Weight Loss in Type 2 Diabetic Patients

Abstract

A guiding principle in the treatment of type 2 diabetic patients has been the recommendation to lose weight (1,2). This is because the health benefits of weight loss have long been recognized (3). As weight loss progresses and is maintained, an improvement of glycemia may be evidenced by a reduction in glycosylated hemoglobin (4,5). Redmon et al. (6) report in this issue of Diabetes Care the 2-year outcome of a combination of weight loss therapies in type 2 diabetic patients. The end result was a weight loss of 4.6 kg sustained over 2 years, which led to a decrease of HbA1c of 0.5%. While full credit must be given to the authors for their innovative approach, and for their hard and dedicated work, it is disappointing that such a combination therapy program in an excellent medical center with outstanding clinicians and facilities could not lead to a greater weight loss and particularly a greater improvement in blood glucose control. Why is weight loss in obese diabetic patients so modest? Here, as mentioned, in the best of hands, patients who started at a weight of 113.2 kg ended 2 years later at a weight of 108.6, a 4% drop. Why can’t we do better, all of us, in treating type 2 diabetic patients? Therapeutic weight loss in type 2 diabetic patients has been very difficult to achieve. In an 18-month study that compared the use of three sets …