The Comparison of Four Weight Reduction Strategies Aimed at Overweight Diabetic Patients

Manning, R. M.; Jung, R. T.; Leese, Graham; Newton, R. W.

doi:10.1111/j.1464-5491.1995.tb00504.x

Cited by 33 publications

(27 citation statements)

References 19 publications

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“…75 When compared to dietetic consultations alone, there was a statistically signi®cant between group difference, mean weight change: 73.40 kg vs 71.59 respectively, at 3 months. By the end of the one year intervention no signi®cant differences were seen between groups.…”

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confidence: 86%

Review: The treatment and prevention of obesity: a systematic review of the literature

et al. 1997

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OBJECTIVE: To determine the effectiveness of interventions designed to prevent and treat obesity, and maintain weight loss. DESIGN: A systematic review of randomised controlled trials. SUBJECTS: Overweight and obese adults and children. MEASUREMENTS: Post-intervention changes in weight, fat content and fat distribution, measured relative to baseline. RESULTS: For obese children, family therapy and lifestyle modi®cation appear to be effective in prevention and treatment, respectively. The effectiveness of interventions to prevent and treat obesity in adults remains unclear, although behavioural therapy and multicomponent strategies may be useful. Continued therapist contact appears to be useful for maintaining weight loss. Pharmacological interventions appear to be effective for up to 9 months, after which regain occurs. Surgery appears to be effective for the morbidly obese and gastric bypass is more effective than gastroplasty. In general, the methodological quality of studies was poor. CONCLUSION: Due to problems with methodological quality, it is recommended that research ®ndings indicative of promising interventions are replicated.

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confidence: 86%

Review: The treatment and prevention of obesity: a systematic review of the literature

et al. 1997

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“…Weight loss due to successful treatment Promoting long-term weight loss in type 2 diabetic patients is difficult [29,30]. Even in successful intensive behaviourmodification programmes a pattern of weight regain is the predominant outcome [31,32], and diabetic patients demonstrate even poorer weight loss maintenance than their nondiabetic peers [33].…”

Section: Weight Loss Due To Calorie Loss In Glucosuriamentioning

confidence: 99%

Changes in patient weight and the impact of antidiabetic therapy during the first 5 years after diagnosis of diabetes mellitus

et al. 2006

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Aims/hypothesis It is generally thought difficult for type 2 diabetic patients to lose weight. We monitored changes in patients' weight during the first 5 years after diabetes diagnosis in relation to initiation of antidiabetic treatment. Subjects and methods Data from 711 newly diagnosed diabetic patients aged 40 or over were analysed with a random-effect linear-regression model. Patients were included consecutively from a well-defined patient list in general practice. Results In 245 patients whose only treatment was advice on diet, an initial weight loss of 6 to 7 kg was largely maintained over 5 years. Patients receiving metformin (n=86) or sulfonylureas (n=330) maintained an average weight loss of 2 to 4 kg that was dependent on age and sex. Patients' weight did not change on initiation of treatment with sulfonylureas or metformin. Over 5 years, median HbA 1c increased from 7.0 to 7.8% (reference range 5.4-7.4%) in the diet-alone group. HbA 1c was approximately 1 percentage point higher for most of the other treatment groups. Conclusions/interpretation In newly diagnosed type 2 diabetic patients, long-term weight loss was common and weight loss was not affected by sulfonylurea treatment. The measurements in the study are taken from treatment results achieved in the general population of diabetic patients, who are rarely treated in secondary care and seldom the subject of research; the results thus indicate that weight reduction is a practicable treatment in diabetic patients.

