of the disease and its strong association with that of obesity. Several ... [more ▼]

The World Health Organisation strongly recommends strategies for the prevention of type 2 diabetes, knowing the epidemics of the disease and its strong association with that of obesity. Several intervention studies, in China ("Da-Qing Study"), in Europe ("Malmo study", "Finnish Diabetes Prevention Study") and in the United States ("Diabetes Prevention Program"), showed that lifestyle change are able to reduce by around 50% the incidence of type 2 diabetes in at risk individuals. Various pharmacological approaches have also proven their efficacy in preventing type 2 diabetes, but in most cases with less impressive reductions, between 25% and 35%. It is the case for metformin, acarbose, orlistat or various inhibitors of the renin-angiotensin system. After the report of promising results with troglitazone, large prospective studies are ongoing to test the efficacy of rosiglitazone and pioglitazone in such an indication, two insulinsensitizers of the thiazolidinedione family. We will briefly described the main results of intervention studies to prevent type 2 diabetes in at risk subjects, because of the presence of obesity, impaired glucose tolerance and/or arterial hypertension. [less ▲]

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See detailRelation between disease phenotype and HLA-DQ genotype in diabetic patients diagnosed in early adulthood
Weets, Ilse; Siraux, Valérie; Daubresse, Jean-Claude ULg et al

in Journal of Clinical Endocrinology and Metabolism (2002), 87(6), 2597-2605

We investigated inaugural disease phenotype in relation to the presence or absence of diabetes-associated autoantibodies and human leukocyte antigen (HLA) DQ risk genotypes in adult-onset diabetic ... [more ▼]

We investigated inaugural disease phenotype in relation to the presence or absence of diabetes-associated autoantibodies and human leukocyte antigen (HLA) DQ risk genotypes in adult-onset diabetic patients. Blood samples and questionnaires were obtained from 1584 recent-onset Belgian Caucasian patients (age 15-39 yr at diagnosis of primary diabetes) who were recruited by the Belgian Diabetes Registry over an 11-yr period. At clinical diagnosis, antibody-positive patients (n = 1198) were on average younger and had more symptoms, a more acute disease onset, lower body mass index, and random C-peptide levels, but higher insulin needs, glycemia, and prevalence of ketonuria, HLA-DQ, and 5' insulin gene susceptibility genotypes (P < 0.001 vs. antibody-negative patients; n = 386). In antibody-positive patients, these characteristics did not differ according to HLA-DQ genotype. However, in antibody-negative subjects, we found that patients were younger (P = 0.001); had a lower body mass index (P < 0.001), higher insulin needs (P = 0.014), and amylasemia (P = 0.001); and tended to have a higher glycemia and lower C-peptide in the presence of susceptible HLA-DQ genotypes. Differences according to HLA-DQ genotype subsisted after careful age-matching. In conclusion, we found no relation between initial disease phenotype and HLA-DQ genotype in antibody-positive diabetic young adults. In contrast, antibody-negative patients displayed more type I-like features when carrying susceptible HLA-DQ genotypes known to promote the development of antibody-positive diabetes. The overrepresentation of these susceptibility genotypes in antibody-negative patients suggests the existence of an immune-mediated disease process with as yet unidentified immune markers in a subgroup of seronegative patients. [less ▲]

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See detailApproches pharmacologiques de prévention du diabète de type 2.
SCHEEN, André ULg; PAQUOT, Nicolas ULg; LETIEXHE, Michel ULg et al

in Médecine et Hygiène (2002), 60

L’augmentation rapide de la prévalence du diabète de type 2 impose la mise en place de stratégies de prévention. Outre les mesures hygiéno-diététiques, essentielles, diverses approches pharmacologiques ... [more ▼]

L’augmentation rapide de la prévalence du diabète de type 2 impose la mise en place de stratégies de prévention. Outre les mesures hygiéno-diététiques, essentielles, diverses approches pharmacologiques ont apporté récemment la preuve d’une certaine efficacité chez les sujets à risque de par la présence d’un excès pondéral et/ou d’une diminution de la tolérance au glucose. C’est le cas de plusieurs antidiabétiques oraux comme la metformine, l’acarbose ou encore la troglitazone. C’est également le cas de médicaments anti-obésité comme l’orlistat et, peut-être aussi, la sibutramine. L’inhibition du système rénine-angiotensine par un inhibiteur de l’enzyme de conversion ou par un antagoniste sélectif des récepteurs AT1 peut aussi, outre protéger contre les complications cardiovasculaires, prévenir l’apparition d’un diabète de type 2. Enfin, le rôle des médicaments hypolipidémiants reste controversé. De nouvelles études prospectives sont en cours pour confirmer ces résultats. [less ▲]

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See detailL'hyperglycemie post-prandiale. II. Approches therapeutiques medicamenteuses.
Scheen, André ULg; Letiexhe, Michel ULg; Geronooz, I. et al

in Revue Médicale de Liège (2002), 57(4), 196-201

Besides dietary approaches, various pharmacological means have been recently developed in order to better control postprandial hyperglycaemia. This objective may be obtained: 1) by slowing down the ... [more ▼]

