Efficiency of 15-Week Weight Loss Program in T2D Patients
A structured weight-loss program is effective in the short term in reducing HbA1c, weight, and antidiabetic medication in patients with T2DM who are overweight or obese, according to a new study.

Participants in this prospective, interventional study were 36 patients (14 men and 22 women) with a median age of 58.5 years and median BMI of 34.1 enrolled in a 15-week structured weight-loss program with a low-calorie formula diet (LCD) for 6 weeks.

Daily consumption consisted of 5 sachets fully replacing normal food and corresponding to an energy content of 800 kcal. Five sachets contained an average of 96 g carbohydrates, 6.5 carbohydrate units (1.0–1.5 carbohydrate units per sachet), 70 g proteins, 15 g fat, and the recommended daily amounts of vitamins and minerals. Patients were advised to drink more than 2.5 L of water and other calorie-free beverages each day.

This fasting phase was followed by a 4-week refeeding phase, during which regular food was reintroduced and the formula diet was gradually replaced until a daily total intake of 1,200 kcal was reached.

During the last 5 weeks of the program, energy intake was gradually increased to an individual level of between 1,200 and 1,500 kcal that allowed participants to keep their weight stable.

The exercise course combined cardiovascular and strength training, which was part of the standardized weight-loss program. Training intensity was increased gradually, from 30% and 1–2 series with 15–25 repetitions to 70% and 1–3 series with 15–25 repetitions. The program was adjusted to an individual’s fitness level and disease at the discretion of the trainer.

During the fasting phase, oral insulinotropic drugs and metformin were paused. In patients taking insulin, the prandial insulin was reduced to 2 insulin units per carbohydrate units, and the basal insulin rate was left unchanged unless the fasting blood glucose was less than 5.6 mmol/L.

During the refeeding phase, metformin was reintroduced when blood glucose levels were repeatedly more than 12 mmol/L, and other oral antidiabetic drugs were added when necessary.

Laboratory values and quality of life were assessed at baseline and after 15 weeks.

Researchers found that, independent of their medical therapy, patients with T2DM who are overweight or obese were able to improve their glycaemic control and reduce their body weight by participating in a standardized weight-loss program that included a LCD, with no adverse events, especially hypoglycaemia.

“Levels of HDL-C and LDL-C were not affected by short-term weight loss,” the researchers mentioned. “The decline in mental health and the long-term effects of improved glycaemic control require further trials.”