The comparison of four weight reduction strategies aimed at overweight patients with diabetes mellitus: four-year follow-up

• Published in: Diabetic medicine 1998-06, Vol.15 (6), p.497-502
• Main Authors: Manning, R.M., Jung, R.T., Leese, G.P., Newton, R.W.
• Format: Article
• Language: English
• Subjects: Ambulatory Care; Appetite Depressants - therapeutic use; behavioural therapy; Biological and medical sciences; dexfenfluramine; diabetes mellitus; Diabetes Mellitus - diet therapy; Diabetes Mellitus - therapy; Diabetes. Impaired glucose tolerance; Dietetics; dietitian; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Fenfluramine - therapeutic use; Follow-Up Studies; Glycated Hemoglobin A - metabolism; Home Care Services; home visits; Humans; Male; Management. Various non-drug treatments. Langerhans islet grafts; Medical sciences; Middle Aged; Obesity; Psychotherapy, Group; Weight Loss
• ISSN: 0742-3071; 1096-9136; 1464-5491
• DOI: 10.1002/(SICI)1096-9136(199806)15:6<497::AID-DIA599>3.0.CO;2-W

Weight change and glycaemic control in 132 diabetic patients previously treated for 1 year by four different methods aimed at weight loss were reanalysed 4 years after the outset. The four treatment groups comprised clinic visits, home visits, behavioural group therapy, and dexfenfluramine given for the initial 3 months followed by clinic visits. When analysed on an intention to treat basis only the dexfenfluramine group maintained a significant weight loss at year 4 (mean −2.46 kg) with 43 % of patients losing 3 kg or more; HBA1c was not decreased. The other treatment groups showed overall weight regain from year 1 to year 4. Within the home visit group however, the number of patients losing at least 3 kg doubled between years 1 (21 %) and 4 (38 %). When analysed on a completion basis, weight loss in the dexfenfluramine group was significant in females but not in males at year 4. During the 4 years of observation a cohort of 54 patients reflecting our routine clinic practice gained on average 0.35 kg. Although now withdrawn, the use of an appetite suppressant dexfenfluramine for just 3 months would appear to have a long‐term advantage on weight loss in this diabetic population, although the weight lost was not associated with improvement in glycaemic control. © 1998 John Wiley & Sons, Ltd.