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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.
Grant L, Gotthelf L.
Obes 2007;15 suppl:A97.
Objectives: Type 2 diabetes is increasing rapidly along with the epidemic rise in obesity. Studies have found that modest lifestyle changes can positively impact the course of diabetes and co-morbid conditions. The purpose of this study was to compare medications, medical risk factors, and lifestyle behaviors for patients with Type 2 diabetes who lost modest amounts of weight (5-10% of initial body weight) with those who lost larger amounts of weight (> 20%).
Subjects: Patients on medications for Type 2 diabetes who entered the HMR® Program for Weight ManagementTM and completed a follow-up health risk appraisal from January, 2005 to April, 2007, were analyzed.
Programs: HMR offers a range of weight-loss treatment options, including medically supervised low and very low-calorie diets, moderately restricted diets and phone-based programs as well as long-term maintenance. The program is based on measurable, evidence-based variables allowing for specific goals to be set and compliance to be tracked. All options for weight loss and maintenance focus on the same lifestyle changes: increased physical activity (> 2000 kcal/wk); use of meal replacements (> 35/wk in weight loss and 14/wk in maintenance); increased vegetable and fruit intake (> 35/wk) is included in some weight-loss options and in maintenance.
Results:
|
Measure
|
5-10%
Weight Loss
|
> 20%
Weight Loss
|
| Number of Patients |
46
|
68
|
| Start Weight |
271 lbs.
|
296 lbs.
|
| Weight Loss |
–20 lbs. (7.4%)
|
–89 lbs. (30.1%)
|
| Total Cholesterol/HDL |
–5.4%
|
–17.8%
|
| Triglycerides |
–3.9%
|
–45%
|
| Systolic Blood Pressure |
–4 mmHg
|
–11 mmHg
|
| Diastolic Blood Pressure |
–1 mmHg
|
–4 mmHg
|
| Fasting Blood Glucose |
–5.4%
|
–23.4%
|
| Off Oral Diabetes Meds |
27.9%
|
61.9%
|
| Off Insulin |
33.3%
|
78.6%
|
| Off Cholesterol Meds |
20.7%
|
37.8%
|
| Off Blood Pressure Meds |
15.2%
|
37.7%
|
Conclusions: These data do not reflect the reduction in medication dosages, thereby underestimating the full impact of weight loss on medications for this population. In summary, modest weight loss has a positive impact on those with Type 2 diabetes in terms of medication and medical risk factor reduction. Those losing larger amounts of weight experience even greater reductions in medication and medical risk factors.
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