The American Journal of Medicine

1984

DOI: 10.1016/0002-9343(84)90429-7

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Effects of caloric restriction and weight loss on glycemic control, insulin release and resistance, and atherosclerotic risk in obese patients with type II diabetes mellitus

Thomas A. Hughes

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Boyd R. Switzer

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et al.

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Cited by 164 publications

(100 citation statements)

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“…However, the fact that weight reduction in obese patients affects these atherogenic risk factors for CHD makes obesity important for the prevention of CHD [11][12][13][14][15][16] . Furthermore, data from epidemiologic investigations have provided useful insights from repeated weight determinations in population samples, assessment of pattern of obesity, and evaluation of corresponding changes in cardiovascular factors and overall cardiovascular mortality 12,16,[20][21][22] .…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have shown that weight reduction leads to an improvement of the atherogenic risk-factor profile [11][12][13][14][15][16] . However, there are few trials at workplace to test the feasibility and effectiveness of health education in controlling overweight.…”

Section: Introductionmentioning

confidence: 99%

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Relation of Body Weight Change to Changes in Atherogenic Traits. A Study of Middle-Aged Japanese Obese Male Office Workers.

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et al. 2000

INDUSTRIAL HEALTH

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Abstract:We examined the effect of body weight change on the modification of atherogenic risk factors in 296 middle-aged obese male office workers without medication for hypertension, dyslipidemia, hyperuricemia or diabetes mellitus. During a 1-year education program, 39.2% of the participants could reduce their weight, and the percentage of those who lost 2 kg or more was only 17.7%. Concomitant with the decrease of weight, however, the levels of systolic and diastolic blood pressures, total cholesterol, triglyceride, uric acid and hemoglobin A 1c and the ratio of total cholesterol to high-density lipoprotein (HDL) cholesterol decreased significantly, whereas the HDL cholesterol level increased significantly. In a multivariate regression analysis, in addition to the initial risk-factor level, weight change was an important factor determining the changes in atherogenic risk factors. Changes in alcohol consumption were significantly associated with the changes in systolic blood pressure and HDL cholesterol levels. Changes in cigarettes smoking also showed significant associations with the changes in triglyceride level and the ratio of total cholesterol to HDL cholesterol. These results suggest that although the education program for controlling weight may have limited success, weight reduction exhibits beneficial changes in the atherogenic risk-factor profile in middle-aged obese men.

“…However, the fact that weight reduction in obese patients affects these atherogenic risk factors for CHD makes obesity important for the prevention of CHD [11][12][13][14][15][16] . Furthermore, data from epidemiologic investigations have provided useful insights from repeated weight determinations in population samples, assessment of pattern of obesity, and evaluation of corresponding changes in cardiovascular factors and overall cardiovascular mortality 12,16,[20][21][22] .…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have shown that weight reduction leads to an improvement of the atherogenic risk-factor profile [11][12][13][14][15][16] . However, there are few trials at workplace to test the feasibility and effectiveness of health education in controlling overweight.…”

Section: Introductionmentioning

confidence: 99%

Relation of Body Weight Change to Changes in Atherogenic Traits. A Study of Middle-Aged Japanese Obese Male Office Workers.

¹

,

²

,

et al. 2000

INDUSTRIAL HEALTH

View full text Add to dashboard Cite

Abstract:We examined the effect of body weight change on the modification of atherogenic risk factors in 296 middle-aged obese male office workers without medication for hypertension, dyslipidemia, hyperuricemia or diabetes mellitus. During a 1-year education program, 39.2% of the participants could reduce their weight, and the percentage of those who lost 2 kg or more was only 17.7%. Concomitant with the decrease of weight, however, the levels of systolic and diastolic blood pressures, total cholesterol, triglyceride, uric acid and hemoglobin A 1c and the ratio of total cholesterol to high-density lipoprotein (HDL) cholesterol decreased significantly, whereas the HDL cholesterol level increased significantly. In a multivariate regression analysis, in addition to the initial risk-factor level, weight change was an important factor determining the changes in atherogenic risk factors. Changes in alcohol consumption were significantly associated with the changes in systolic blood pressure and HDL cholesterol levels. Changes in cigarettes smoking also showed significant associations with the changes in triglyceride level and the ratio of total cholesterol to HDL cholesterol. These results suggest that although the education program for controlling weight may have limited success, weight reduction exhibits beneficial changes in the atherogenic risk-factor profile in middle-aged obese men.

