Glycemic Control in T2D and Its Association with Body Weight
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Obesity is one of the main risk factors for type 2 diabetes (T2D), representing a major worldwide health crisis. Modest weight-loss (>5% but <10%) can minimize and reduce diabetes-associated complications, and significant weight-loss can potentially resolve the disease.

Treatment guidelines recommend that intensive lifestyle interventions, pharmacologic therapy, and/or metabolic surgery be considered as options for patients with T2D and obesity.

In a study, researchers analysed quantitatively the association between the durability of glycaemic control and body weight changes during the treatment.

Studies with follow-ups > 12 months, and final and intermediate assessments of HbA1cwere included. Four outcomes assessing therapeutic durability were extracted and synthesized using Stata statistical software, including changes in HbA1c, goal-achievement rate, failure rate and coefficient of failure (CoF).

After 8.9 months of treatment, HbA1c levels declined from 8.03 to 7.15% and then gradually increased up to 7.72% 5 years later. The goal-achievement rate decreased from 54.8% (after 1 year of treatment) to 19.4% 5 years later. The CoF was 0.123 ± 0.022%/year. After stratification, the CoFs were 0.224 ± 0.025%/year for weight gain, 0.137 ± 0.034%/year for neutral weight and -0.024 ± 0.032%/year for weight loss.

After stratification by treatment approaches, the CoFs were 0.45%/year for insulin, 0.43%/year for sulphonylurea, 0.34%/year for thiazolidinedione, 0.29%/year for metformin, 0.16% for glucagon-like polypeptide-1 receptor agonists, 0.12% for surgery, -0.03% for sodium-glucose cotransporter-2 inhibitors and -0.21% for dipeptidyl peptidase-IV inhibitors.

It was concluded that the modest weight loss with a goal of 2-3% of body weight should be recommended to improve therapeutic durability and prevent beta-cell deterioration.