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“…In most cases, high doses of hypoglycemic drugs and statins or fibrates are required, and it is usually difficult to regulate metabolic parameters. Modification of dietary habits and subsequent weight loss can improve glycemic control, insulin level, and lipid profile findings (3,4); however, unfortunately, diet restriction alone usually does not lead to adequate weight loss (3,5,6).…”

Section: Diabetes Care 24:1957-1960 2001mentioning

confidence: 99%

“…Nonpharmacological treatment modalities, such as weight loss and increased physical activity, represent the basis of treatment for obese patients with this disease. The efficacy of these approaches has been demonstrated by numerous studies and was summarized in recent reviews (16,17); however, adequate weight loss is seldom attained with diet therapy alone (3,5,6).…”

Section: Research Design Andmentioning

confidence: 99%

Effects of Sibutramine in Obese Female Subjects With Type 2 Diabetes and Poor Blood Glucose Control

et al. 2001

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OBJECTIVE -In this study, we evaluated the efficacy of sibutramine in combination with hypoglycemic drugs in obese type 2 diabetic women whose glucose levels were poorly regulated.RESEARCH DESIGN AND METHODS -Female patients with type 2 diabetes, poorly controlled glucose levels, and HbA 1c Ͼ8% were randomly assigned to one of two groups. In addition to their prescribed hypoglycemic agents (maximum doses of sulfonylureas and metformin), one group (n ϭ 30) received a placebo twice daily for 6 months and the other (n ϭ 30) received sibutramine 10 mg b.i.d. for the same period.RESULTS -One patient in the sibutramine group was excluded during the study period because of hypertension; thus, a total of 29 data sets were analyzed for this group. In the placebo group, five patients had to be excluded because of low treatment efficacy, leaving a total of 25 who completed the study. Comparing the changes that occurred over 6 months in the sibutramine and placebo groups, the former showed significantly greater reductions in fasting blood glucose (P Ͻ 0.0001), second-hour postprandial blood glucose (P Ͻ 0.0001), insulin resistance (P Ͻ 0.0001), waist circumference (P Ͻ 0.0001), BMI (P Ͻ 0.0001), HbA 1c (P Ͻ 0.0001), diastolic blood pressure, pulse rate, uric acid levels, and all elements of the lipid profile except HDL cholesterol and apolipoprotein A1.CONCLUSIONS -The addition of sibutramine to oral hypoglycemic therapy resulted in significant weight loss and improvement in metabolic parameters in this patient group. Sibutramine is an effective adjunct to oral hypoglycemic therapy in obese women with type 2 diabetes. Diabetes Care 24:1957-1960, 2001M ost patients with type 2 diabetes are obese, dyslipidemic, and insulin-resistant (1,2). In most cases, high doses of hypoglycemic drugs and statins or fibrates are required, and it is usually difficult to regulate metabolic parameters. Modification of dietary habits and subsequent weight loss can improve glycemic control, insulin level, and lipid profile findings (3,4); however, unfortunately, diet restriction alone usually does not lead to adequate weight loss (3,5,6).Previous studies have shown that tight glycemic control reduces the longterm complications of the disease. The U.K. Prospective Diabetes Study (UKPDS) showed that a 1% reduction in the average HbA 1c level was associated with a 21% reduction in risk for any end point related to diabetes, 37% for microvascular complications, and 14% for myocardial infarction (7,8). The subgroup analysis of the simvastatin (4S) study showed that reducing the level of LDL cholesterol decreased cardiovascular mortality in diabetic patients (9).Recent studies on dexfenfluramine and fluoxetine have revealed that weight reduction with these agents improves glucose control and reduces HbA 1c , BMI, and blood pressure (10 -12). Sibutramine is an anti-obesity drug that induces satiety and thermogenesis (13). Administration of sibutramine has been shown to reduce weight gain, lower the levels of nonesterified fatty acids, decrease hyperins...

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The Comparison of Four Weight Reduction Strategies Aimed at Overweight Diabetic Patients

Cited by 33 publications

References 19 publications

Review: The treatment and prevention of obesity: a systematic review of the literature

Review: The treatment and prevention of obesity: a systematic review of the literature

Changes in patient weight and the impact of antidiabetic therapy during the first 5 years after diagnosis of diabetes mellitus

Effects of Sibutramine in Obese Female Subjects With Type 2 Diabetes and Poor Blood Glucose Control

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