Coleman C D, Kiel J R, Mitola A H, Arterburn L M
Department of Scientific and Clinical Affairs, Medifast, Inc. 11445 Cronhill Drive, Owings Mills, MD, USA.
Independent Consultant, Clifton Park, NY, USA.
Nutr Diabetes. 2017 Jul 10;7(7):e284. doi: 10.1038/nutd.2017.32.
Individuals with type 2 diabetes (DM2) may be less successful at achieving therapeutic weight loss than their counterparts without diabetes. This study compares weight loss in a cohort of adults with DM2 or high blood sugar (D/HBS) to a cohort of adults without D/HBS. All were overweight/obese and following a reduced or low-calorie commercial weight-loss program incorporating meal replacements (MRs) and one-on-one behavioral support.
SUBJECTS/METHODS: Demographic, weight, body composition, anthropometric, pulse and blood pressure data were collected as part of systematic retrospective chart review studies. Differences between cohorts by D/HBS status were analyzed using Mann-Whitney U-tests and mixed model regression.
A total of 816 charts were included (125 with self-reported D/HBS). The cohort with D/HBS had more males (40.8 vs 25.6%), higher BMI (39.0 vs 36.3 kg m) and was older (56 vs 48 years). Among clients continuing on program, the cohorts with and without D/HBS lost, on average, 5.6 vs 5.8 kg (NS) (5.0 vs 5.6%; P=0.005) of baseline weight at 4 weeks, 11.0 vs 11.6 kg (NS) (9.9 vs 11.1%; P=0.027) at 12 weeks and 16.3 vs 17.1 kg (13.9 vs 15.7%; NS) at 24 weeks, respectively. In a mixed model regression controlling for baseline weight, gender and meal plan, and an intention-to-treat analysis, there was no significant difference in weight loss between the cohorts at any time point. Over 70% in both cohorts lost ⩾5% of their baseline weight by the final visit on their originally assigned meal plan. Both cohorts had significant reductions from baseline in body fat, blood pressure, pulse and abdominal circumference.
Adults who were overweight/obese and with D/HBS following a commercial weight-loss program incorporating MRs and one-on-one behavioral support achieved therapeutic weight loss. The program was equally effective for weight loss and reductions in cardiometabolic risk factors among adults with and without D/HBS.
2型糖尿病（DM2）患者在实现治疗性体重减轻方面可能不如非糖尿病患者成功。本研究比较了一组患有DM2或高血糖（D/HBS）的成年人与一组没有D/HBS的成年人的体重减轻情况。所有参与者均超重/肥胖，并遵循一项包含代餐（MRs）和一对一行为支持的低热量或减少热量的商业减肥计划。
受试者/方法：作为系统回顾性图表审查研究的一部分，收集了人口统计学、体重、身体成分、人体测量学、脉搏和血压数据。使用曼-惠特尼U检验和混合模型回归分析按D/HBS状态划分的队列之间的差异。
共纳入816份图表（125份自我报告有D/HBS）。有D/HBS的队列男性更多（40.8%对25.6%），BMI更高（39.0对36.3kg/m²），年龄更大（56岁对48岁）。在继续参与该计划的客户中，有D/HBS和没有D/HBS的队列在4周时平均减轻的基线体重分别为5.6kg对5.8kg（无显著差异）（5.0%对5.6%；P=0.005），在12周时为11.0kg对11.6kg（无显著差异）（9.9%对11.1%；P=0.027），在24周时为16.3kg对17.1kg（13.9%对15.7%；无显著差异）。在控制基线体重、性别和饮食计划的混合模型回归以及意向性分析中，各队列在任何时间点的体重减轻均无显著差异。两个队列中超过70%的人在按照最初分配的饮食计划进行最后一次访视时，体重减轻了至少5%的基线体重。两个队列的体脂、血压、脉搏和腹围均较基线有显著降低。
超重/肥胖且患有D/HBS的成年人在遵循一项包含MRs和一对一行为支持的商业减肥计划后实现了治疗性体重减轻。该计划对有和没有D/HBS的成年人在体重减轻和降低心血管代谢危险因素方面同样有效。
