Window of opportunity for newly diagnosed diabetics

Aug 13 2008

According to health researchers in the U.S., people who lose weight soon after being diagnosed with type 2 diabetes are far more likely to reach satisfactory blood glucose and blood pressure goals.

The researchers at Kaiser Permanente's Center for Health Research (KPCHR) in Portland, Oregon say losing weight initially doubles the likelihood of achieving set goals, even if the weight ultimately returns.

The researchers say that losing a moderate amount of weight (a mean of 9.8 percent of body weight) within an average of 18 months of diagnosis, helped people with type 2 diabetes to achieve blood pressure and blood glucose levels within the target range; and the improvements were sustained three years later, even if the weight had returned.

Lead researcher, Dr. Adrianne Feldstein says the critical factor is that early weight loss can provide lasting benefits for risk factor control which in turn can reduce diabetes-related complications and mortality.

Dr. Feldstein says it is well known that weight loss is an important component in diabetes treatment and prevention, but it now appears there may be a critical window of opportunity following diagnosis in which some lasting gains can be achieved if people are willing to take immediate steps toward lifestyle changes.

Most adults with type 2 diabetes are overweight and more than half are obese; type 2 diabetes is a condition that is associated with poor blood glucose control and other cardiovascular risk factors and other research has also shown that losing weight and maintaining a healthy weight helps people with diabetes improve glycemic control, reduce blood pressure and improve blood lipids.

The researchers say their findings suggest that, even in the face of weight regain, losing weight can have long-lasting benefits in type 2 diabetes.

They say the therapeutic advantage achieved through weight loss is very important because of the close connection between glycemic and blood pressure control and cardiovascular outcomes.

The researchers suggest that people with type 2 diabetes may also be more motivated to lose weight when they are first diagnosed, and that doctors should encourage them to do so during this important window of opportunity.

However, they say it is unclear whether the initial weight loss increases the body's sensitivity to insulin, or if the sustained lifestyle changes are the reason for the long-term health benefits.

But they say what is clear is that losing weight reduces the risk factors that often lead to heart disease, blindness, nerve and kidney damage, amputations and death.

The study which is published online in the journal Diabetes Care, used data from the clinical medical records of 2,574 HMO patients aged 21-75 who had received a diagnosis of type 2 diabetes between 1997 and 2002 and were followed over a 48-month period.