Combination weight-loss therapies for type 2 diabetes mellitus

• Published in: International Journal of Obesity Vol. 28; p. S145
• Main Authors: Raatz, S K, Bruce, R J, Reck, K P, Swanson, JE, Kwong, CA, William, T, Bantle, J P
• Format: Journal Article
• Language: English
• Published: 01.05.2004
• ISSN: 0307-0565

Aims: To evaluate the effects over 2 years of a combination weight-loss program on weight loss, diabetes control and cardiovascular risk factors in overweight or obese subjects with type 2 diabetes. We hypothesized that long-term efficacy of weight-loss therapies would be increased if several weight-loss approaches are combined. Methods: A total of 59 subjects treated with diet or oral medication were randomly assigned to either combination therapy (CT) for 2 years or a standard therapy (ST) for 1 year, followed by a CT in the second year (S/C). All participants received diet, exercise and behavioral instruction as ST. CT consisted of ST plus daily sibutramine; low-calorie diets (LCD) using meal replacements 1 week every 2 months; and, between LCD weeks, once daily use of meal replacements. The outcome measures were body weight, glycemic control, plasma lipids, blood pressure, and body composition. Results: In all, 48 participants (23 CT and 25 S/C) completed 2 years. Both groups had significant weight loss from baseline (4.6 plus or minus 1.2 kg CT and 8.1 plus or minus 1.6 kg S/C, P = 0.08). At 2 years, the change in hgb A1c from baseline was -0.5 plus or minus 0.3% CT and -0.3 plus or minus 0.2% S/C (P = 0.61). However, the average reduction in hgb A1c over 2 years was significantly greater for the CT (0.8 plus or minus 0.1% vs 0.2 plus or minus 0.1% CTand S/C, respectively; P = 0.009). At 2 years, CT had significant reductions from baseline in weight, BMI, fat mass, lean body mass and SBP. Conclusions: Use of a combination of weight loss therapies resulted in significant weight loss and improved diabetes control over a 2-year period in subjects with type 2 diabetes.