Weight Loss After Diabetes Diagnosis Improves Outcomes

Newly diagnosed type 2 diabetics who lose weight soon after their diagnosis gain better control of their blood pressure and blood sugar, a benefit that lasts even if they regain that weight. Gregory A. Nichols, co-author of new research published online Aug. 12 in the journal Diabetes Care., stated that, "If you lose weight after diagnosis, you can achieve some long-term benefits in terms of blood pressure and glycemic control that extend even beyond the point at which you regain weight."

Added Dr. Spyros Mezitis, an endocrinologist with Lenox Hill Hospital in New York City: "We haven’t had results like this before. This is telling us that with a significant mean weight loss of 10.7 kilograms [23.5 pounds] in 18 months, there’s an improvement despite weight regain after 36 months."

More than 20 million Americans now have type 2 diabetes, and the majority are either overweight or obese.

Studies have shown that weight loss is important to maintain blood-sugar and blood-pressure control, as well as to keep cholesterol levels in check. These parameters, in turn, are critical for avoiding the long-term complications of diabetes, such as heart disease, blindness, kidney damage, amputations and even death.

Nichols, an investigator with the Kaiser Permanente Center for Health Research in Portland, Ore., and his team looked at electronic medical records, spanning 1997 to 2002, for 2,574 patients aged 21 through 75 who had been recently diagnosed with type 2 diabetes. The participants were grouped into weight loss categories and followed for four years.

Just over 12 percent of the participants were in the "weight loss" group, with a mean weight loss of more than 25 pounds. Almost all of those pounds were regained by 36 months. The other groups were labeled as "higher stable weight," "lower stable weight" or "weight gain."

Patients who lost weight were more likely to reach blood pressure and blood sugar targets during the fourth year, although, by then, they had regained the weight.

The researchers acknowledged, however, that they don’t know what happens after the four-year mark, and they don’t know why the benefit was sustained. "It’s entirely possible that one of the explanations here is that if we looked at 15 years, we wouldn’t find that benefit continuing," Nichols said.

Whatever the final answers, "losing weight is a good idea, even if you regain it," Nichols said.

Gregory A. Nichols, Ph.D., investigator, Kaiser Permanente Center for Health Research, Portland, Ore.; Spyros Mezitis, M.D., Ph.D., endocrinologist, Lenox Hill Hospital, New York City; Aug. 12, 2008,Diabetes Care, online

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DID YOU KNOW: 

Oral insulin capsule safe and effective: An oral insulin capsule for the treatment of type 2 diabetes lowered glucose levels and C peptide, according to the findings from a phase-2A trial. The researchers conducted a study on the effect of an orally administered insulin capsule (ORMD 0801, Oramed Pharmaceuticals) on patients with type 2 diabetes. “ORMD 0801 had a good safety profile, and it was well tolerated by 100% of the patients; no serious adverse events were encountered throughout the study,” Nadav Kidron, CEO of Oramed, said. There was statistically significant response from 66% of the patients in the study, according to Kidron. “The capsule was absorbed through the gastrointestinal wall and achieved its biological effects by reducing blood glucose in patients with type 2 diabetes,” he said. Oramed will conduct more phase-2 trials, commencing by the first quarter 2009, and will meet with the FDA in about one year.

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