joslin diabetes centre

Weight Loss Helps Obese People with Type 2 Diabetes Combat Health Problems

by Barbara Hewitt on January 10, 2017

Even if it’s just a few pounds, losing weight can help obese people with type 2 diabetes reduce their risk of heart disease and manage their insulin levels better, new research from the Joslin Diabetes Centre in Boston, United States has found. And those who can achieve a 7% weight loss after a year are more likely to benefit and also keep the weight off.

The study followed 129 people taking part in the centre’s Weight Achievement and Intensive Management (WAIT) programme. The participants had an average body mass index (BMI) of 38, were regarded as obese, and showed an average loss of body weight of 9.7% after an initial 12 weeks and maintained an average loss of 6.4% after five years.

appetite-obesity‘This weight loss was very impressive, since we know from previous research that if this population can maintain a 7% weight loss, they show a marked improvement in insulin sensitivity and many other cardiovascular risk factors,’ said Osama Hamdy, medical director of Joslin’s obesity clinical program and assistant professor of medicine at Harvard Medical School.

‘To the best of our knowledge, this is the longest follow-up in the real world of clinical practice to show encouraging results that weight loss can be achieved and maintained,’ he added.

The researchers divided the participants into two groups, depending on whether they reached that level of weight loss or not after a year. The group that didn’t achieve this goal saw an average weight loss of 3.5% after five years, while the second group, some 53% of participants, maintained an average loss of 9%.

The higher weight loss group saw average A1C levels drop from 7.4% to 6.4% at 12 weeks and then slowly climb to 7.3% over the five year period. In the lower weight loss group, results were not so positive, as average A1C decreased from 7.5% to 6.7% at 12 weeks and then rose to 8% at five years.

These A1C trends were reflected in patient use of insulin and drugs that help maintain control of blood glucose levels, blood pressure and cholesterol level. Prescriptions of these medications increased significantly among lower weight loss participants, but either did not change or dropped in the higher weight loss group after five years.

However, the lower weight loss group maintained better LDL (bad cholesterol) and HDL (good cholesterol) levels over five years, and participants’ average blood pressure remained unchanged during that time.

The higher weight loss group also maintained improvements in their LDL and HDL levels over the length of the study. Additionally, these participants showed lower blood pressure at 18 months, although blood pressure returned to baseline levels after five years.

Hamdy pointed out that obese people with type 2 diabetes generally continue to gain weight over time, increasing their risks of cardiovascular damage – if they do not do something about their lifestyle.

‘This programme is giving hope to many people with diabetes that there is something that works for weight loss and can work for a long time. People can maintain their weight loss, and their big benefits in cardiovascular risk factors and diabetes control,’ he concluded.

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