Besides dietary approaches, various pharmacological means have been recently developed in order to better control postprandial hyperglycaemia. This objective may be obtained: 1) by slowing down the intestinal absorption of carbohydrates; 2) by insuring a better insulin priming soon after the meal; and 3) by inhibiting post-prandial glucagon secretion or action. Some hormones (amylin, glucagon-like peptide-1) can slow gastric emptying while alpha-glucosidase inhibitors (acarbose, miglitol) retard intestinal digestion and resorption of complex carbohydrates. A more physiological post-meal profile of insulin may be obtained in type 2 diabetes by using new insulin secretagogues of the glinide family (repaglinide, nateglinide) with an earlier and shorter insulinotropic action or, mainly in type 1 diabetes but also in type 2 diabetes, by using short-acting insulin analogues (lispro. Asp B28) or inhated insulin the action of which is faster than that of subcutaneous insulin. Post-prandial glucagon secretion can be inhibited by amylin. GLP-1 or insulin while other glucagon antagonists are currently in development. [less ▲]

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See detailContrôle pharmacologique de l’hyperglycémie postprandiale
SCHEEN, André ULg; JANDRAIN, Bernard ULg; PAQUOT, Nicolas ULg et al

in Médecine et Hygiène (2001), 59

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See detailLe cas clinique du mois. L'histoire naturelle d'une obesite morbide: aller vers le diabete de type 2 insulinorequerant et retour apres chirurgie bariatrique.
De Flines, Jenny ULg; Letiexhe, Michel ULg; Desaive, Claude ULg et al

in Revue Médicale de Liège (2001), 56(12), 816-22

Morbid obesity is a crucial risk factor in the development of type 2 diabetes and is often associated with a metabolic syndrome closely linked to insulin resistance. This case report illustrates the ... [more ▼]

Morbid obesity is a crucial risk factor in the development of type 2 diabetes and is often associated with a metabolic syndrome closely linked to insulin resistance. This case report illustrates the natural history of morbid obesity, starting during the adolescence and ending with an extremely severe type 2 diabetes at the age of 40. Numerous attempts of weight loss with various medical approaches failed and diabetes mellitus rapidly became insulin-requiring in a context of extreme insulin resistance. Finally, the patient was submitted to a gastric bypass which resulted in a drastic weight loss over 50 kg during the year following surgery without any significant side-effects or complications. Type 2 diabetes almost disappeared and the classical markers of insulin resistance were markedly improved. This clinical case clearly demonstrates that successful management of obesity with bariatric surgery can reverse severe type 2 diabetes. [less ▲]

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See detailL'exercice physique pour prevenir l'obesite, favoriser l'amaigrissement et maintenir la perte ponderale.
Scheen, André ULg; Rorive, Marcelle ULg; Letiexhe, Michel ULg

in Revue Médicale de Liège (2001), 56(4), 244-7

Obesity is a multifactorial disease making difficult the determination of the precise role of one specific factor such as physical activity or sedentary. Nevertheless, numerous arguments, derived from ... [more ▼]

Obesity is a multifactorial disease making difficult the determination of the precise role of one specific factor such as physical activity or sedentary. Nevertheless, numerous arguments, derived from epidemiological observational studies or from randomized controlled interventional trials, support a favourable role of regular physical activity in the control of body weight. Physical activity contributes to prevent the occurrence of weight excess, especially in children or adolescents, to obtain a satisfactory weight loss, in general in combination with reduced-energy diets, and to maintain long-term weight loss. In addition, physical activity improves both the metabolic profile and health of obese subjects. [less ▲]

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See detailUn sujet obese par une approche multidisciplinaire: l'exemple du Centre de l'Obesite du CHU Ourthe-Ambleve.
Scheen, André ULg; Rorive, Marcelle ULg; Letiexhe, Michel ULg et al

in Revue Médicale de Liège (2001), 56(7), 474-9

Obesity is a mulfactorial disease whose prevalence is progressively increasing. Ideally, it requires a multidisciplinary management by medical doctors, dieticians, psychologists and kinetherapists. The ... [more ▼]

Obesity is a mulfactorial disease whose prevalence is progressively increasing. Ideally, it requires a multidisciplinary management by medical doctors, dieticians, psychologists and kinetherapists. The new "Centre de l'Obesite" at the University of Liege aims at fulfilling such objectives with: 1) a first outpatient visit including the simultaneous participation of an endocrinologist, a dietician and a psychologist; 2) a structured and individualized programme of physical rehabilitation; 3) an individualized management of obese subjects as in-(hospital) and/or outpatients, using medical and/or surgical approaches; and 4) an opportunity to benefit of other specialized medical advices, if necessary, in order to increase both the efficacy and safety of the treatment. Owing to the increasing importance of obesity and the well-known difficulties to succeed in treating it, general practitioners should consider this new centre as a valuable help rather than a competitive structure for the management of their patients, especially those with severe or morbid obesity. [less ▲]

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See detailThiazolidinediones.
Scheen, André ULg; Paquot, Nicolas ULg; Letiexhe, Michel ULg et al

in Journées Annuelles de Diabetologie de l'Hôtel-Dieu (1999)

