Two-Year Outcome of a Combination of Weight Loss Therapies for Type 2 Diabetes

Redmon JB, Reck KP, Raatz SK, Swanson JE, Kwong CA, Ji H, Thomas W, Bantle JP Diabetes Care. 2005;28(6):1311-1315.

Objective

To evaluate the effects of a weight loss program that combined several weight loss strategies in overweight or obese people with type 2 diabetes.

Methods

A total of 59 subjects were randomized to follow the combination therapy weight loss program for 2 years (C therapy), or a standard weight loss program for 1 year followed by the combination therapy weight loss program for 1 year (S/C therapy control group). The C therapy intervention consisted of calorie-controlled meal replacement products (Slim•Fast®), repetitive intermittent low-calorie diet weeks, and pharmacologic therapy with sibutramine. Subjects in both groups received individual counseling by a registered dietitian and an individualized exercise prescription that included, at minimum, walking for 30 minutes, 3 times weekly added to usual activity.

Results

A total of 48 patients completed the study, including 23 in the C therapy group and 25 in the S/C therapy control group. At follow up, subjects in the C therapy group had a weight loss of 4.6 kg (10.1lbs.) +/- 1.2 kg (P<0.001), as well as reductions in HbA1c, body mass index (BMI), fat mass, lean body mass and systolic blood pressure. Little weight loss occurred in the S/C therapy control group in the first year of standard therapy, but by the end of year 2, reductions in HbA1c and weight loss were similar to those seen in the intervention group.

Conclusion

The use of daily meal replacements as part of a combination of treatments was effective in helping overweight and obese people with type 2 diabetes achieve and maintain significant weight loss over 2 years, which was accompanied by an improvement in diabetes control. The intervention was simple for the subjects to understand and follow. For people with type 2 diabetes, a weight loss at 2 years of 4-5 kg (9-11 lbs.) or about 4% of starting body weight, can produce improvements in diabetes control that are likely to be clinically significant.

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