Issue 181 Item 13 Weight Management a Therapeutic Priority for Individuals with

Weight management may be the most important therapy for obese individuals with type 2 diabetes, according to a recent American review.

Obesity and weight gain are important risk factors for the development of diabetes and can significantly influence the outcome for those already diagnosed with the disease. Obesity is also a known risk factor for coronary heart disease (CHD), which is responsible for 70% to 80% of deaths in diabetics.

“Unfortunately, most pharmacologic approaches for diabetes contribute to weight gain, as does intensive therapy,” writes James W. Anderson, MD, of the University of Kentucky, Lexington. This observation has led to the proposal that weight management should receive a higher priority in the management of diabetes in obese individuals.

Dr. Anderson and colleagues reviewed medical literature to determine the impact of obesity on the risk for diabetes and CHD. In addition, they performed a meta-analysis of 15 reports providing data for 342 obese diabetic subjects to assess the benefits of weight loss.

According to the reviewers, studies spanning diverse populations show that obesity can increase the risk for diabetes by 90-fold. Furthermore, obesity can increase the risk for CHD by 6-fold, and diabetes is an independent risk factor for CHD.

The meta-analysis revealed that obese individuals with type 2 diabetes experienced a 9.6% decrease in body weight and 25.7% decrease in fasting plasma glucose after 12 weeks on a restricted energy diet. Other cardiovascular risk factors were also improved; LDL and HDL cholesterol decreased by 11.0% and 9.2%, respectively, triglycerides decreased by 26.7%, systolic blood pressure decreased by 8.1 %, and diastolic blood pressure decreased by 8.6%.

“For many obese diabetic individuals, an emphasis on weight management may be the most important therapeutic task,” the researchers conclude, supporting recommendations that diabetics achieve and maintain a BMI of
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FACT: After adjusting for age, more blacks with and without diabetes (11 percent compared to 4 percent) reported having had a stroke than either whites (8 percent compared to 3 percent) or Hispanics (8 percent compared to 2 percent). CDC November 2003
Diabetes is often preventable. Results from the Diabetes Prevention Program clinical trials indicated that with improved diet, modest weight loss, and increased physical activity, diabetes can be prevented or delayed among adults at high risk of developing the disease. To see the latest report, please visit https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5244a2.htm.