One-Year Outcome of a Combination of Weight Loss Therapies for Subjects With Type 2 Diabetes: A Randomized Trial

Redmon JB, Raatz SK, Reck KP, Swanson JE, Kwong CA, Fan Q, Thomas W, Bantle JP. Diabetes Care. 2003;26(9):2505-2511.

Objective

To determine whether a combination weight loss program using 1) intermittent low-calorie diets comprised of Slim•Fast meal replacement only, 2) use of Slim-Fast to replace one meal and one snack daily between intermittent low-calorie diet periods, and 3) sibutramine would result in long-term weight loss and help improve glycemic control and cardiovascular risk factors in overweight or obese individuals with type 2 diabetes.

Methods

In this study, 61 overweight or obese individuals with type 2 diabetes were randomized to either a standard therapy or a combination therapy. Subjects in both groups received individual counseling by a registered dietitian. Subjects also received an individualized exercise prescription that included walking at least 30 minutes per day 3 times a week in addition to usual daily activity. Subjects in the combination therapy group, who after 6 months had a BMI >27, received the following additional interventions: 1)10-15 mg sibutramine, 2) low-calorie diet providing 900-1300 calories per day comprised of Slim•Fast Ready-To-Drink shakes or meal bars for 7 consecutive days, and 3) between low-calorie diet weeks, use of one Slim•Fast meal replacement and one snack bar daily to replace one usual meal.

Results

Fifty-four out of the 61 subjects completed the study. At one year, 28 subjects had changes in their diabetes medications. Sixteen subjects in the standard therapy group (59%) and 4 subjects in the combination therapy group (15%) were taking more diabetes medications, whereas one subject in the standard therapy group (4%) and 7 subjects in the combination group (26%) were taking less medications (p= 0.01). At 12 months, weight loss was 0.8 +/- 0.9 kg in the standard therapy group, and 7.3 +/- 1.3 kg in the combinations group (p<0.001). Decreases in BMI, fat mass, and lean body mass at one year were all significantly greater in the combination therapy group than in the standard therapy group.

Conclusion

combination therapy approach of intermittent low-calorie diets, Slim•Fast meal replacements and sibutramine has beneficial effects on weight loss and glycemic control in overweight or obese individuals with type 2 diabetes, and is simple and easy to follow.

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