Fridman Moshe, Lucas Mariann E, Paprocki Yurek, Dang-Tan Tam, Iyer Neeraj N
Biostatistics, AMF Consulting, Los Angeles, CA, USA.
Information Science, Scientific Analytics, Novo Nordisk Inc, Plainsboro Township, NJ, USA.
Clinicoecon Outcomes Res. 2020 Sep 29;12:555-566. doi: 10.2147/CEOR.S266873. eCollection 2020.
Weight reduction is a key component of diabetes management in adults with type 2 diabetes mellitus (T2DM), yet the benefits of weight loss in T2DM patients have been difficult to quantify. We examined the medical literature regarding the relationships between weight change and 1) glycemic control and 2) cost and resource use.
Systematic searches were conducted in the electronic databases Embase, MEDLINE, and the Cochrane Database of Systematic Reviews to identify publications regarding the impact of weight change on T2DM outcomes from 2007 onward. Identified publications were screened for relevance against predefined eligibility criteria, and methodological approaches and results were extracted. Evidence for the impact of weight change on outcomes was evaluated and used to identify strengths, limitations, and gaps in the current literature.
The number of studies meeting eligibility criteria for each outcome was: glycemic control (n=38) and cost and resource use (n=11). The relationship between weight change and glycemic control was dependent on the interplay of multiple factors, eg, the weight loss interventions employed, the antidiabetic medication classes used, the time horizon, and baseline BMI and glycemic control. With respect to cost and resource use, the review indicated that savings were associated with weight loss, and increased costs were associated with weight gain.
Studies regarding weight change in T2DM patients demonstrated varying effects on glycemic control and a positive association with costs and resource use, where weight loss was associated with decreased costs and resource use. Future studies may be able to clarify these relationships.
体重减轻是成年2型糖尿病(T2DM)患者糖尿病管理的关键组成部分,然而T2DM患者体重减轻的益处一直难以量化。我们查阅了医学文献,以研究体重变化与1)血糖控制以及2)成本和资源利用之间的关系。
在电子数据库Embase、MEDLINE和Cochrane系统评价数据库中进行系统检索,以识别自2007年起有关体重变化对T2DM结局影响的出版物。根据预先定义的纳入标准筛选所识别的出版物的相关性,并提取方法学方法和结果。评估体重变化对结局影响的证据,并用于确定当前文献中的优势、局限性和差距。
符合各结局纳入标准的研究数量分别为:血糖控制(n = 38)和成本及资源利用(n = 11)。体重变化与血糖控制之间的关系取决于多种因素的相互作用,例如所采用的体重减轻干预措施、所使用的抗糖尿病药物类别、时间范围以及基线BMI和血糖控制情况。关于成本和资源利用,该综述表明体重减轻与成本节约相关,而体重增加与成本增加相关。
关于T2DM患者体重变化的研究表明,其对血糖控制的影响各不相同,且与成本和资源利用呈正相关,其中体重减轻与成本和资源利用的减少相关。未来的研究或许能够阐明这些关系。