Document Detail

Long-term non-pharmacologic weight loss interventions for adults with type 2 diabetes.
MedLine Citation:
PMID:  15846698     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Most persons with type 2 diabetes are overweight and obesity worsens the metabolic and physiologic abnormalities associated with diabetes.
OBJECTIVES: The objective of this review is to assess the effectiveness of lifestyle and behavioral weight loss and weight control interventions for adults with type 2 diabetes.
SEARCH STRATEGY: Studies were obtained from computerized searches of multiple electronic bibliographic databases, supplemented with hand searches of selected journals and consultation with experts in obesity research. The last search was conducted May, 2004.
SELECTION CRITERIA: Studies were included if they were published or unpublished randomized controlled trials in any language, and examined weight loss or weight control strategies using one or more dietary, physical activity, or behavioral interventions, with a follow-up interval of at least 12 months.
DATA COLLECTION AND ANALYSIS: Effects were combined using a random effects model.
MAIN RESULTS: The 22 studies of weight loss interventions identified had a 4,659 participants and follow-up of 1 to 5 years. The pooled weight loss for any intervention in comparison to usual care among 585 subjects was 1.7 kg (95 % confidence interval [CI] 0.3 to 3.2), or 3.1% of baseline body weight among 517 subjects. Other main comparisons demonstrated nonsignificant results: among 126 persons receiving a physical activity and behavioral intervention, those who also received a very low calorie diet lost 3.0 kg (95% CI -0.5 to 6.4), or 1.6% of baseline body weight, more than persons receiving a low-calorie diet. Among 53 persons receiving identical dietary and behavioral interventions, those receiving more intense physical activity interventions lost 3.9 kg (95% CI -1.9 to 9.7), or 3.6% of baseline body weight, more than those receiving a less intense or no physical activity intervention. Comparison groups often achieved significant weight loss (up to 10.0 kg), minimizing between-group differences. Changes in glycated hemoglobin generally corresponded to changes in weight and were not significant when between-group differences were examined. No data were identified on quality of life and mortality.
AUTHORS' CONCLUSIONS: Weight loss strategies using dietary, physical activity, or behavioral interventions produced small between-group improvements in weight. These results were minimized by weight loss in the comparison group, however, and examination of individual study arms revealed that multicomponent interventions including very low calorie diets or low calorie diets may hold promise for achieving weight loss in adults with type 2 diabetes.
S L Norris; X Zhang; A Avenell; E Gregg; T J Brown; C H Schmid; J Lau
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2005-04-18
Journal Detail:
Title:  The Cochrane database of systematic reviews     Volume:  -     ISSN:  1469-493X     ISO Abbreviation:  Cochrane Database Syst Rev     Publication Date:  2005  
Date Detail:
Created Date:  2005-04-22     Completed Date:  2005-07-19     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  100909747     Medline TA:  Cochrane Database Syst Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  CD004095     Citation Subset:  IM    
Center for Outcomes and Evidence, Agency for Healthcare, Research and Quality, 540 Gaithers Road, Room 6325, Rockville, MD 20850, USA.
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MeSH Terms
Diabetes Mellitus, Type 2 / complications*
Obesity / etiology,  mortality,  therapy*
Quality of Life
Randomized Controlled Trials as Topic
Weight Loss*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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