West-German Centre of Diabetes and Health, Dusseldorf Catholic Hospital Group, 40591 Dusseldorf, Germany.
Hochschule Niederrhein, University of Applied Sciences, 41065 Mönchengladbach, Germany.
Nutrients. 2020 Sep 30;12(10):3004. doi: 10.3390/nu12103004.
Continuous high insulin levels are associated with weight gain and lead to cardiometabolic diseases. Therefore, we have developed the Low-Insulin-Method and integrated it into the multi-component, occupational healthcare program SHAPE-AND-MOTION-Medical-Accompanied-Slimming (SAMMAS) to reduce daily insulin levels for long-term weight reduction in overweight or obesity. Employees were randomized into a starting intervention group (SI, = 15) or waiting list control group (WL, = 15). SAMMAS consisted of group-based seminars, low-carbohydrate nutrition including formula diet, continuous glucose monitoring, telemetric monitoring, and telemedical coaching. Both groups received telemetric devices at baseline. Intention-to-treat analyses were performed after 12, 26, and 52 weeks. The estimated treatment difference in weight reduction after 12 weeks, which is the primary endpoint of the study, showed a pronounced effect in favour of SI (-6.3 kg with (95% confidence interval) (-7.4; -4.5) ( < 0.001)) after 12 weeks. Furthermore, SI improved fasting blood glucose, HbA1c, quality of life, fasting insulin, blood pressure, and eating behaviour (all < 0.05) in the within-group analysis, while WL did not. After 26 and 52 weeks, weight reduction could be maintained in the whole group (both groups together) by -6.7 kg (-9.5; -3.8) ( < 0.001) and -6.1 kg (-9.2; -2.7) ( < 0.01). SAMMAS supports clinically relevant weight reduction and long-term weight loss maintenance in individuals with overweight or obesity.
持续的高胰岛素水平与体重增加有关，并导致代谢心血管疾病。因此，我们开发了低胰岛素方法，并将其整合到多组分、职业保健计划 SHAPE-AND-MOTION-Medical-Accompanied-Slimming（SAMMAS）中，以降低超重或肥胖人群的日常胰岛素水平，从而实现长期减肥。员工被随机分为起始干预组（SI，n = 15）或候补名单对照组（WL，n = 15）。SAMMAS 包括小组研讨会、低碳水化合物营养（包括配方饮食）、连续血糖监测、遥测监测和远程医疗辅导。两组在基线时均收到遥测设备。在 12、26 和 52 周后进行意向治疗分析。在 12 周时，体重减轻的估计治疗差异是该研究的主要终点，SI 组的效果明显（-6.3kg，95%置信区间（-7.4；-4.5）（<0.001））。此外，SI 组在 12 周内改善了空腹血糖、HbA1c、生活质量、空腹胰岛素、血压和饮食行为（均<0.05），而 WL 组没有。在 26 和 52 周后，整个组（两组合计）的体重减轻可以维持在-6.7kg（-9.5；-3.8）（<0.001）和-6.1kg（-9.2；-2.7）（<0.01）。SAMMAS 支持超重或肥胖个体的临床相关减肥和长期减肥维持。
