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Two-Year Outcome of a Combination of Weight Loss Therapies for Type 2 Diabetes

Division of Endocrinology and Diabetes, Department of Medicine, General Clinical Research Center, and the Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota

Address correspondence and reprint requests to J. Bruce Redmon, MD, Division of Endocrinology and Diabetes, Department of Medicine, University of Minnesota, MMC 101, 420 Delaware St. SE, Minneapolis, MN 55455. E-mail: redmo001{at}umn.edu

OBJECTIVE—To evaluate the effects over 2 years of a weight loss program combining several weight loss strategies on weight loss and diabetes control in overweight subjects with type 2 diabetes.

RESEARCH DESIGN AND METHODS—A total of 59 overweight or obese individuals with type 2 diabetes were randomly assigned to either a combination therapy weight loss program for 2 years (C therapy) or a standard therapy weight loss program for 1 year followed by a combination therapy weight loss program in the 2nd year (S/C therapy). C therapy combined the use of meal replacement products, repetitive intermittent low-calorie-diet weeks, and pharmacologic therapy with sibutramine. Outcome measures included changes in weight, glycemic control, plasma lipids, blood pressure, and body composition over 2 years.

RESULTS—A total of 48 participants (23 in the C therapy group and 25 in the S/C therapy group) completed 2 years of study. After 2 years, the C therapy group had weight loss of 4.6 ± 1.2 kg (P < 0.001) and a decrease in HbA_1c of 0.5 ± 0.3% (P = 0.08) from baseline. At 2 years, the C therapy group had significant reductions in BMI, fat mass, lean body mass, and systolic blood pressure. The S/C therapy group showed changes in weight and HbA_1c in year 2 of the study that were similar to those demonstrated by the C therapy group in year 1.

CONCLUSIONS—This combination weight loss program resulted in significant weight loss and improved diabetes control over a 2-year period in overweight subjects with type 2 diabetes.

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