The effect of weight loss on fasting blood sugars and hemoglobin A1c in overweight and obese diabetics and non-diabetics

Stanford, James K.; Kaiser, M; Ablah, Elizabeth; Dong, Frank; Paull-Forney, Bobbie; Early, James L.

doi:10.4236/jdm.2012.21021

Cited by 11 publications

(10 citation statements)

References 28 publications

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“…None of the diets altered HbA1c, a longer-term measure of glycaemia. Reduced HbA1c with weight loss has not been consistently demonstrated in non-diabetic populations ( 46 ) , and may not be sensitive enough to highlight changes in the normoglycaemic population studied here.…”

Section: Discussionmentioning

confidence: 78%

The effect of intermittent energy and carbohydrate restrictionv. daily energy restriction on weight loss and metabolic disease risk markers in overweight women

Harvie¹,

Wright

Pegington³

et al. 2013

Br J Nutr

377

468

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Intermittent energy restriction may result in greater improvements in insulin sensitivity and weight control than daily energy restriction (DER). We tested two intermittent energy and carbohydrate restriction (IECR) regimens, including one which allowed ad libitum protein and fat (IECR þ PF). Overweight women (n 115) aged 20 and 69 years with a family history of breast cancer were randomised to an overall 25 % energy restriction, either as an IECR (2500 -2717 kJ/d, , 40 g carbohydrate/d for 2 d/week) or a 25 % DER (approximately 6000 kJ/d for 7 d/week) or an IECR þ PF for a 3-month weight-loss period and 1 month of weight maintenance (IECR or IECR þ PF for 1 d/week). Insulin resistance reduced with the IECR diets (mean 20·34 (95 % CI 2 0·66, 2 0·02) units) and the IECR þ PF diet (mean 2 0·38 (95 % CI 20·75, 2 0·01) units). Reductions with the IECR diets were significantly greater compared with the DER diet (mean 0·2 (95 % CI 2 0·19, 0·66) mU/unit, P¼0·02). Both IECR groups had greater reductions in body fat compared with the DER group (IECR: mean 2 3·7 (95 % CI 22·5, 24·9) kg, P¼0·007; IECR þ PF: mean 23·7 (95 % CI 2 2·8, 24·7) kg, P¼0·019; DER: mean 22·0 (95 % CI 21·0, 3·0) kg). During the weight maintenance phase, 1 d of IECR or IECR þ PF per week maintained the reductions in insulin resistance and weight. In the short term, IECR is superior to DER with respect to improved insulin sensitivity and body fat reduction. Longer-term studies into the safety and effectiveness of IECR diets are warranted.Key words: Intermittent energy restriction: Low-carbohydrate diets: Weight loss: Daily energy restriction: Insulin resistanceThe global health burden of obesity-related conditions such as diabetes, CVD, dementia and certain cancers, including breast cancer, may be reduced by weight loss and the associated improvements in insulin sensitivity. The difficulties of achieving and sustaining weight loss by energy restriction are well known (1) . Even when reduced weights are maintained, metabolic benefits achieved with weight loss are often attenuated because of non-compliance or adaptation (2 -4) . Effective dietary interventions are needed that promote long-term adherence and sustained beneficial effects on metabolic and disease markers. Such interventions need to be palatable and satiating, meet minimal nutritional requirements, promote loss of fat and preserve lean body mass, ensure long-term safety, be simple to administer and monitor and have widespread public health utility. Multiple dietary approaches have been studied that vary in macronutrient composition (5) and the degree of energy restriction (6) . These typically achieve long-term 5 % weight loss in

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Section: Discussionmentioning

confidence: 78%

The effect of intermittent energy and carbohydrate restrictionv. daily energy restriction on weight loss and metabolic disease risk markers in overweight women

Harvie¹,

Wright

Pegington³

et al. 2013

Br J Nutr

377

468

View full text Add to dashboard Cite

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“…Weight reduction in particular is a well-established method for delaying and/or preventing the development of type 2 diabetes in people with prediabetes 4–8. A variety of weight loss interventions are available for adults with obesity, including behavioral/lifestyle treatment, pharmacotherapy, and bariatric surgery 4–14. Behavioral treatment commonly produces mean losses of 8%–10% of initial body weight without the negative side effects or complications associated with pharmacotherapy or surgery 12 13.…”

Section: Introductionmentioning

confidence: 99%

Effect of dose of behavioral weight loss treatment on glycemic control in adults with prediabetes

