Introduction: Patients who are overweight or obese have an increased risk of developing type 2 diabetes mellitus (T2DM). Weight loss can have a positive effect on glycemic control. Objective: We aimed to investigate glycemic control in patients with T2DM and overweight or obesity during a structured weight-loss program. Methods: This was a prospective, interventional study. We recruited 36 patients (14 men and 22 women) with a median age of 58.5 years and median body mass index (BMI) of 34.1, to a 15-week structured weight-loss program with a low-calorie (800 kcal) formula diet for 6 weeks. The primary end point, HbA_1c level, and secondary end points, anthropometric data, medication, and safety, were assessed weekly. Laboratory values and quality of life were assessed at baseline and after 15 weeks. Results: HbA_1c decreased from 7.3% at baseline to 6.5% at 15 weeks (p #x3c; 0.001), median body weight by 11.9 kg (p #x3c; 0.001), median BMI by 4.3 (p #x3c; 0.001) and median waist circumference by 11.0 cm (p #x3c; 0.001). Two participants discontinued insulin therapy, 4 could reduce their dosage of oral antidiabetic agents, and 6 completely discontinued their antidiabetic medication. Insulin dose decreased from 0.63 (0.38–0.89) to 0.39 (0.15–0.70) units/kg body weight (p #x3c; 0.001). No patient experienced hypoglycemic episodes or hospital emergency visits. Triglycerides and total cholesterol decreased as well as surrogate markers of liver function. However, the levels of high-density and low-density lipoprotein cholesterol (HDL-C and LDL-C) as well as uric acid remain unchanged. Regarding quality of life, the median physical health score increased from 44.5 (39.7–51.4) at baseline to 48.0 (43.1–55.3; p = 0.007), and the median mental health score decreased from 42.1 (36.1–46.7) to 37.4 (30.3–43.7; p = 0.004). Conclusions: A structured weight-loss program is effective in the short term in reducing HbA_1c, weight, and antidiabetic medication in patients with T2DM who are overweight or obese. Levels of HDL-C and LDL-C were not affected by short-term weight loss. The decline in mental health and the long-term effects of improved glycemic control require further trials.
Obes Facts

中文翻译：

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15周减重计划（包括低热量配方饮食）对2型糖尿病和超重或肥胖患者血糖控制的有效性

简介：超重或肥胖的患者患2型糖尿病（T2DM）的风险增加。减肥对血糖控制有积极作用。目的：我们旨在研究结构化减肥计划期间T2DM和超重或肥胖患者的血糖控制。方法：这是一项前瞻性干预研究。我们招募了36位患者（14位男性和22位女性），中位年龄为58.5岁，中位体重指数（BMI）为34.1，参加了为期15周的低热量（800 kcal）配方饮食的结构化减肥计划持续6周。主要终点，HbA _1c每周评估一次水平，次要终点，人体测量数据，药物治疗和安全性。在基线和15周后评估实验室值和生活质量。结果： HbA _1c从基线的7.3％降低到15周时的6.5％（p＃x3c; 0.001），中位数体重降低了11.9 kg（p＃x3c; 0.001），BMI中位数降低了4.3（p＃x3c; 0.001）和腰围中位数增加11.0厘米（p＃x3c; 0.001）。两名参与者终止了胰岛素治疗，其中四名可以减少口服降糖药的剂量，六名完全终止了他们的抗糖尿病药物。胰岛素剂量从0.63（0.38–0.89）降低至0.39（0.15–0.70）单位/ kg体重（p＃x3c; 0.001）。没有患者出现降血糖事件或医院急诊就诊。甘油三酸酯和总胆固醇下降，以及肝功能的替代指标。但是，高密度和低密度脂蛋白胆固醇（HDL-C和LDL-C）以及尿酸的水平保持不变。关于生活质量，身体健康状况中位数从基线时的44.5（39.7–51.4）增加到48.0（43.1–55.3；p = 0.007），精神健康中位数从42.1（36.1–46.7）降低至37.4（30.3） –43.7；p = 0.004）。结论：结构化减肥计划在短期内可有效降低HbA _1c超重或肥胖的T2DM患者的，体重和抗糖尿病药物。HDL-C和LDL-C的水平不受短期减肥的影响。心理健康下降和血糖控制改善的长期影响尚需进一步试验。
肥胖事实