Weight Management as a Treatment for Type 2 Diabetes and Pre-Diabetes

Patients with diabetes who lose greater amounts of weight have greater reductions in fasting lipids, hyperlipidemia medications and associated costs compared to those who lose modest amounts of weight.

Obes 2012:S170.

Data from 139 patients with type 2 diabetes on diabetes medications were analyzed. At an average of 111 weeks follow-up, 23.3% of those who lost 5-10% of initial weight (average of 20 lbs) had discontinued hyperlipidemia medications. At an average of 90 weeks follow-up, 41% of those who lost ≥ 20% of initial weight (average of 81 lbs) had discontinued hyperlipidemia medications.

Patients with diabetes who lose greater amounts of weight have greater reductions in fasting blood glucose, diabetes medications and associated costs compared to those who lose modest amounts of weight.

Obes 2012:S170.

Data from 139 patients with type 2 diabetes on diabetes medications were analyzed. At an average of 111 weeks follow-up, 19% of those who lost 5-10% of initial weight had discontinued insulin and 29.8% had discontinued oral medications. At an average of 90 weeks follow-up, 53.5% of those who lost ≥ 20% of initial weight had discontinued insulin and 57.7% had discontinued oral medications.

Greater weight loss maintenance in patients with diabetes impacts medication use.

Obes 2011;19 suppl 1:S97.

Factors that differentiated patients with diabetes who were able to eliminate medications versus those who were not included greater weight loss maintenance (56 vs. 35 lbs) and greater physical activity. The no diabetes medication patients also eliminated more cholesterol (53% vs. 16%) and more blood pressure medications (48% vs. 13%) than patients who did not eliminate diabetes medications.

Weight loss impacts pre-diabetes in participants in an ongoing behavioral treatment program.

Obes 2010;18 suppl 2:S85.

Compared with patients with fasting blood glucose > 100 mg/dL at follow-up, those with glucose < 100 mg/dL lost significantly more weight (56 vs. 30 lbs), had greater decreases in TC/HDL(14.8% vs. 10.6%) and triglycerides (26.3% vs. 5.3%). Those with lower glucose discontinued 26.4% of cholesterol and blood pressure medications (vs. 16.9%) and no patients went on diabetes medications at follow-up.

Patients with Pre-diabetes Who Lose Greater Amounts of Weight Have Greater Reductions in Medical Risk Factors and Medication Use

Obes 2009;17:suppl 2:S278

Changes in medical risk factors and medication use were assessed in patients with pre-diabetes by weight change categories (> 100 lbs, 50-99 lbs, 1-49 lbs, weight gain). Although all weight loss categories had substantial health benefits, there was a dose-response relationship between weight loss and health changes with those losing the most weight having the greatest changes. The percent on diabetes medications at follow-up by weight loss category were: 0%, 1.8%, 6.3% and 10.5% respectively.

Patients with Type 2 Diabetes Who Lose Greater Amounts of Weight Have Greater Reductions in Medications and Risk Factors Compared to Those Who Lose Modest Amounts of Weight. Obes 2007;15 suppl:A97.

Patients with diabetes who lost > 20% of initial body weight (average of 89 lbs.) were 2-3 times more likely to come off insulin, oral diabetes, cholesterol and blood pressure medications compared to patients who lost 5-10% of initial weight.

Decrease in Medication Usage in Type 2 Diabetics during Very-Low-Calorie and Low-Calorie Diets. Obes 2006;14 suppl:A170
29 patients who lost weight on a very-low-calorie diet decreased daily oral diabetes medications by 57% and total daily medications by 41%.  Those patients (n = 16) who used a low-calorie diet decreased daily oral diabetes medications by 45% and total daily medications by 26%.

Weight Loss Associated with Greater Reductions in Plasma Glucose Values with Impaired Fasting Glucose than with Normoglycemic for Obese Individuals. Obes 2006;14 suppl:A167
Weight loss in obese and severely obese patients was accompanied by substantially larger improvements in cardiovascular risk factors in those with impaired fasting glucose or high normal fasting plasma glucose than with normoglycemia.

