Comparison of Obese NIDDM and Nondiabetic Women: Short‐ and Long‐Term Weight Loss

Guare, John; Wing, Rena R.; Grant, Aedamar

doi:10.1002/j.1550-8528.1995.tb00158.x

Cited by 107 publications

(78 citation statements)

References 29 publications

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“…Prior studies of weight management programs for adults with diabetes 10,19 show that weight regain is common during a 1-year follow-up period; we found that more than one in six middle-aged adults with diabetes experienced weight loss and regain over 10 years.…”

Section: Discussionmentioning

confidence: 48%

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BMI Change Patterns and Disability Development of Middle-aged Adults with Diabetes: A Dual Trajectory Modeling Approach

Chiu

Wray

et al. 2013

J GEN INTERN MED

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BACKGROUND: Few longitudinal studies have examined associations between body mass index (BMI) changes in adults with diabetes and the development of disability. OBJECTIVE: To investigate association patterns between BMI and disability in middle-aged adults with diabetes. DESIGN AND SETTING: Retrospective cohort design with data from the 1992-2006 Health and Retirement Study (HRS). A group-based joint trajectory method identified distinct BMI change trajectories and their link to subsequent disability trajectories. PARTICIPANTS: U.S. nationally representative adults aged 51-61 who reported a diagnosis of diabetes in the 1992 HRS (N=1,064). MEASUREMENTS: BMI and self-reported disability score were the main variables. Sociodemographic, clinical, behavioral, and diabetes-related factors were also examined. RESULTS: Four distinct weight trajectories (stable normal weight, 28.7 %; stable overweight, 46.2 %; loss and regain obese, 18.0 %; weight cumulating morbidly obese, 7.1 %) and three disability trajectories (little or low increase, 34.4 %; moderate increase, 45.4 %; chronic high increase, 20.2 %) best characterized the long-term patterns of BMI and disability change in middle-aged adults with diabetes. Adults in stable normal weight had the highest probability of being in the little/low increase disability group; however, one in five adults in that group progressed into chronic high disability, a higher proportion compared to the stable overweight group. CONCLUSIONS: Although there were various ways in which the two trajectories were linked, the beneficial impacts of optimizing weight in adults with diabetes were supported. In addition, the complexity of diabetes control in those with relatively normal weight was highlighted from this study.

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Section: Discussionmentioning

confidence: 48%

“…8,9 However, these studies are limited by relatively short periods of follow-up (1 and 3 years, respectively); thus, weight fluctuations 10 may not be well-detected. In addition, use of medical records rather than population-based data may not capture variations in demographically and geographically heterogeneous adults with diabetes.…”

mentioning

confidence: 99%

BMI Change Patterns and Disability Development of Middle-aged Adults with Diabetes: A Dual Trajectory Modeling Approach

Chiu

Wray

et al. 2013

J GEN INTERN MED

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“…Although only moderate weight loss (5-10% of bodyweight) is required to improve glycaemic control, weight loss and maintenance of weight loss in patients with type 2 diabetes are generally more difficult than in non-diabetic individuals. 8,43 Furthermore, most antidiabetic medications (in particular sulphonylureas, thiazolidinediones, and insulin) produce concomitant weight gain. 5,31,44 In this study, a mean weight loss of 6·1 kg was noted in patients who completed the 1-year treatment with 20 mg/day rimonabant, much the same as that described in the Diabetes Prevention Program (DPP), 45 in which patients were treated with an intensive lifestyle intervention.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and tolerability of rimonabant in overweight or obese patients with type 2 diabetes: a randomised controlled study

