A clinical score to predict dose reductions of antidiabetes medications with intentional weight loss: A retrospective cohort study

• Published in: Biomedical Journal 2016-06, Vol.39 (3), p.188-194
• Main Authors: Shantha, Ghanshyam Palamaner Subash, Kumar, Anita Ashok, Ravi, Vimal, Khanna, Rohit C, Kahan, Scott, Cheskin, Lawrence J
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antidiabetics; Behavior modification; Blood Glucose - physiology; Blood pressure; Body mass index; Body weight; Body Weight - drug effects; Body Weight - physiology; Body weight loss; Cholesterol; Clinical score; Cohort analysis; Diabetes; Diabetes mellitus; Diabetes Mellitus - drug therapy; Drug dosages; Exercise; Female; Glycated Hemoglobin A - therapeutic use; Hemoglobin; Humans; Hypertension; Insulin; Insulin resistance; Intervention; Lipoproteins; Male; Middle Aged; Obesity; Original; Overweight; Overweight - drug therapy; Overweight - physiopathology; Patients; Physical fitness; Reproducibility; Reproducibility of Results; Retrospective Studies; Success; Variables; Weight control; Weight loss; Weight Loss - drug effects
• ISSN: 2319-4170; 2320-2890
• DOI: 10.1016/j.bj.2016.06.002

We assessed the predictive accuracy of an empirically-derived score (weight loss, insulin resistance, and glycemic control: "WIG") to predict patients who will be successful in reducing diabetes mellitus (DM) medication use with weight loss. Case records of 121 overweight and obese patients with DM at two outpatient weight management centers were analyzed. Mean period of follow-up was 12.5 ± 3.5 months. To derive the "WIG" scoring algorithm, one point each was assigned to "W" (loss of 5% of initial body weight within the first 3 months of attempting weight loss), "I" (triglyceride [TGL]/highdensity lipoprotein ratio >3 [marker of insulin resistance] at baseline), and "G" (glycosylated hemoglobin [A1c%] >8.5 at baseline). WIG score showed moderate accuracy in discriminating anti-DM dose reductions at baseline, and after 3 months of weight loss efforts (likelihood ratios [LR] + >1, LR- 0.7), and demonstrated good reproducibility. WIG score shows promise as a tool to predict success with dose reductions of antidiabetes medications.