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June 28, 2013

Weight Loss Benefits In Diabetics

Weight Loss Benefits in Diabetics

Lose weight and you reduce the risk of heart disease and strokes, right?  Maybe not if you’re a diabetic, but that does not mean there are not weight loss benefits in diabetics.

A recent study sponsored by the NIH and published in the New England Journal of Medicine sheds light on the weight loss benefits in diabetics. Some of the results are unexpected. The most surprising finding is that weight loss in diabetics did not lower the risk of heart disease or stroke. Most scientists and doctors probably would not have predicted that. But, these findings may be misleading (more on that later).

On the positive end weight loss in diabetics did reduce the risk of chronic kidney disease, loss of vision, and depression. Weight loss also led to improved blood sugar control, reduced need for medications, and fewer hospitalizations, while improving quality of life. Another encouraging point was the diabetics who lost weight were able to keep most of it off after 10 years.

Diabetes is model of accelerated aging. Diabetics are at risk for cardiovascular and peripheral vascular disease as sugar is damaging to the vascular endothelium.  This leads to higher rates of heart disease, strokes, kidney disease, blindness, and amputation of the foot or lower leg.

Many of these complications of diabetes are adversely affected by obesity, too. That’s one reason why it is surprising the weight loss did not lower heart disease or strokes in diabetics.

The study involved 16 centers around the world and included 5,145 obese type 2 diabetics who were followed for 10 years. The participants were divided into two groups. Half of them were assigned to an intensive diet and exercise program (weight loss group), and the other half received a general program of diabetes education.

Those in the weight loss group lost 8.6% of their starting weight in the first year of the study.

The results of the study may be misleading, though. Those in the diabetes education program were noted to have better LDL levels but more of them were on statin drugs. This may explain why heart disease and strokes did not decrease in the weight loss group relative to the diabetic education only group.

Though we believe statin drugs are generally over prescribed their benefits are more pronounced in high risk populations such as diabetics. If both groups had similar LDLs would the risk of heart disease and strokes in the weight loss group declined?

The biggest benefit from weight loss in diabetics was in the 31% reduction in chronic kidney disease. This benefit cannot be overstated as chronic kidney disease significantly impacts quality of life and predisposes to an entire set of medical problems.

The take home point is that weight loss in diabetics has significant health benefits even if reducing risk of heart disease and stroke are not among them.

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Dr. Joe Jacko


Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio. Read more about Dr. Joe Jacko

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