et al. 2006

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SummaryBackground Rimonabant, a selective cannabinoid type 1 receptor blocker, reduces bodyweight and improves cardiovascular and metabolic risk factors in non-diabetic overweight or obese patients. The aim of the RIODiabetes trial was to assess the efficacy and safety of rimonabant in overweight or obese patients with type 2 diabetes that was inadequately controlled by metformin or sulphonylureas. Methods 1047 overweight or obese type 2 diabetes patients (body-mass index 27-40 kg/m 2 ) with a haemoglobin A 1c (HbA 1c ) concentration of 6•5-10•0% (mean 7•3% [SD 0•9] at baseline) already on metformin or sulphonylurea monotherapy were given a mild hypocaloric diet and advice for increased physical activity, and randomly assigned placebo (n=348), 5 mg/day rimonabant (360) or 20 mg/day rimonabant (339) for 1 year. Two individuals in the 5 mg/day group did not receive double-blind treatment and were thus not included in the final analysis. The primary endpoint was weight change from baseline after 1 year of treatment. Analyses were done on an intention-to-treat basis. This trial is registered at ClinicalTrials.gov, number NCT00029848. Findings 692 patients completed the 1 year follow-up; numbers in each group after 1 year were much the same. Rimonabant was generally well tolerated. The incidence of adverse events that led to discontinuation was slightly greater in the 20 mg/day rimonabant group, mainly due to depressed mood disorders, nausea, and dizziness. Interpretation These data indicate that 20 mg/day rimonabant, in combination with diet and exercise, can produce a clinically meaningful reduction in bodyweight and improve HbA 1c and a number of cardiovascular and metabolic risk factors in overweight or obese patients with type 2 diabetes inadequately controlled by metformin or sulphonylureas.

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“…27,28 Thus, pharmacological support for weight loss may be particularly appropriate in the diabetic population. Subjects were predominantly normotensive and normolipidemic at baseline.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of topiramate in combination with metformin in the treatment of obese subjects with type 2 diabetes: a randomized, double-blind, placebo-controlled study

Toplak

Hamann

Moore³

et al. 2006

Int J Obes

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Objective: To investigate the efficacy and safety of topiramate in obese subjects with type 2 diabetes treated with metformin. Design: This was a multicenter, double-blind, placebo-controlled trial. All subjects received a non-pharmacological program of diet, exercise and behavioral modification throughout the study; the assigned diet was 600 kcal/day less than the subject's individually calculated energy expenditure. After a 6-week single-blind placebo run-in, subjects were randomized to placebo, topiramate 96 mg/day or topiramate 192 mg/day. Following an 8-week titration period, subjects remained on their assigned dose for 52 weeks. However, the sponsor ended the study early in order to develop a new controlled-release formulation with the potential to enhance tolerability and simplify dosing in this patient population. A total of 646 obese men and women (age: 18-75 years, body mass index: 27-50 kg/m 2 ) with an established history of type 2 diabetes mellitus controlled by metformin monotherapy were randomized. Efficacy was assessed in a pre-determined modified intent-to-treat (MITT) population of 307 subjects whose randomization date would have allowed them to complete 24 weeks on study medication before the announcement of study termination. Measurements: Joint primary efficacy parameters were mean percent change in weight and change in glycosylated hemoglobin (HbA 1c ) from baseline to week 24. Results: Subjects in the placebo, topiramate 96 mg/day and topiramate 192 mg/day groups lost 1.7%, 4.5% (Po0.001) and 6.5% (Po0.001), respectively, of their baseline body weight and had absolute decreases in HbA 1c of 0.1%, 0.4% (Po0.001) and 0.6% (Po0.001) (MITT, last observation carried forward). Topiramate-treated subjects also experienced statistically significant decreases in systolic blood pressure. Most common adverse events were paresthesia and events related to the central nervous system. Conclusions: Topiramate was effective for weight reduction and improvement in glycemic control in obese subjects with type 2 diabetes treated with metformin monotherapy. Further study in obese diabetics is warranted.

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Comparison of Obese NIDDM and Nondiabetic Women: Short‐ and Long‐Term Weight Loss

Cited by 107 publications

References 29 publications

BMI Change Patterns and Disability Development of Middle-aged Adults with Diabetes: A Dual Trajectory Modeling Approach

BMI Change Patterns and Disability Development of Middle-aged Adults with Diabetes: A Dual Trajectory Modeling Approach

Efficacy and tolerability of rimonabant in overweight or obese patients with type 2 diabetes: a randomised controlled study

Efficacy and safety of topiramate in combination with metformin in the treatment of obese subjects with type 2 diabetes: a randomized, double-blind, placebo-controlled study

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