Publications by authors named "Carlo M Rotella"

Purpose: Emotional eating is a trans-diagnostic dimension in eating disorders and is present in many other conditions that could affect eating attitudes. At present, there is no instrument that measures emotional eating evaluating both the intensity and the frequency of emotion-induced desire to eat. The aim of the study was the validation of the Florence Emotional Eating Drive (FEED).

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Background: Obesity represents the second preventable mortality cause worldwide, and is very often associated with type 2 Diabetes Mellitus (T2DM). The first line treatment is lifestyle modification to weight-loss, but for those who fail to achieve the goal or have difficulty in maintaining achieved results, pharmacological treatment is needed. Few drugs are available today, because of their side effects.

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Background: Insulinoma is a rare tumour representing 1-2% of all pancreatic neoplasms and it is malignant in only 10% of cases. Locoregional invasion or metastases define malignancy, whereas the dimension (> 2 cm), CK19 status, the tumor staging and grading (Ki67 > 2%), and the age of onset (> 50 years) can be considered elements of suspect.

Case Presentation: We describe the case of a 68-year-old man presenting symptoms compatible with hypoglycemia.

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Background: Diabetic Cardiomyopathy (DC) has been defined as a distinct entity characterized by the presence of diastolic or systolic cardiac dysfunction in a diabetic patient in the absence of other causes for Cardiomyopathy, such as coronary artery disease (CAD), hypertension (HTN), or valvular heart disease. Diabetes affects every organ in the body and cardiovascular disease accounts for two-thirds of the mortality in the diabetic population. Diabetes-related heart disease occurs in the form of coronary artery disease (CAD), cardiac autonomic neuropathy or DC.

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Background: Endothelial dysfunction (ED) is a pathophysiological mechanism present in patients affected by type 2 diabetes (T2DM) supporting the development of cardiovascular disease. Among immune- and inflammatory cells accelerating atherosclerosis, dendritic cells (DC) play a pivotal role, however their pathogenetic mechanism has not been fully clarified, at present. The aim of our review is to explore the relationship between ED, DCs and cardiovascular events.

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Aims: Evidences showed a link between statins and new-onset diabetes and large clinical trials in type 2 diabetes (T2DM) suggested a mild glycemic progression in statin treated. Since this effect has not yet elucidated in real world, we investigated the effects of different statins on glycemia in T2DM clinic outpatients.

Methods: In a retrospective cohort study, we recorded at 6 and 12months modifications of fasting glucose (FPG), HbA1c, diabetes intensification therapy and target rate for HbA1c in 421 T2DM non-users and new statin users.

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Background: Experimental and clinical studies have shown a strong association between hypertriglyceridemia and diabetic nephropathy. A variability of triglyceride (TG) levels has been reported in diabetes.

Objectives: To investigate the relationship of TG variability with the incidence of microalbuminuria (albumin excretion rate > 20 μg/min), in patients with type 2 diabetes.

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We previously reported that circulating lipid (malondialdehyde, MDA) and protein oxidation (carbonyl residues, CO) products can be used as markers of risk for complications in poorly controlled type 2 diabetics. Now, we aimed to evaluate the existence of a gender effect on classical disease markers and oxidative stress parameters and on the effectiveness of metformin and/or statins in reducing CV risk in poorly controlled type 2 diabetics with and without complications. Our results show that diabetics with complications had higher plasma levels of FRAP, SOD and hs-CRP than those without complications, with FRAP and SOD found increased in both genders.

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A pilot uncontrolled study aimed at investigating the efficacy of a motivational enhancement therapy adapted for obesity was conducted on 71 obese patients (59 females). Treatment consisted of 5 weekly group sessions and 3 weekly individual sessions. Outcome measures included Treatment, Motivation and Readiness test (TREMORE) and anthropometric measures.

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In clinical practice obesity is primarily diagnosed through the body mass index. In order to characterize patients affected by obesity the use of traditional anthropometric measures appears misleading. Beyond the body mass index, there are overwhelming evidences towards the relevance of a more detailed description of the individual phenotype by characterizing the main body components as free-fat mass, muscle mass, and fat mass.

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Obesity is a multifactorial disease and the prominent factors playing a role in its pathogenesis are biological, environmental and psychological. There is a growing interest in understanding psychological functioning of obese subjects and the influence of psychological factors on treatment outcome. The aim of the present narrative review is to critically analyze the current literature, in order to point out the most common psychological constructs studied in obesity and to give an overview of the main existing tools investigating psychological features which have been considered significant for the prediction of success in weight loss and maintenance programs in obese patients.

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Objectives: To review information on cardiovascular health and migration, to stress the attention of researchers that much needs to be done in the collection of sound data in Italy and to allow policy makers identifying this issue as an important public health concern.

Background: In Italy, the rate of immigrants in the total number of residents increased from 2.5% in 1990 to 7.

