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Jul 22, 2013

Weight Loss Program Fails to Reduce Cardiovascular Risk in Patients with Diabetes

13-year study cut short after weight loss intervention didn’t reduce cardiovascular risk in patients with type 2 diabetes.

For overweight or obese patients with type 2 diabetes, losing weight is one of the best ways to improve blood sugar control and reduce risk of complications. In fact, losing just 5-7% of body weight can have big health benefits for patients with diabetes. However, a recent study found that modest weight loss may not reduce cardiovascular risk over time.

This study was conducted at 16 different U.S. medical centers and enrolled nearly 5,150 overweight or obese patients with type 2 diabetes. Study participants were assigned to one of two groups: an intervention group receiving weight loss support and a control group receiving standard diabetes support and education. The goal of the weight loss program was to help patients lose at least 7% of their body weight through diet and exercise, while the control group simply received support and information on managing their condition. Following enrollment, researchers then followed participants to see who was hospitalized for chest pain, suffered heart attack or stroke, or died as a result of cardiovascular causes.

Researchers had intended to follow participants for as long as 13.5 years, but the study was cut short after about 9 years because there was no major difference in outcomes between the two study groups. Although patients in the intervention group lost more weight compared to those in the control group, cardiovascular risk was similar in both groups. In other words, patients were just as likely to suffer a heart attack or stroke, regardless of the intervention they received.

The team conducting this study was somewhat surprised by these findings. Research has already shown that weight loss helps patients with type 2 diabetes reduce risk for heart disease short-term, so shouldn’t the same be true further down the road? According to experts, study findings may be a result of flaws in the study design rather than the intervention. It’s possible that the weight loss group did have a slight reduction in cardiovascular risk, but that the study wasn’t long enough or large enough to pick up on this difference. Also, patients in the weight loss group were less likely to be on medications that reduce cardiovascular risk factors, such as blood pressure lowering drugs. This, however, may be due to the fact that weight loss improved heart health in patients so they no longer needed to be on medication.

Weight loss remains one of the best ways for patients with type 2 diabetes to control their condition and reduce risk of complications, and it’s clear that additional research is needed to understand the long-term impact of weight loss on cardiovascular risk. It’s likely that a similar study will be conducted in the future (with certain improvements) and in the meantime, it’s important that patients with type 2 diabetes work with their doctor to help manage their condition and reduce cardiovascular risk through lifestyle changes and other effective therapies.

Questions for You to Consider

  • How much exercise do patients with type 2 diabetes need to promote better health?

  • Studies have shown that patients with type 2 diabetes exercising for at least 150 minutes a week see the greatest health benefits, like blood sugar reduction. Patients with type 2 diabetes engaging in less than 150 minutes of exercise a week are still likely to experience blood sugar reductions and health benefits, but not as much as those exercising 150 minutes a week or more.

  • What is a healthy weight?

  • A few important tools can be used to determine if an individual is underweight, normal weight or overweight. The easiest tool is a Body Mass Index, which is calculated using height and weight to estimate levels of body fat. However, Body Mass Index is not always accurate, particularly among individuals with extremely high or low amounts of muscle. In these cases, measuring waist circumference is helpful in assessing weight, as a waist circumference greater than 35 inches for a woman or 40 inches for a man is considered unhealthy.

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