Endocrine Abstracts (2002) 3 P101

Weight gain is not inevitable in the management of type 2 diabetes mellitus

A Tuthill1, A Suliman1, S Curran2, M McKenna1, D O'Shea1 & TJ McKenna1

1Department of Endocrinology and Diabetes Mellitus, St. Vincent's University Hospital, Dublin, Ireland; 2Department of Nutrition and Dietetics, St. Vincent's University Hospital, Dublin, Ireland.

The Diabetes Control and Complications Study, United States, and the United Kingdom Prospective Diabetes Study both reported increasing weight gain in all groups of patients with diabetes. The present study was designed to examine retrospectively if this was the experience in a clinic with an emphasis on weight loss as a central component of the treatment offered, facilitated by frequent clinic visits, the attendance of a dietitian at all clinics, a relatively low rate of insulin usage and a high ratio of doctors to patients.

The computerised clinical records were reviewed on 1097 type 2 diabetes patients first attending between 1990 - 2000 who had at least three follow-up visits. Weight at diagnosis, after 1 year and at the most recent visit was analysed for the five treatment groups; diet, sulphonylureas, metformin, metformin plus sulphonylureas and insulin, as of the most recent visit. Over a mean follow-up period of 49 plus/minus 2.8 months a significant weight gain occurred in 33.3% patients, no significant change in 22.2% and a significant weight loss was achieved by 44.4%. Although significant weight gain occurred in 54.1% of men and only 5.5% women, the HbA1c levels for the different treatment groups were similar in men and women with the diet group achieving the lowest level and the insulin-treated group the highest values.

These data indicate that in the clinic experience reported, weight gain occurred only in a minority and this was more likely to occur in men than in women.

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