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Insulin resistance is a clinical condition shared by many diseases besides type 2 diabetes (T2DM) such as obesity, polycystic ovary syndrome (PCOS) and non-alcoholic fatty liver disease (NAFLD). Experimental evidence, produced over the years, suggests that metformin has many benefits in the treatment of these diseases. Metformin is a first-line drug in the treatment of overweight and obese type 2 diabetic patients, offering a selective pathophysiological approach by its effect on insulin resistance.

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Purpose: Obesity treatment based on lifestyle modifications is characterized by a high proportion of treatment failures. The study of predictors of success could be useful for a better definition of therapeutic needs in individual patients. Few studies have attempted a comprehensive assessment of psychological factors related with treatment response.

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Reducing low-density lipoprotein cholesterol (LDL-C) levels using statins is associated with significant reductions in cardiovascular (CV) events in a wide range of patient populations. Although statins are generally considered to be safe, recent studies suggest they are associated with an increased risk of developing Type 2 diabetes (T2D). This led the US Food and Drug Administration (FDA) to change their labelling requirements for statins to include a warning about the possibility of increased blood sugar and HbA1c levels and the European Medicines Agency (EMA) to issue guidance on a small increased risk of T2D with the statin class.

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Purpose: Weight loss treatment effectiveness and cost-effectiveness may be improved by the identification of patients who are more prone to participate and gain benefit from specific interventions. Aim of the present study is to identify easily available additional predictors of weight loss among data usually present in the medical records of obese/overweight patients attending an outpatient clinic for a non-pharmacological lifestyle change program.

Results: 268 patients, 74 men and 195 women (age 43.

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Objective: Obesity prevalence is increasing worldwide and it is nowadays considered a real public health problem. Obesity is associated with co-morbidities like cardiovascular diseases (CVD) and type 2 diabetes mellitus (T2DM), furthermore visceral obesity can be related to low testosterone (T) plasma levels. The link between obesity and hypogonadism (HG) is complex and not completely clarified.

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Many psychiatric disorders and symptoms have been associated with impaired metabolic control in type 2 diabetes; several studies focused on non-pathological psychological features. Aims of this observational, longitudinal study are: the assessment of the impact of a wide range of psychological factors on metabolic control in type 2 diabetes; and the development and validation of a simple questionnaire to assess the impact of psychological factors on therapeutic success. To identify psychological factors interfering with attainment of glycemic targets, a prospective 1-year study was performed on a sample of 250 patients with type 2 diabetes.

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Article Synopsis
  • This study investigates the link between plasma lipids (like triglycerides and LDL/HDL cholesterol) and microvascular complications (kidney disease and retinopathy) in 2,535 individuals with type 2 diabetes over a 14-year period.
  • Results show that higher triglyceride levels are significantly associated with an increased risk of diabetic kidney disease, while higher HDL cholesterol is linked to a reduced risk.
  • The findings suggest that targeting lipid levels, particularly triglycerides and HDL cholesterol, could be beneficial in the management and treatment of diabetic kidney disease, although the link with retinopathy was less clear.
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Purpose: To compare the psychopathological characteristics of obese patients seeking bariatric surgery with those seeking a medical approach.

Methods: A total of 394 consecutive outpatients seeking bariatric surgery were compared with 683 outpatients seeking a medical treatment. All patients were referred to the same institution.

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Purpose: Body mass index has been often reported in the normal range in bulimic patients and the literature considering the association between bulimia nervosa (BN) and overweight is scant. The aim of the present study was to compare two groups of normal and overweight BN patients, carefully assessed for several clinical and psychopathological features.

Methods: In the present cross-sectional study, a consecutive series of 124 female BN patients was divided into two groups according to their BMI: normal-weight group (with BMI ≤25; N = 91) and overweight group (with BMI >25; N = 33).

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Background: In previous pilot studies we have demonstrated that the Treatment Motivation and Readiness Test (TRE-MORE) is capable of predicting the outcome of obesity therapy and that a higher muscle mass (MM) is associated with a greater weight loss. Purposes of the present study were: to confirm the predictive value of TRE-MORE scores and MM, using a standardized non-pharmacologic intervention for weight loss; to explore the relationship between TRE-MORE and MM; to discriminate predictors of attendance from predictors of final therapeutic success.

Methods: A consecutive series of 331 patients was enrolled and addressed to a standardized treatment protocol.

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Patients with diabetes frequently exhibit the combined occurrence of hyperglycemia and dyslipidemia. Published data on their coexistence are often controversial. Some studies provide evidence for suboptimal lifestyle and exogenous hyperinsulinism at "mild insulin resistance" in adult diabetic patients as main pathogenic factors.

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Background: The aim of the present paper is to provide some further data on the relationship between β-blocker treatment and the incidence of cancer, using two different approaches (epidemiological study and meta-analysis of clinical trials).

Methods: In a consecutive series of 1340 diabetic patients starting insulin therapy, 112 cases of cancer during a mean follow-up of 75.9 months were identified as first hospital admission or death.

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