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\title{Healthy Lifestyles in Patients with Type 2 Diabetes Mellitus and Alteration Genetic Compatible with Ctp-Ii According to Clinical Evidence}
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             \author[1]{Estefany  Rivera}

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\date{\small \em Received: 1 January 1970 Accepted: 1 January 1970 Published: 1 January 1970}

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\begin{abstract}
        


Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia. It may be due to impaired insulin secretion, resistance to peripheral actions of insulin, or both. According to the International Diabetes Federation

\end{abstract}


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\section[{Introduction}]{Introduction}\par
iabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia. It may be due to impaired insulin secretion, resistance to peripheral actions of insulin, or both. According to the International Diabetes Federation (IDF) \hyperref[b0]{[1]} Carnitine palmitoyltransferase (CPT) catalyzes the transfer of long-and medium-chain fatty acids from cytoplasm into mitochondria, where oxidation of fatty acids takes place. Deficiency of CPT enzyme is associated with rare diseases of fatty acid metabolism. CPT is present in two subforms: CPT I at the outer mitochondrial membrane and carnitine palmitoyltransferase II (CPT II) inside the mitochondria. Deficiency of CPT II results in the most common inherited disorder of long-chain fatty acid oxidation affecting skeletal muscle.  {\ref [2]} Obesity and type 2 diabetes are caused by a combination of poor diet quality, high caloric intake, and physical inactivity. The skeletal muscle accounts for 50\% of total energy expenditure (EE), and because it is highly bioenergetically demanding and insulinresponsive, it greatly affects systemic metabolism in physiological and pathological scenario \hyperref[b1]{[3]}.\par
Carnitine palmitoyltransferase II (CPT II) deficiency is an important cause of recurrent rhabdomyolysis in children and adults. Current treatment includes dietary fat restriction, with increased carbohydrate intake and exercise restriction to avoid muscle pain and rhabdomyolysis \hyperref[b2]{[4]}. The term "fats" designates a set of nutrients with great chemical heterogeneity, due to their different composition in fatty acids. Therefore, it is totally logical consider that its biological effect will vary depending on the type of fatty acid predominant in its molecule. All fats are insoluble in water and soluble in organic solvents, they are present in all cells (animal and plant) and most can be synthesized from carbohydrates \hyperref[b3]{[5]}.\par
Author ? ?: Medico, Universidad del Sinú, seccional Cartagena de Indias, Colombia. e-mail: estefaniirive@hotmail.com According to Khazrai and collaborators, there are many food plans available so that patients with DM2 can choose one based on their personal tastes and cultural traditions. It is important to provide a personalized diet when possible in order to increase its effectiveness in reducing diabetes symptoms and encouraging patient adhesion \hyperref[b4]{[6]}.\par
There is currently no specific etiological treatment. General recommendations include avoiding situations that can precipitate myoglobinuria, such as intense exercise, and a diet high in complex carbohydrates and low in fat can be useful to ensure glucose supply from liver glycogen stores \hyperref[b5]{[7]}.\par
A concise review of the available clinical evidence on this topic is carried out, where we can conclude that having multiple comorbidities leads to adjusting changes in healthy lifestyles, in this case of metabolic pathologies, the clinical evidence is clear about the advantages and good quality of life that is obtained by having an adequate adherence not only in the pharmacological treatment but also by a suitable diet, which must be individualized and given by a trained multidisciplinary team that allows reaching the goals and in turn avoiding complications.		 		\backmatter  			  				\begin{bibitemlist}{1}
\bibitem[Cortés and Kleinsteuber ()]{b5}\label{b5} 	 		\textit{},  		 			Rocío Cortés 		,  		 			Karin Kleinsteuber 		.  		2018. Carmen Paz Vargas, María de Los Ángeles Avaria..  	 
\bibitem[ Metabolic Myopathies. REV. MED. CLIN. CONDES ()]{b6}\label{b6} 	 		\textit{},  	 	 		\textit{Metabolic Myopathies. REV. MED. CLIN. CONDES}  		2018. 29  (6)  p. .  	 
\bibitem[Orozco González et al. ()]{b4}\label{b4} 	 		‘Adherencia a las intervenciones dietéticas en pacientes con diabetes mellitus tipo 2: una revisión narrativa de la literatura’.  		 			C N Orozco González 		,  		 			C Vieyra-Angeles 		,  		 			M I Rojo-López 		,  		 			L Aguilar-Aguayo 		,  		 			S Camacho-López 		.  	 	 		\textit{Revista De Nutrición Clínica Y Metabolismo}  		2021. 4  (3) .  	 
\bibitem[Roe et al. ()]{b2}\label{b2} 	 		‘Carnitinepalmitoyltransferase II deficiency: successful anaplerotic diet therapy’.  		 			C R Roe 		,  		 			B Z Yang 		,  		 			H Brunengraber 		,  		 			D S Roe 		,  		 			M Wallace 		,  		 			B K Garritson 		.  	 	 		\textit{Neurology}  		2008. 71  (4)  p. .  	 
\bibitem[Fernández et al. ()]{b3}\label{b3} 	 		‘Grasas de la dieta y salud cardiovascular [Dietary fats and cardiovascular health’.  		 			L C Fernández 		,  		 			J D Serra 		,  		 			J R Álvarez 		,  		 			R S Alberich 		,  		 			F P Jiménez 		.  	 	 		\textit{Atencion primaria}  		2011. 43  (3)  p. .  	 	 (e16) 
\bibitem[Goyal and Jialal (2020)]{b0}\label{b0} 	 		‘Joshi PR, Zierz S. Muscle Carnitine Palmitoyltransferase II (CPT II) Deficiency: A Conceptual Approach’.  		 			R Goyal 		,  		 			I Jialal 		.  		 30020625.  	 	 		\textit{StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing},  				2021 Sep 28. 2022 Jan. 2020 Apr 13. 25 p. 1784.  	 	 (Diabetes Mellitus Type 2) 
\bibitem[Pereyra et al. (2020)]{b1}\label{b1} 	 		‘Loss of Muscle Carnitine Palmitoyltransferase 2 Prevents Diet-Induced Obesity and Insulin Resistance despite Long-Chain Acylcarnitine Accumulation’.  		 			A S Pereyra 		,  		 			A Rajan 		,  		 			C R Ferreira 		,  		 			J M Ellis 		.  	 	 		\textit{Cell Rep}  		2020 Nov 10. 33  (6)  p. 108374.  	 
\end{bibitemlist}
 			 		 	 
\end{document}