“…Shortterm studies have demonstrated that weight loss in overweight or obese type 2 diabetic subjects is associated with decreased insulin resistance, improved measures of glycemic control, reduced lipemia, and reduced blood pressure (2)(3)(4). However, the most recent American Diabetes Association nutrition recommendations concluded that "optimal strategies for preventing and treating obesity long term have yet to be defined" (5).…”

mentioning

confidence: 99%

Two-Year Outcome of a Combination of Weight Loss Therapies for Type 2 Diabetes

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²

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et al. 2005

Diabetes Care

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OBJECTIVE -To evaluate the effects over 2 years of a weight loss program combining several weight loss strategies on weight loss and diabetes control in overweight subjects with type 2 diabetes. RESEARCH DESIGN AND METHODS-A total of 59 overweight or obese individuals with type 2 diabetes were randomly assigned to either a combination therapy weight loss program for 2 years (C therapy) or a standard therapy weight loss program for 1 year followed by a combination therapy weight loss program in the 2nd year (S/C therapy). C therapy combined the use of meal replacement products, repetitive intermittent low-calorie-diet weeks, and pharmacologic therapy with sibutramine. Outcome measures included changes in weight, glycemic control, plasma lipids, blood pressure, and body composition over 2 years.RESULTS -A total of 48 participants (23 in the C therapy group and 25 in the S/C therapy group) completed 2 years of study. After 2 years, the C therapy group had weight loss of 4.6 Ϯ 1.2 kg (P Ͻ 0.001) and a decrease in HbA 1c of 0.5 Ϯ 0.3% (P ϭ 0.08) from baseline. At 2 years, the C therapy group had significant reductions in BMI, fat mass, lean body mass, and systolic blood pressure. The S/C therapy group showed changes in weight and HbA 1c in year 2 of the study that were similar to those demonstrated by the C therapy group in year 1.CONCLUSIONS -This combination weight loss program resulted in significant weight loss and improved diabetes control over a 2-year period in overweight subjects with type 2 diabetes. Diabetes Care 28:1311-1315, 2005W eight loss is an important therapeutic objective for individuals with type 2 diabetes (1). Shortterm studies have demonstrated that weight loss in overweight or obese type 2 diabetic subjects is associated with decreased insulin resistance, improved measures of glycemic control, reduced lipemia, and reduced blood pressure (2-4). However, the most recent American Diabetes Association nutrition recommendations concluded that "optimal strategies for preventing and treating obesity long term have yet to be defined" (5).Long-term options to promote weight loss in people with type 2 diabetes include standard weight-reduction diets and very-low-calorie diets. However, standard weight-reduction diets are usually not effective (5). Very-low-calorie diets produce substantial initial weight loss but do not maintain weight loss long term (6).Other approaches to weight loss that might be effective in type 2 diabetic subjects include use of meal replacements, repetitive use of low-calorie diets, and weight loss medications. Hensrud (7) reported significant weight loss at 3 months using meal replacements in type 2 diabetic subjects, but weight and measures of glycemic control trended toward baseline values at 1 year. Williams et al. (8) compared a standard diet to very-low-calorie diets used either 1 day per week or 5 consecutive days every 5 weeks in type 2 diabetic subjects. After 15 weeks, the verylow-calorie diet groups lost 9.6 and 10.4 kg, respectively, compared with weight loss of 5.4 k...

“…Weight loss may be the single most important therapeutic objective for such individuals (2). Short-term studies lasting 6 months or less have demonstrated that weight loss in overweight or obese type 2 diabetic subjects is associated with decreased insulin resistance, substantial improvements in measures of glycemic control, reduced lipemia, and reduced blood pressure (3)(4)(5). However, long-term data substantiating that these improvements can be maintained are limited.…”

mentioning

confidence: 99%

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

¹

,

²

,

³

et al. 2003

Diabetes Care

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OBJECTIVE -The purpose of this study was to evaluate the effects of a combination weight loss program using intermittent low-calorie diets, energy-controlled meal replacement products, and sibutramine on weight loss, diabetes control, and cardiovascular risk factors in overweight or obese subjects with type 2 diabetes.RESEARCH DESIGN AND METHODS -Overweight or obese individuals with type 2 diabetes treated with diet or oral medication were randomly assigned to either a standard therapy or combination therapy group. Both groups received a standardized program to facilitate weight loss. The combination therapy group also received 10 -15 mg sibutramine daily, low-calorie diets using meal replacement products for 1 week every 2 months, and between low-calorie diet weeks, once daily use of meal replacement product and snack bars to replace one usual meal and snack. Primary outcome measures were changes in body weight, glycemic control, plasma lipids, blood pressure, pulse, and body composition at 1 year.RESULTS -At 1 year, combination therapy, compared with standard therapy, resulted in significantly more weight loss (Ϫ7.3 Ϯ 1.3 kg vs. Ϫ0.8 Ϯ 0.9 kg, P Ͻ 0.001) and reduction in HbA 1c (Ϫ0.6 Ϯ 0.3 vs. 0.0 Ϯ 0.2%, P ϭ 0.05). Combination therapy resulted in reduced requirement for diabetes medications and decreased fat mass and lean body mass. A 5-kg decrease in weight at 1 year was associated with a decrease of 0.4% in HbA 1c (P ϭ 0.006). Changes in fasting glucose, lipids, pulse, and blood pressure did not differ between groups.CONCLUSIONS -This combination weight loss program resulted in greater weight loss and improved diabetes control compared with a standard weight loss program in overweight or obese subjects with type 2 diabetes.

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