Early Weight Loss Reaps Long-Term Benefits for Type 2 Diabetes

Researchers at Kaiser Permanente's Center for Health Research (KPCHR) in Portland, OR, found that losing a moderate amount of weight (a mean of 9.8 percent of body weight) within an average of 18 months of diagnosis helped people with type 2 diabetes to achieve blood pressure and blood glucose levels within the target range. Those improvements remained three years later, even if the weight returned.

"What's critical here is that early weight loss may provide lasting benefits for risk factor control that in turn can reduce diabetes-related complications and mortality," said the Kaiser Center's lead researcher, Dr. Adrianne Feldstein. "We have known for a long time that weight loss is an important component in diabetes treatment and prevention. Now it appears there may be a critical window of opportunity following diagnosis in which some lasting gains can be achieved if people are willing to take immediate steps toward lifestyle changes."

Nearly all adults with type 2 diabetes are overweight and more than half are obese, a condition that is associated with poor blood glucose control and other cardiovascular risk factors. Previous research shows that losing weight and maintaining a healthy weight helps people with diabetes improve glycemic control, reduce blood pressure and improve blood lipids.

"These findings suggest that, even in the face of weight regain, losing weight can have long-lasting benefits in type 2 diabetes," the researchers concluded. "The therapeutic advantage achieved through weight loss is exceedingly important, given the close connection between glycemic and blood pressure control and cardiovascular outcomes."

Gregory Nichols, another author on the study, said people with type 2 diabetes may also be more motivated to lose weight when they are first diagnosed, and that doctors should encourage them to do so during this important window of opportunity.

However, he said, "We don't know if the initial weight loss increases the body's sensitivity to insulin, or if the sustained lifestyle changes are the reason for the long-term health benefits. What we do know is that losing weight reduces the risk factors that often lead to heart disease, blindness, nerve and kidney damage, amputations and death."

The study, a retrospective cohort, used data from the clinical medical records of 2,574 HMO patients aged 21-75 who had received a diagnosis of type 2 diabetes between 1997 and 2002. Patients were followed over a 48-month period. The study was supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

To set up interviews with researchers from Kaiser Permanente's Center for Health Research, contact Mary Sawyers at 503-335-6602 or email mary.a.sawyers@kpchr.org.

Diabetes Care, published by the American Diabetes Association, is the leading peer-reviewed journal of clinical research into the nation's fifth leading cause of death by disease. Diabetes also is a leading cause of heart disease and stroke, as well as the leading cause of adult blindness, kidney failure, and non-traumatic amputations. For more information about diabetes, visit the American Diabetes Association Web site www.diabetes.org or call 1-800-DIABETES (1-800-342-2383).