Significant Improvement in Glycemic Control With Weight Loss Intervention
This article is written live from the American Association of Clinical Endocrinologists (AACE) 2017 Annual Meeting in Austin, TX. MPR will be reporting news on the latest findings from leading experts in endocrinology. Check back for more news from AACE 2017.
A medically supervised weight loss program over 6 months led to a significant improvement in glycemic control, presented Jonathan Allen, MS, RD, from the North Florida Regional Thyroid Center, at the AACE 2017 Annual Meeting.
The rise of obesity over the past 40 years has brought with it a significant rise in prediabetes and type 2 diabetes, carrying health, financial, and social burdens. A loss of 5% of body weight has demonstrated significant improvements in blood pressure, lipid levels (eg, HDL, triglycerides), and blood sugar. A loss of 10–15% of body weight has also demonstrated a higher likelihood of achieving health improvements.
Weight loss recommendations start with an initial lifestyle modification, including improved dietary intake and more physical activity. Medication therapy is also available for patients who have severe comorbidities as are medically supervised meal replacement programs when major dietary interventions are warranted.
Allen and colleagues conducted a retrospective study to assess phentermine and the OPTIFAST diet program on weight and diabetes outcomes at 6 months. They reviewed 15 patients who completed treatment with phentermine and 6 patients who completed 6 months of the OPTIFAST program with HbA1c >6%. At baseline, the average in the phentermine group was 229.6lbs vs. 209.7lbs in the OPTIFAST group.
The analysis showed a significant effect on HbA1c where phentermine therapy led to a 0.06% increase vs. a 1.8% decrease with OPTIFAST (P<0.001). There was a 50.3lbs (17.9%) decrease in weight among OPTIFAST patients vs. 13.6lbs (6.0%) decrease in weight among the phentermine patients. Moreover, one-third of the patients in the phentermine group had a decrease in antidiabetic medications and all participants in the OPTIFAST decreased antidiabetic medications by 50% or discontinued completely.
In general, improved glycemic control was seen following a 6-month, medically supervised meal replacement weight loss program. "Despite reduced or discontinued diabetes medication, sustained weight loss promotes improvements in long-term blood glucose control," concluded Allen.
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