Bauman

Ariel-Donges

Gordon

et al. 2019

BMJ Open Diab Res Care

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ObjectiveThis study examined the effects of three doses of behavioral weight loss treatment, compared with a nutrition education control group, on changes in glycemic control in individuals with obesity and prediabetes.Research design and methodsThe study included 287 adults (77% female, 81% White; mean (SD) age=54.1 (10.5) years, body mass index=36.3 (3.9) kg/m2, and hemoglobin A1c (HbA1c)=5.9 (0.2%)). Participants were randomized to one of three behavioral treatment doses (high=24 sessions, moderate=16 sessions, or low=8 sessions) or to an education group (control=8 sessions). Changes in HbA1c, fasting glucose, and body weight were assessed from baseline to 6 months.ResultsMean (99.2% credible interval (CI)) reductions in HbA1c were 0.11% (0.07% to 0.16%), 0.08% (0.03% to 0.13%), 0.03% (–0.01% to 0.07%), and 0.02% (–0.02% to 0.07%), for the high, moderate, low, and control conditions, respectively. Mean (CI) reductions in fasting blood glucose were 0.26 mmol/L (0.14 to 0.39), 0.09 mmol/L (0 to 0.19), 0.01 mmol/L (–0.07 to 0.09), and 0.04 mmol/L (–0.03 to 0.12) for the high, moderate, low, and control conditions, respectively. The high-dose treatment produced significantly greater reductions in HbA1c and fasting blood glucose than the low-dose and control conditions (posterior probabilities (pp)<0.001); no other significant between-group differences were observed. Mean (CI) reductions in body weight were 10.91 kg (9.30 to 12.64), 10.08 kg (8.38 to 11.72), 6.35 kg (5.19 to 7.69), and 3.82 kg (3.04 to 4.54) for the high, moderate, low, and control conditions, respectively. All between-group differences in 6-month weight change were significant (pps<0.001) except for the high-dose versus moderate-dose comparison.ConclusionFor adults with obesity and prediabetes a high dose of behavioral treatment involving 24 sessions over 6 months may be needed to optimize improvements in glycemic control.Trial registration numberNCT00912652.

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“…In the RCTs no structured lifestyle advice was described in the methods sections. Non‐adherence to lifestyle advice has been associated with worsening glycaemic control and weight gain, with subsequent increases in HbA1c leading to treatment intensification …”

Section: Discussionmentioning

confidence: 99%

“…Nonadherence to lifestyle advice has been associated with worsening glycaemic control and weight gain, [37][38][39] with subsequent increases in HbA1c leading to treatment intensification. 40 The sample used in the present study has a high degree of generalizability and represents the majority of primary care-treated patients in the Netherlands. Large regions of the Netherlands are participating in projects similar to that included the present study, and all patients with type 2 diabetes have the opportunity to opt out.…”

Section: Discussionmentioning

confidence: 99%

Addition of sulphonylurea to metformin does not relevantly change body weight: a prospective observational cohort study (ZODIAC‐39)

Schrijnders

Wever

Kleefstra

et al. 2016

Diabetes Obesity Metabolism

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AimTo investigate changes in body weight trajectories after the addition of individual sulphonylureas (SUs) to metformin in patients with type 2 diabetes.Materials and methodsWe conducted a retrospective observational cohort study, in a primary care setting in the Netherlands. Patients aged ≥18 years with type 2 diabetes who were included in the ZODIAC cohort between 1998 and 2012 and who received metformin monotherapy at inclusion (n = 29 195), and had used metformin as monotherapy for at least 1 year before receiving dual therapy through the addition of an SU for at least 1 year were eligible for inclusion. The primary outcome was within‐drug yearly change in body weight after receiving add‐on therapy with individual SUs during 5 years of follow‐up. The secondary outcome was within‐drug yearly change in glycated haemoglobin (HbA1c). Annual changes in weight and HbA1c were estimated with linear mixed models, adjusted for age, gender and diabetes duration.ResultsA total of 2958 patients were included. No significant weight changes were observed within and between any of the individual SUs after treatment intensification (p = 0.24). In addition, no significant difference in weight between the add‐on therapy combinations was observed (p = 0.26). The average HbA1c the year before intensification was 7.2% (55 mmol/mol) and dropped below 7.0% (53 mmol/mol) the year after.ConclusionsIn patients with type 2 diabetes treated in primary care, strict glycaemic control can be maintained with SUs used as add‐on therapy to metformin, without the offset of relevant weight changes.

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The effect of weight loss on fasting blood sugars and hemoglobin A1c in overweight and obese diabetics and non-diabetics

Cited by 11 publications

References 28 publications

The effect of intermittent energy and carbohydrate restrictionv. daily energy restriction on weight loss and metabolic disease risk markers in overweight women

The effect of intermittent energy and carbohydrate restrictionv. daily energy restriction on weight loss and metabolic disease risk markers in overweight women

Effect of dose of behavioral weight loss treatment on glycemic control in adults with prediabetes

Addition of sulphonylurea to metformin does not relevantly change body weight: a prospective observational cohort study (ZODIAC‐39)

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