Weight management program substantially reduces risk factors for those with pre-diabetes.  Obes Res 2005;13 suppl:A83.
This study documented lifestyle changes and medical outcomes of 175 maintenance participants who entered the HMR^® program with pre-diabetes (impaired fasting plasma glucose) and continued in the maintenance phase. The average maintenance of weight loss was 47 lbs. after an average of 2.6 years. Lifestyle changes were associated with highly significant reductions in all measured medical risk factors, including fasting blood glucose, total cholesterol/HDL ratio, triglycerides, and blood pressure.

Practical office strategies for weight management of the obese diabetic individual. Endocr Pract 2004;10:153–159.
This summary article reviews strategies for enhancing lifestyle change and weight loss in the obese individual with type 2 diabetes. In particular, the strategies used in the HMR Program, such as the use of meal replacements, increased intake of vegetables and fruits, and physical activity, are included.

Obese diabetic and nondiabetic individuals lose similar amounts of weight in a medically supervised behavioral weight loss program. Obes Res 2004;12 suppl:A40.
The results of this study demonstrated that participants with type 2 diabetes can successfully participate in a medically supervised behavioral program. Patients lost an average of 18% of their body weight over a 21-week period.

Low-energy diet effects on percentage weight and body fat changes in women with and without type 2 diabetes. Obes Res 2004;12 suppl:A36.
After 16 weeks of weight loss, preliminary data indicated no significant difference in the percent weight loss between individuals with or without type 2 diabetes. Those with diabetes lost significantly less percent body fat compared to those without diabetes.

Patients at risk for type 2 diabetes substantially improve risk factors in an intensive weight management treatment program. J Am Diet Assoc 2004;104 suppl 2:A-24.
Data from 150 maintenance patients who entered the HMR program (including participation in maintenance) at risk for diabetes indicated that participants were maintaining an average weight loss of 38 lbs. or 15% of initial body weight at an average of 3 years. Only 3.4% were taking oral diabetes medications at follow-up.

Importance of weight management in type 2 diabetes: review with meta-analysis of clinical studies. J Am Coll Nutr 2003;22:331–339.
This analysis of data concluded that weight management may be the most important therapeutic task for most obese individuals with type 2 diabetes. A weight loss of 10% of initial body weight dramatically improves glycemic control and reduces lipids and blood pressure.

Rosiglitazone amplifies the benefits of lifestyle intervention measures in long-standing type 2 diabetes mellitus. Diabetes Obes Metab 2002;4:270–275.
Obese patients who had type 2 diabetes for an average of 17 years had substantial reductions in cardiovascular risk factors (such as weight, blood pressure, HbA1c, and lipids) after participating in an HMR Healthy Solutions^® program.

Patients with type 2 diabetes in weight management program have significant improvement in risk factors. Obes Res 2001;9 suppl 3:181S.
Data from 57 maintenance patients entering the program with type 2 diabetes, but not using medications, were analyzed. The average weight loss being maintained was 58 lbs. or 21% of initial body weight after an average of more than two years. There were significant changes in medical risk factors, including fasting blood glucose, total cholesterol/HDL ratio, triglycerides, and blood pressure.

Weight management program improves risk factors for diabetic patients. J Am Diet Assoc 2001;101 suppl:A-18.
Data from 65 maintenance patients who had entered with a diagnosis of type 2 diabetes found that the average weight loss being maintained was 53 lbs. or 19% of initial body weight over an average of 1.8 years.

Medication cost savings associated with weight loss for obese non-insulin-dependent diabetic men and women. Prev Med 1995;24:369–374.
Significant short-and long-term savings in prescription costs were obtained following a 12-week, 800-calorie HMR weight management program for obese individuals with type 2 diabetes.