Heavy people with type 2 diabetes who lose a modest amount of weight and keep it off get many long-term health benefits, including reduced risk of chronic kidney disease, depression and eye disease, a landmark study has found.
They also have better blood sugar control, better quality of life, fewer hospitalizations and take less medication, which reduces medical costs.
The weight loss, however, doesn't lower their risk of having a heart attack or stroke. The study's authors reported that information last fall.
"Weight loss is still important, but the reasons why it is important are different than we thought," says study chairman Rena Wing, a professor of psychiatry and human behavior at Brown University. Wing and other investigators presented their findings Monday at the American Diabetes Association's annual scientific meeting in Chicago.
"Other short-term studies have shown the benefits of weight loss (for people with diabetes), but this is the first large, long-term trial examining a diverse set of health benefits," says Tim Church, director of preventive medicine research at the Pennington Biomedical Research Center in Baton Rouge.
Almost 26 million U.S. children and adults have diabetes. There are two major forms: type 1 and type 2. Type 2 accounts for 90% to 95% of cases. Diabetes can lead to heart disease, stroke, kidney failure, foot and leg amputations and blindness.
For the study, researchers at 16 centers around the country worked with 5,145 obese people with type 2 diabetes. Their average starting weight was about 200 pounds. Half of the participants were assigned to an intensive diet and exercise program. The rest got a general program of diabetes education several times a year. They were followed for about 10 years. Among findings:
--Those in the diet-and-exercise group lost about 8.6% of their starting weight in the first year and maintained a 6% loss after about 10 years. Participants in the diabetes education group lost almost 1% of their starting weight at one year, and at 10 years had lost about 3.5%.
--Participants in the diet-and-exercise group were 31% less likely to develop chronic kidney disease than the diabetes education group.
--The diet-and-exercise group improved their hemoglobin A1C readings (average blood sugar over three months) and HDL (good) cholesterol more than the other group.
--Participants in the diabetes education group, however, had better LDL (bad) cholesterol, possibly because more of them were taking cholesterol-lowering statin medications.
There was no difference between the two groups in the incidence of heart attacks and strokes, but it was low in both groups, Wing says.
Church says participants' low rates of cardiovascular disease "reflect the growing national trend of doctors aggressively treating chronic conditions such as high cholesterol and hypertension."
Gary Foster, an obesity researcher at Temple University in Philadelphia, says the other impressive result is that the people who lost weight were able to keep most of it off, contrary to the belief that almost everyone who loses weight regains it.
People with type 2 diabetes who lost even modest amounts
SHERRY BROWN FOR USA TODAY
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