In a statement released today by Joslin Diabetes Center in Boston, physicians at the Harvard Medical School-affiliated research and clinical care center strongly disagreed with comments made recently by Richard Kahn, M.D., a former executive of the American Diabetes Association.
At a briefing held on Tuesday for public health advocates and diabetes researchers by the journal Health Affairs, entitled "Confronting the Growing Diabetes Crisis," Dr. Kahn stated that even though weight loss can prevent or delay the onset of diabetes, the failure of patients to maintain weight loss beyond an average of four years makes diabetes prevention programs a "waste of resources" and the health system should focus instead on reducing the likelihood of complications once patients have been diagnosed with diabetes.
In response, Osama Hamdy, M.D., Ph. D., Medical Director of the Obesity Clinical Program at Joslin Diabetes Center and Assistant Professor of Medicine at Harvard Medical School stated, "Saying that physicians should stand by and allow patients to proceed to a diagnosis of diabetes is a disservice to patients and constitutes a surrender in the face of one of the greatest threats to public health the world faces today.
"Everyone who has ever struggled with reducing and controlling their weight knows how difficult that is. And they recognize that maintaining a healthy weight is not a one-time victory but rather a lifelong battle. That does not constitute failure but a recognition that they will have to make a continuing and often renewed commitment.
"Joslin's experience with innovative weight management programs at Joslin is showing that patients can maintain healthy weight levels well past four years. Our findings showed that people who initially lost weight, collectively maintained a weight loss of 7.6% of their initial body weight at three years in clinical practice. At least 50% did not gain more than five lbs at four years. They reduced diabetes medication by around 50% at the end of the program and saved 44% on diabetes related cost and 27% on the total health care cost. Eighty two percent achieved the target glucose control set by the ADA by the end of the weight loss program, and those who maintained the weight loss were able to maintain their excellent diabetes control for three years. The improved quality of life is worth every penny invested in weight loss."
"There is a legacy for the initial weight loss even if people cannot maintain it," added Edward S. Horton, M.D., Professor of Medicine at Harvard Medical School, past President of the American Diabetes Association and one of the investigators in the Diabetes Prevention Program and Look AHEAD study. "The 10-year follow up of the patients who completed the diabetes prevention program showed that people who initially lost weight continued to develop diabetes at a lower rate over 10 years than those who did not lose weight, even if they gained part of that weight back."
"Diabetes prevention through lifestyle intervention works among different cultures as shown in many big trials in the US, Europe and Asia," added Enrique Caballero, M.D., Assistant Professor of Medicine at Harvard Medical School and one of the co-investigators of the Diabetes Prevention Program. "Not having a full answer on what to do in the long term does not mean that efforts to identify these strategies and translate them to clinical practice model should be abandoned," he added.
Obesity and weight management are among Joslin's broad range of research and clinical care initiatives in basic research, clinical research and clinical care. The work of Joslin researchers and clinicians has produced a number of significant discoveries and innovations that have been reported in peer-reviewed journals, including the discovery of brown fat in adults and the development of a series of clinically proven weight management programs.
Martin Abrahamson, M.D., Chief Medical Officer at Joslin Diabetes Center and an Associate Professor of Medicine at Harvard Medical School, added "Since we know which weight management programs will work in the fight against obesity, the challenge is to find ways to implement them in communities, which we at Joslin are working hard to do."
Joslin Diabetes Center, news release 3-8-2012 Joslin Diabetes Center Champions Diabetes Prevention