Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Security Forces Hospital Programme, Riyadh, Saudi Arabia.
Diabet Med. 2020 Feb;37(2):248-255. doi: 10.1111/dme.14093. Epub 2019 Sep 3.
To compare weight change in a lifestyle-based weight management programme between participants taking weight-gaining, weight-neutral/loss and mixed diabetes medications.
Electronic health records for individuals (≥ 18 years) with Type 2 diabetes who had been referred to a non-surgical weight management programme between February 2008 and May 2014 were studied. Diabetes medications were classified into three categories based on their effect on body weight. In this intervention cohort study, weight change was calculated for participants attending two or more sessions.
All 998 individuals who took oral diabetes medications and attended two or more sessions of weight management were included. Some 59.5% of participants were women, and participants had a mean BMI of 41.1 kg/m (women) and 40.2 kg/m (men). Of the diabetes medication combinations prescribed, 46.0% were weight-neutral/loss, 41.3% mixed and 12.7% weight-gaining. The mean weight change for participants on weight-gaining and weight-neutral/loss diabetes medications respectively was -2.5 kg [95% confidence interval (CI) -3.2 to -1.8) and -3.3 kg (95% CI -3.8 to -2.9) (P = 0.05) for those attending two or more sessions (n = 998). Compared with those prescribed weight-neutral medications, participants prescribed weight-gaining medication lost 0.86 kg less (95% CI 0.02 to 1.7; P = 0.045) in a model adjusted for age, sex, BMI and socio-economic status.
Participants on weight-neutral/loss diabetes medications had a greater absolute weight loss within a weight management intervention compared with those on weight-gaining medications. Diabetes medications should be reviewed ahead of planned weight-loss interventions to help ensure maximal effectiveness of the intervention.
比较参加基于生活方式的体重管理计划的参与者中，服用增重、体重中性/减轻和混合糖尿病药物的体重变化。
研究了 2008 年 2 月至 2014 年 5 月期间被转介至非手术体重管理计划的 2 型糖尿病患者的电子健康记录。根据对体重的影响，将糖尿病药物分为三类。在这项干预队列研究中，为参加两次或更多次会议的参与者计算体重变化。
共纳入 998 名服用口服糖尿病药物且参加两次或更多次体重管理会议的个体。女性参与者占 59.5%，参与者的平均 BMI 为 41.1kg/m（女性）和 40.2kg/m（男性）。所开处方的糖尿病药物组合中，46.0%为体重中性/减轻，41.3%为混合，12.7%为增重。分别服用增重和体重中性/减轻糖尿病药物的参与者，在参加两次或更多次会议（n=998）时的平均体重变化分别为-2.5kg[95%置信区间（CI）-3.2 至-1.8]和-3.3kg（95%CI-3.8 至-2.9）（P=0.05）。与服用体重中性药物的患者相比，在调整年龄、性别、BMI 和社会经济地位后，服用增重药物的患者体重减轻了 0.86kg（95%CI 0.02 至 1.7；P=0.045）。
在体重管理干预中，服用体重中性/减轻糖尿病药物的参与者体重减轻幅度明显大于服用增重药物的参与者。在计划进行体重减轻干预之前，应审查糖尿病药物，以帮助确保干预的最大效果。
