Even modest weight loss may be worthwhile in type 2 diabetes

A fat stomach

One of the main aims of diabetes care is to reduce the risk of serious complications such as cardiovascular disease.

We already know that obesity is associated with an increased risk of cardiovascular outcomes in people with type 2 diabetes, and treatment aims to reduce the risk by reducing blood pressure, cholesterol levels, body weight and other risk factors.

A recent observational study followed looked at whether a more modest weight reduction was associated with an improvement in

Clinical question

In overweight or obese people with type 2 diabetes, does modest weight loss lead to an improvement in cardiovascular risk factors?

Key finding

The researchers found that even modest weight loss of between 5 and 10% of body weight was associated with  improvements in glycaemic control, blood pressure, triglycerides, and HDL cholesterol.  This is consistent with the hypothesis that modest weight loss is worthwhile, offering encouragement in controlling body weight.

The study’s findings were also consistent with the suggestion that the benefits are in proportion to the amount of weight lost, so losing more weight could reduce the cardiovascular risk further.

Appraisal hints

Readers of this article should consider:

  • This is an observational study, so we can’t say that the weight loss is causing the reduction in risk factors.  The causal relationship might be the other direction, or there might be some other factor/s that is reducing all of them together.  Perhaps exercise and improved diet reduces weight and cardiovascular risk.
  • Whether the researchers looked at all the right outcomes (risk factors).
  • Whether the findings were consistent across all outcomes.
  • Was follow-up long enough to really be sure about the findings?

Reference

This paper is available for free in full text form from the link below.

Wing RR, Lang W, Wadden TA, Safford M, Knowler WC, Bertoni AG, Hill JO, Brancati FL, Peters A, Wagenknecht L; Look AHEAD Research Group. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011 Jul;34(7):1481-6. Epub 2011 May 18.

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Badenoch

Badenoch
I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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