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Vascular Disease Prevention (Discontinued)

Editor-in-Chief

ISSN (Print): 1567-2700
ISSN (Online): 1567-2700

Clinical Resolution of Type 2 Diabetes with Reduction in Body Mass Index Using Meal Replacement Based Weight Loss

Author(s): Katherine E. Nori Janosz, Karen A. Koenig Berris, Carrie Leff, Wendy M. Miller, Jose Yanez, Samantha Myers, Claire Vial, Merry VanderLinden, Barry A. Franklin and Peter A. McCullough

Volume 5, Issue 1, 2008

Page: [17 - 23] Pages: 7

DOI: 10.2174/1567270010805010017

Price: $65

Abstract

Background: The positive correlation between body mass index (BMI) and type 2 diabetes (DM) is well established. Data on the clinical resolution of DM through diet-induced weight loss, however, are limited. Objective: Examine the relationship between BMI reduction and resolution of type 2 DM using a medically-monitored, behavior modification, weight-management program involving low-calorie, meal replacement diets in obese subjects. Methods: Through a retrospective, chart review in a suburban weight management center, case patients (n=33) that clinically resolved DM were identified in a suburban weight loss clinic and compared with age- and gender-matched control patients (n= 100), that did not clinically resolve DM following the same interventions in the same weight loss clinic. Clinical resolution of DM was defined as an initial elevated glycohemoglobin (HbA1C) ≥ 6.0% that decreased to < 6.0% with weight loss allowing discontinuation of all diabetic medications. Results: The mean ± SD age was 54.1 ± 9.7 and 58.2 ± 9.4 years for cases and controls respectively, p = 0.03. The baseline BMI was similar for cases and controls, 42.0 ± 9.0 and 42.9 ± 8.6 kg/m2, p = 0.63. The absolute and relative reduction in BMI was 7.6 ± 3.7 kg/m2 and 18.1 ± 8.2% in cases vs. 3.9 ± 3.7 kg/m2 and 8.5 ± 8.0% in controls, respectively, (p < 0.0001 for both comparisons) over a mean duration of 11.2 ± 4.9 and 14.9 ± 13.0 months for cases and controls. Multiple logistic regression found that lower baseline HbA1C (p = 0.02), younger age (p = 0.01), and greater relative BMI reduction (p < 0.0001) were independent predictors of the clinical resolution of DM. Conclusions: Positive predictive factors for clinical resolution of DM through diet-induced weight loss include younger age and better baseline glycemic control. Clinical resolution of DM likely requires a minimum BMI reduction of 10% in obese individuals.

Keywords: Obesity, diabetes, BMI (body mass index), weight loss, waist circumference, meal replacement, portion control, glycosylated hemoglobin


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