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See detailMinimal influence of the time interval between injection of regular insulin and food intake on blood glucose control of type 1 diabetic patients on a basal-bolus insulin scheme.
Scheen, André ULg; Letiexhe, Michel ULg; Lefebvre, Pierre ULg

in Diabètes & Métabolism (1999), 25(2), 157-62

The present study aimed at investigating the influence of the time interval between injection of regular insulin and meal ingestion on postprandial glucose changes and overall blood glucose control in ... [more ▼]

The present study aimed at investigating the influence of the time interval between injection of regular insulin and meal ingestion on postprandial glucose changes and overall blood glucose control in patients with type 1 diabetes on intensive insulin therapy. Fifteen C-peptide negative subjects were submitted, in a randomized order, to two 6-week treatment periods in which regular insulin was injected either 5 minutes or 30 minutes before each of the three main meals, in combination with a bedtime NPH insulin injection. The changes in plasma glucose excursions following a breakfast test (Cmax, Tmax, Cmin, Tmin, AUC0-240 min) were similar in the two experimental protocols. Furthermore, no significant changes were observed in daily insulin dosages nor in glucose profiles obtained using home blood glucose monitoring. Only a tendency to a greater 90-minutes postprandial increase in blood glucose levels was observed when regular insulin was injected 5 minutes rather than 30 minutes before meal. Glycated haemoglobin levels were similar after each treatment period (7.6 +/- 0.2% versus 7.5 +/- 0.2%; NS) and no differences in the incidence or severity of hypoglycaemic episodes were noticed between the two insulin schemes. In conclusion, in type 1 diabetic patients who are rather well controlled with a basal-bolus insulin scheme, the injection of regular insulin 30 minutes before each main meal provides no significant advantage as compared to the injection of regular insulin 5 minutes before meal. [less ▲]

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See detailInsulin lispro (Humalog) in the treatment of diabetes mellitus: overview of belgian clinical data from global studies.
Bex, M.; Buysschaert, M.; De Leeuw, I. et al

in Acta Clinica Belgica (1999), 54(5), 241-5

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See detailPharma-clinics le medicament du mois. L'orlistat (xenical).
Scheen, André ULg; Ernest, Philippe ULg; Letiexhe, Michel ULg

in Revue Médicale de Liège (1999), 54(3), 192-6

Orlistat (tetrahydrolipstatin), launched by Roche under the trade name Xenical, is a selective inhibitor of pancreatic and gastro-intestinal lipases. It reduces the digestion of dietary fat and its ... [more ▼]

Orlistat (tetrahydrolipstatin), launched by Roche under the trade name Xenical, is a selective inhibitor of pancreatic and gastro-intestinal lipases. It reduces the digestion of dietary fat and its resorption through digestive mucosa by around 30%. It is indicated, at a dose of 3 x 120 mg/day (one dose with each meal) and together with a moderately low-calorie and low-fat diet, for the treatment of obesity. It has been shown, in placebo-controlled two-year trials, to almost double the number of obese subjects who succeed in loosing at least 10% of initial body weight. Independently, it contributes to decrease serum cholesterol levels by 6-10%. Because of its mechanism of action, this drug can induce intestinal side-effects which tend to decrease with time and with the reduction of fat intake, thus improving diet compliance. [less ▲]

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See detailComment je traite ... une obesite severe et ses anomalies metaboliques par une gastroplastie.
Luyckx, Françoise ULg; Scheen, André ULg; Letiexhe, Michel ULg et al

in Revue Médicale de Liège (1999), 54(3), 138-42

Severe obesity, defined as a body mass index > or = 35 kg/m2, is frequently associated with various biological abnormalities, particularly in the presence of intra-abdominal adiposity. The most important ... [more ▼]

Severe obesity, defined as a body mass index > or = 35 kg/m2, is frequently associated with various biological abnormalities, particularly in the presence of intra-abdominal adiposity. The most important disorders belong to the so-called insulin resistance syndrome, metabolic syndrome or syndrome X: hyperinsulinaemia, impaired glucose tolerance or type 2 diabetes, dyslipidaemias, hyperuricaemia, hyperfibrinogenaemia. All these metabolic abnormalities are considered as cardiovascular risk factors. They are also correlated with the severity of the liver steatosis which is commonly observed in individuals with severe obesity. We report our experience of the evolution of these metabolic abnormalities after a marked weight loss induced by gastroplasty. We will analyse the favourable effects of bariatric surgery on insulin sensitivity, biological components of the metabolic syndrome, type 2 diabetes and liver steatosis. [less ▲]

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See detailLes thiazolidinediones : quel avenir dans le traitement du diabète de type 2 ?
SCHEEN, André ULg; PAQUOT, Nicolas ULg; LETIEXHE, Michel ULg et al

in Médecine et Hygiène (1998), 56

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See detailTraitement ultime du diabete de type 2: insulinotherapie intensive ou chirurgie bariatrique?
Scheen, André ULg; Paquot, Nicolas ULg; Triches, K. et al

in Journées Annuelles de Diabetologie de l'Hôtel-Dieu (1998)

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